| Acupoint PC6 stimulation and antiemetic combination compared to antiemetic for preventing postoperative nausea and vomiting | ||||||
|---|---|---|---|---|---|---|
| Patient or population: People at risk of postoperative nausea and vomiting Settings: Surgery Intervention: Acupoint PC6 stimulation and antiemetic combination Comparison: Antiemetic drug | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Antiemetic | Acupoint PC6 stimulation and antiemetic combination | |||||
| Nausea | Low | RR 0.79 (0.55 to 1.13) | 642 (8 studies) | ⊕○○○ very low1,2,3 |
||
| 200 per 1000 | 158 per 1000 (110 to 226) | |||||
| Moderate | ||||||
| 400 per 1000 | 316 per 1000 (220 to 452) | |||||
| High | ||||||
| 600 per 1000 | 474 per 1000 (330 to 678) | |||||
| Vomiting | Low | RR 0.56 (0.35 to 0.91) | 687 (9 studies) | ⊕○○○ very low3,4,5 |
||
| 200 per 1000 | 112 per 1000 (70 to 182) | |||||
| Moderate | ||||||
| 400 per 1000 | 224 per 1000 (140 to 364) | |||||
| High | ||||||
| 600 per 1000 | 336 per 1000 (210 to 546) | |||||
| Rescue antiemetic | 316 per 1000 | 193 per 1000 (139 to 272) | RR 0.61 (0.44 to 0.86) | 419 (5 studies) | ⊕⊕○○ low3,6 |
|
| Adverse effects | See comment | See comment | Not estimable | 6 studies7 | Not applicable | See footnote7 |
The basis for the assumed risks for nausea and vomiting is from a consensus panel (Gan 2014) using Apfel’s simplified risk score (Apfel 1999). The assumed risk for rescue antiemetic is the median antiemetic group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. |
Of the 8 trials, 2 had one or more high risk of bias domains (downgrade 1 point due to study limitations).
Substantial heterogeneity present (downgrade 1 point due to inconsistency).
Optimal information size is far from reached and/or total number of events is less than 300 (downgrade 1 point due to imprecision).
Of the 9 trials, 3 had one or more high risk of bias domains (downgrade 1 point due to study limitations).
Moderate amount of heterogeneity (downgrade 1 point due to inconsistency).
Of the 5 trials, 1 had one or more high risk of bias domains (downgrade 1 point due to study limitations).
No major adverse effects reported in the trials.