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Table 1 Summary of findings

From: Corticosteroid treatment for early acute respiratory distress syndrome: a systematic review and meta-analysis of randomized trials

Outcomes Anticipated absolute effects (95% CI) Relative effect (OR (95% CI)) No. of participants (no. of studies) Certainty of evidence (GRADE)
Control Risk difference with corticosteroids
All-cause 28- or 30-day mortality 389 per 1000 109 fewer per 1000 (170 fewer to 38 fewer) 0.61 (044–0.85) 742 (4 RCTs) Moderatea
All-cause 60-day mortality 381 per 1000 121 fewer per 1000 (183 fewer to 43 fewer) 0.57 (040–0.83) 565 (3 RCTs) Moderatea
Ventilator-free days at 28 days   MD 3.74 more (1.53 more to 5.95 more)   742 (4 RCTs) Lowa,b
PaO2/FiO2 at days 6 or 7   MD 54.22 more (33.5 more to 74.93 more)   494 (3 RCTs) Very lowa,c
Hyperglycemia 687 per 1000 82 more per 1000 (8 more to 142 more) 1.52 (1.04–2.21) 565 (3 RCTs) Moderatea
Nosocomial infections 232 per 1000 28 fewer per 1000 (81 fewer to 36 more) 0.85 (0.59–1.21) 742 (4 RCTs) Lowa,d
Gastrointestinal bleeding 31 per 1000 12 more per 1000 (19 fewer to 110 more) 1.39 (0.38–5.06) 374 (2 RCTs) Lowa,d
  1. Grades of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group:
  2. High certainty—We are very confident that the true effect lies close to that of the estimate of the effect
  3. Moderate certainty—We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  4. Low certainty—Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect
  5. Very low certainty—We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of the effect
  6. PaO2 partial pressure of oxygen in arterial blood, FiO2 fraction of inspired oxygen
  7. aDifferent types of corticosteroids and treatment regimens among studies were regarded as indirectness of evidence. Downgraded by 1
  8. bHeterogeneity observed among the studies (I2 = 61.0%, χ2 = 7.65, p = 0.05) was regarded as inconsistency of evidence. Downgraded by 1
  9. cHeterogeneity observed among the studies (I2 = 93.0%, χ2 = 26.75, p < 0.001) was regarded as inconsistency of evidence. Downgraded by 1
  10. dImprecision was observed among the studies. Downgraded by 1