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Table 2 Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) evidence profile

From: Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials

Quality assessment Patients, number Effect Quality
Studies, number Risk of bias Inconsistency Indirectness Imprecision Other considerations PPIs H2RAs Relative (95 % CI) Absolute (95 % CI)
Clinically important bleeding
14 Seriousa Not serious Not serious Not seriousb None 13/986 (1.3 %) 39/693 (5.6 %) RR 0.39 (0.21, 0.71) 15 fewer per 1000 (7–20 fewer) Moderatea,b
Overt upper gastrointestinal bleeding
17 Seriousa Not seriousc Not serious Not serious None 53/1102 (4.8 %) 118/795 (14.8 %) RR 0.48 (0.34, 0.66) 26 fewer per 1000 (17–33 fewer) Moderatea,c
Nosocomial pneumonia
13 Seriousa Not seriousd Not serious Seriouse None 119/862 (13.8 %) 92/709 (13.0 %) RR 1.12 (0.86, 1.46) 16 more per 1000 (18 fewer to 60 more) Lowa,d,e
Mortality
11 Not seriousf Not serious Not serious Seriouse None 151/874 (17.3 %) 120/614 (19.5 %) RR 1.05 (0.87, 1.27) 10 more per 1000 (25 fewer to 53 more) Moderatee,f
ICU length of stay
7 Seriousg Not serious Not serious Serioush None 371 373 - MD 0.58 days fewer (2.03 fewer to 0.86 more) Lowg,h
  1. The Guideline Development Tool was used to summarize the quality of evidence for individual outcomes based on five main domains: risk of bias, inconsistency, indirectness, imprecision, and publication bias. PPI proton pump inhibitor, H2RA histamine-2-receptor antagonist, MD mean difference, RR relative risk. aWe downgraded by one level, for risk of bias; most studies were unblinded. bAlthough the total number of events was small, we did not downgrade for imprecision. cSignificant inconsistency was not present (I 2 = 6 %). dSignificant inconsistency was not present (I 2 = 4 %). eWe downgraded by one level for imprecision; the confidence interval contains significant benefit and harm. fWe did not downgrade for risk of bias because mortality is an objective outcome that is less likely to be affected by lack of blinding in clinical trials. gWe downgraded by one level for risk of bias. hWe downgraded by one level for imprecision; the confidence interval contained significant benefit and harm