Chinese Medicinal Herbs for Childhood Pneumonia: A Systematic Review of Effectiveness and Safety

Table 3

Grade quality of evidence.

Chinese medicinal herbs plus basic therapy versus basic therapy alone for childhood pneumonia
Patient or population: patients with childhood pneumonia
Settings: inpatients or outpatients
Intervention: Chinese medicinal herbs plus basic therapy versus basic therapy alone
	Illustrative comparative risks (95% CI)*
Outcomes	Assumed risk	Corresponding risk	Relative effect; (95% CI)	Number of Participants; (studies)	Quality of evidence; (grade)	Comments
	Control	Chinese medicinal herbs plus basic therapy versus basic therapy alone
	Study population
Total effective rate	779 per 1000	920 per 1000; (865–982)
	Moderate		RR 1.18; (1.11–1.26)	1720; (14 studies)	⊕⊕○○; Low ^1,2	Important
	800 per 1000	944 per 1000; (888–1000)
	Study population
Adverse effects	419 per 1000	164 per 1000; (38–721)
	Moderate		RR 0.39; (0.09–1.72)	434; (3 studies)	⊕○○○; Very low ^1,3	Important
	113 per 1000	44 per 1000; (10 to 194)
Time (day) to improvement of cough		The mean time (days) to improvement in cough in the intervention groups was; 2.18 lower; (2.66 to 1.71 lower)		1208; (9 studies)	⊕⊕○○; Low ^1,4	Important
Time (day) to improvement of fever		The mean time (days) to improvement in fever in the intervention groups was; 2.12 lower; (2.25 to 1.98 lower)		1262; (10 studies)	⊕⊕○○; Low ^1,2	Important
Time (day) to improvement of rales		The mean time (days) to improvement in rales in the intervention groups was; 1.53 lower; (1.84 to 1.23 lower)		1208; (9 studies)	⊕⊕○○; Low ^1,4	Important
Time (day) to improvement in chest films		The mean time (days) to improvement in chest films in the intervention groups was; 3.1 lower; (4.11 to 2.08 lower)		648; (5 studies)	⊕⊕○○; Low ^1,4	Important
Length of hospital stay		The mean length of hospital stay in the intervention groups was; 3 lower; (3.52 to 2.48 lower)		180; (1 study)	⊕○○○; Very low ^1,5	Important

∗The basis for the assumed risk (e.g., the median control group risk across studies) is provided in the footnotes. 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. Handbook description: randomized controlled trial.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Cochrane Handbook description: relegation randomized controlled trial.
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. Cochrane Handbook description: two or more degradation factors of randomized controlled trials.
Very low quality: we are very uncertain about the estimate. Cochrane Handbook description: more than three degradation factors of randomized controlled trials.
Reduce the evidence quality factors: methodology defect, included in the research results of the inconsistency, indirect evidence, inexactness, and publication bias.
Increase the level of evidence factor: large effect quantity, confounding factors cannot change effect quantity, or the existing concentration-response relationship.
¹There is a high risk of selection bias, performance bias, and detection bias.
²Some studies showed a significant difference, but some studies showed no significant difference.
³Few studies included.
⁴The protocol of the published studies could not be compared.
⁵Only one study included.