Grade table 2

Question: Peak flow self-management versus symptoms self-management for self-management education for adults with asthma

Settings:

Bibliography: Powell H, Gibson PG (1)

Quality assessmentSummary of findingsImportance
No of patientsEffectsQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsPeak flow self-managementSymptoms self-managementRelative (95% CI)Absolute
Hospitalization (subjects)
4randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none8/213 (3.8%)6/199 (3%)RR 1.17 (0.44 to 3.12)5 more per 1000 (from 17 fewer to 64 more)⊕⊕○○
LOW		IMPORTANT
Emergency room visits (subjects)
5randomised trialsserious1serious3no serious indirectnessserious2none38/269 (14.1%)39/243 (16%)RR 0.91 (0.61 to 1.35)14 fewer per 1000 (from 63 fewer to 56 more)⊕○○○
VERY LOW		IMPORTANT
Doctor visits (subjects)
2randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none55/76 (72.4%)66/85 (77.6%)RR 0.93 (0.78 to 1.1)54 fewer per 1000 (from 171 fewer to 78 more)⊕⊕○○
LOW		IMPORTANT
Days off work (mean) (better indicated by lower values)
2randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none123106–MD 1.96 higher (0.44 lower to 4.36 higher)⊕⊕○○
LOW		IMPORTANT
Oral corticosteroid courses
2randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none17/71 (23.9%)13/81 (16%)RR 1.53 (0.82 to 2.87)85 more per 1000 (from 29 fewer to 300 more)⊕⊕○○
LOW		IMPORTANT
1

Allocation and blinding of outcome assessment inconsistent.

2

CIs include clinically significant harm and benefit.

3

Significant heterogeneity of results with large differences in both directions between trials.

From: Annex 4, Grade tables

Cover of Prevention and Control of Noncommunicable Diseases
Prevention and Control of Noncommunicable Diseases: Guidelines for Primary Health Care in Low Resource Settings.
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