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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, 1719] 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, 1720] 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