Table 5

GRADE evidence profile for RCTs: Herbal compared with placebo

Quality assessmentSummary of findings
No of participants
(studies)
Range follow-up time
Risk of biasInconsistencyIndirectnessImprecisionPublication biasStudy event ratesRelative risk
(95% CI)
Anticipated absolute effects
Over 24 hours
Certainty in estimates
OR
Quality of evidence
PlaceboHerbalPlaceboHerbal
Vomiting
272
(3)
4–24 hours
Serious limitation*No serious limitationsSerious limitations†Serious imprecision‡Undetected42/13624/1360.57 (0.38 to 0.86)466 per 1000200 fewer per 1000
(288 fewer to 205 fewer)
⊕ΟΟΟ
VERY LOW
Nausea
212
(2)
4–24 hours
Serious limitations§No serious limitationsSerious limitations†Serious imprecision‡Undetected42/10629/1060.69 (0.50 to 0.96)666 per 1000207 fewer per 1000
(333 fewer to 27 fewer)
⊕ΟΟΟ
VERY LOW
Pain
92
(1)
24 hours
Serious limitations¶UndetectedSerious limitations†Serious imprecision‡Undetected42/466/460.14 (0.07 to 0.30)913 per 1000785 fewer per 1000
(849 fewer to 639 fewer)
⊕ΟΟΟ
VERY LOW
Need for rescue medication for pain
272
(3)
6–24 hours
Serious limitations**Serious limitations††Serious limitations†Serious imprecision‡Undetected86/13645/1360.52 (0.13 to 2.13)666 per 1000320 fewer per 1000
(580 fewer to 752 more)
⊕ΟΟΟ
VERY LOW
  • *Serious limitations related to allocation concealment,44 lack of blinding of caregivers,44 data collectors,44 data analyst44 49 54 and outcomes assessment.44 54

  • †Serious limitations related to surgery where the results are not applicable for cardiac surgery.

  • ‡Serious imprecision related to outcome (fewer than 300 to 400 events).

  • §Serious limitations related to lack of blinding of data analyst,49 54 and outcomes assessment54 and selective outcome reporting.49

  • ¶Serious limitations related to random generation, allocation concealment, lack of blinding of data analyst and selective outcome reporting.47

  • **Serious limitations related random generation,47 allocation concealment,44 47 lack of blinding of caregivers,44 data collectors,44 data analyst44 47 49 and outcomes assessment,44 selective outcome reporting.47 49

  • ††Serious limitation related to inconsistency (I2=92%).