Summary of findings summarises the quality of evidence and the magnitude of relative and absolute effects for each important outcome
| Patient or population: apnoea of prematurity. Setting: randomised controlled trials. Intervention: high dose caffeine. Comparison: standard dose caffeine | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with standard-dose caffeine | Risk with high-dose caffeine | ||||
| Combined BPD and mortality at 36 weeks PMA | 407/1000 | 362/1000 (264 to 492) | TRR 0.89 (0.65 to 1.21) | 428 (3 RCTs) | ⨁⨁◯◯ LOW †‡§ |
| BPD at 36 weeks PMA | 416/1000 | 337/1000 (262 to 433) | TRR 0.81 (0.63 to 1.04) | 418 (3 RCTs) | ⨁◯◯◯ VERY LOW † ‡ § |
| Tachycardia | 33/1000 | 111/1000 (49 to 249) | TRR 3.39 (1.50 to 7.64) | 528 (5 RCTs) | ⨁◯◯◯ VERY LOW ‡§ ¶**† † |
| NEC≥grade 2 | 59/1000 | 42/1000 (20 to 87) | TRR 0.71 (0.33 to 1.46) | 578 (5 RCTs) | ⨁◯◯◯ VERY LOW†‡¶ ** |
| IVH≥grade 3 | 57/1000 | 70/1000 (37 to 134) | TRR 1.15 (0.65 to 2.36) | 567 (4 RCTs) | ⨁◯◯◯ VERY LOW †‡§† † |
| Death before 1-year CA | 98/1000 | 91/1000 (46 to 181) | TRR 0.93 (0.47 to 1.85) | 304 (2 RCTs) | ⨁◯◯◯ VERY LOW †‡§ |
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
† Gray et al 23: high risk of attrition bias.
‡ Different definitions of high-dose and standard-dose caffeine.
§ Sample size <200 events/group.
¶ Romagnoli et al 20: high risk of attrition bias.
** Scanlon et al 21: high risk of performance bias.
† † Wide 95% CI.
BPD, bronchopulmonary dysplasia; CA, corrected age; IVH, intraventricular haemorrhage ≥grade 3; NEC, necrotizing enterocolitis ≥grade 2; PMA, postmenstrual age; TRR, typical risk ratio.