Quality assessment | No of patients | Effect | Quality | Importance | ||||||||
No of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Early rehabilitation | Control | Relative (95% CI) | Absolute (95% CI) | ||
Incidence of ICU-AW | ||||||||||||
2 | Randomised trials | Serious* | Not serious | Not serious | Serious† | None | 22/78 (28.2%) | 37/76 (48.7%) | OR 0.42 (0.22 to 0.82) |
202 fewer per 1000 (from 49 fewer to 314 fewer) | ⨁⨁◯◯ Low | Critical |
MRC | ||||||||||||
3 | Randomised trials | Serious* | Not serious | Not serious | Serious† | None | 97 | 99 | – | SMD 0.38 higher (0.1 higher to 0.66 higher) | ⨁⨁◯◯ Low | Critical |
Delirium-free days | ||||||||||||
3 | Randomised trials | Serious* | Not serious | Not serious | Serious† | None | 164 | 162 | – | SMD 0.02 lower (0.23 lower to 0.2 higher) | ⨁⨁◯◯ Low | Critical |
Incidence of HADS/HAS | ||||||||||||
2 | Randomised trials | Serious* | Serious | Not serious | Serious† | None | 10/48 (20.8%) | 11/44 (25.0%) | OR 0.79 (0.29 to 2.12) |
42 fewer per 1000 (from 162 fewer to 164 more) | ⨁◯◯◯ Very low | Critical |
Health related QOL score (EQ5D) | ||||||||||||
2 | Randomised trials | Serious* | Serious‡ | Not serious | Serious† | None | 35 | 28 | – | SMD 0.11 SD higher (0.86 lower to 1.09 higher) | ⨁◯◯◯ Very low | Critical |
SF-36 PF | ||||||||||||
2 | Randomised trials | Serious* | Not serious | Not serious | Serious† | None | 93 | 98 | – | SMD 2.41 higher (0.75 lower to 5.58 higher) | ⨁⨁◯◯ Low | Critical |
*Most of the studies are classified as unclear or high risk of bias (performance bias and attrition bias).
†CIs for absolute effects are wide and include no effect and important harm and/or small sample size (the number of events is <300).
‡Substantial heterogeneity present.
AW, acquired weakness; EQ5D, EuroQol 5 Dimensions; HADS/HAS, Hospital Anxiety and Depression Scale; ICU, intensive care unit; MRC, Medical Research Council; QOL, quality of life; SF-36 PF, 36-Item Short Form Health Survey Physical Function scale; SMD, standardised mean difference.