Review Article
Effectiveness of Glucocorticoids in Acute Respiratory Distress Syndrome: An Umbrella Review
Table 4
GRADE evidence summary table for effectiveness of glucocorticoids for mortality reduction.
| | Certainty assessment | No. of participants | Effect | Certainty | Importance | | Author | No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other consideration | Glucocorticoid | Control | Relative (95% CI) | Absolute (95% CI) |
| | Curtis et al. [23] | 3 | RCT | Serious | Serious | Not serious | Serious | None | 144 | 101 | — | MD 0.62 higher (0.43 higher to 0.9 higher) | Very low | Critical | | John et al. [20] | 3 | RCT | Not serious | Not serious | Not serious | Serious | None | 46/88 (52.3%) | 36/66 (54.5%) | OR 1.50 (0.30 to 5.94) | 97 more per 1,000 (from 281 fewer to 332 more) | Moderate | Critical | | Meduri et al. [15] | 9 | RCT | Serious | Not serious | Not serious | Not serious | None | 112/397 (28.2%) | 157/369 (42.5%) | RR 0.68 (0.57 to 0.82) | 136 fewer per 1,000 (from 183 fewer to 77 fewer) | Moderate | Critical | | Yang et al. [22] | 9 | RCT | Not serious | Not serious | Not serious | Not serious | None | 158/584 (27.1%) | 209/555 (37.7%) | RR 0.58 (0.44 to 0.75) | 158 fewer per 1,000 (from 211 fewer to 94 fewer) | High | Critical | | Ruan et al. [21] | 8 | RCT | Serious | Not serious | Not serious | Serious | None | 173/391 (44.2%) | 167/334 (50.0%) | RR 0.91 (0.71 to 1.18) | 45 fewer per 1,000 (from 145 fewer to 90 more) | Low | Critical |
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CI: confidence interval; RR: relative risk; OR: odds ratio; MD: mean difference.
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