Review Article
Effectiveness of Glucocorticoids in Acute Respiratory Distress Syndrome: An Umbrella Review
Table 5
GRADE evidence summary table for effectiveness of glucocorticoids on the number of MV free days and infection rate.
| | 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) |
| | Benjamin et al. [16] | 4 | RCT | Not serious | Serious | Not serious | Serious | None | 140 | 167 | — | MD 4.84 lower (9.28 lower to 0.39 lower) | Low | Important | | Meduri et al. [17] | 4 | RCT | Not serious | Serious | Not serious | Serious | None | 186 | 136 | — | MD 5.76 higher (3.76 higher to 11.52 higher) | Low | Important | | Yang et al. [22] | 4 | RCT | Not serious | Serious | Not serious | Not serious | None | 249 | 225 | — | MD 3.08 1.49 higher (4.68 higher to 0) | Moderate | Important | | Incidence of infection | | Benjamin et al. [16] | 9 | RCT | Serious | Not serious | Not serious | Not serious | None | 84/304 (27.6%) | 74/265 (27.9%) | RR 0.89 (0.65 to 1.23) | 31 fewer per 1,000 (from 98 fewer to 64 more) | Moderate | Important | | Meduri et al. [15] | 8 | RCT | Not serious | Not serious | Not serious | Serious | None | 22/299 (7.4%) | 27/270 (10.0%) | OR 0.77 (0.56 to 1.08) | 21 fewer per 1,000 (from 41 fewer to 7 more) | Moderate | Important | | Yang et al. [22] | 7 | RCT | Not serious | Seriousa | Not serious | Not serious | None | 102/361 (28.3%) | 99/339 (29.2%) | OR 1.00 (0.44 to 2.25) | 0 fewer per 1,000 (from 138 fewer to 189 more) | Moderate | Important | | Ruan et al. [21] | 5 | RCT | Serious | Not serious | Not serious | Serious | None | 79/303 (26.1%) | 70/268 (26.1%) | RR 0.83 (0.65 to 1.06) | 44 fewer per 1,000 (from 91 fewer to 16 more) | Low | Important |
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CI: confidence interval; RR: relative risk; OR: odds ratio; MD: mean difference; MV: mechanical ventilator.
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