Table 2

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


a: Fixed Effect Model

b: Random Effect Model

Das et al. BMC Public Health 2013 13(Suppl 3):S9   doi:10.1186/1471-2458-13-S3-S9

Open Data