Skip to main content

Table 2 Quality assessment of trials of antiemetics on vomiting and hospitalization rates in acute gastroenteritis

From: The effect of antiemetics in childhood gastroenteritis

Quality Assessment

Summary of Findings

 

Directness

No of events

 

No of studies

Design

Limitations

Consistency

Generalizability to population of interest

Generalizability to intervention of interest

Intervention

Control

Relative Risk (95% CI)

Morbidity-Vomiting: Moderate outcome-specific quality

6 [12, 13, 15, 17–19]

RCT

Studies used different follow up periods. Random effect model was used

All studies suggest benefit

Four of six studies were conducted in developed countries

Pooled results for different types of antiemetics and route of administration.

95

210

0.46 [0.35, 0.61] b

4 [13, 15, 17, 18]

RCT

 

All studies suggest benefit

Three of four studies were conducted in developed countries

Effect of oral ondansetron

47

134

0.35 (0.26, 0.46) a

1 [12]

RCT

Insignificant effect

 

In developing country

Effect of IV ondansetron

5

10

0.50 (0.24, 1.04)

1 [12]

RCT

Insignificant effect

 

In developing country

Effect of IV metoclopramide

8

10

0.80 (0.50, 1.28)

1 [19]

RCT

  

In developed country

Effect of rectal dimenhydrinate

35

56

0.60 (0.44, 0.82)

Morbidity- Hospitalization rates: Moderate outcome-specific quality

6 [13, 15, 17–20]

RCT

 

All studies suggest benefit. Fixed effect model used

Five of six studies were conducted in developed countries

Pooled results for different types of antiemetics and route of administration.

24

56

0.46 [0.29, 0.74] a

4 [13, 15, 17, 18]

RCT

 

All studies suggest benefit

Three of four studies were conducted in developed countries

Effect of oral ondansetron

11

33

0.36 (0.18, 0.72) a

1 [20]

RCT

  

Developed country

Effect of IV ondansetron

2

9

0.21 (0.05, 0.94)

1 [20]

RCT

Insignificant effect

 

Developed country

Effect of IV dexamethasone

7

9

0.73 (0.30, 1.79)

1 [19]

RCT

Insignificant effect

 

Developed country

Effect of rectal dimenhydrinate

4

5

0.77 (0.21, 2.78)

Revisit rates : low outcome-specific quality

4 [13, 15, 17, 18]

RCT

Variable time periods used in the four studies

Two studies suggest benefit while two studies report otherwise

Three out of four studies were conducted in developed countries

All studies used oral ondasetron

34/284

30/269

0.97 [0.62, 1.53] a

IVF required rates: Low outcome-specific quality

3 [13, 15, 17]

RCT

 

All studies are consistent in the results. Fixed effect model used

All studies were conducted in developed countries

All studies used oral ondansetron

35

93

0.40 [0.29, 0.56] a

ORT tolerance rates: Low outcome specific quality

3 [17, 18, 20]

RCT

 

Random effect model used. Two of the three studies suggest benefit

All studies were conducted in developed countries

Pooled results for different antiemetics and routes of administrations

155

125

1.22 [1.01, 1.46] b

Admission Rates within 72 hours of discharge from ED: Low outcome-specific quality

3 [13, 15, 17]

RCT

 

All studies suggest benefit

All studies were conducted in developed countries

All studies used oral ondansetron

18

30

0.66 [0.37, 1.19]

IVF requirement Rates within 72 hours of discharge from ED oral ondansetron: low outcome-specific quality

3 [13, 15, 17]

RCT

 

Consistent benefit suggested by the three studies

All studies were conducted in developed countries

All studies used oral ondansetron

49

86

0.57 [0.42, 0.76] a

  1. a: Fixed Effect Model
  2. b: Random Effect Model