Effects of Probiotics Supplementation on CRP, IL-6, and Length of ICU Stay in Traumatic Brain Injuries and Multiple Trauma Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 3

Summary of findings and quality of evidence assessment using the grade approach.

Measures	Summary of findings		Quality of evidence assessment (grade)
	No of patients (trials)	Effect size (95% CI)	Risk of bias^a	Inconsistency^b	Indirectness^c		Imprecision^d	Publication bias^e	Quality of evidence^f
CRP	283 (5)	−1.10 (−2.27, 0.06)	Not serious	Serious		Not serious	Not serious	Not serious	Moderate
IL-6	159 (3)	−2.46 (−12.16, 7.25)	Not serious	Serious		Not serious	Serious	Not serious	Low
Stay in ICU	310 (5)	−0.29 (−0.98, 0.40)	Not serious	Serious		Not serious	Serious	Not serious	Low

CRP, C-reactive protein; ICU, intensive care unit; IL-6; interleukin-6. Presented as standard mean difference (SMD). ^aRisk of bias according to the Cochrane risk of bias tool. This tool evaluates selection bias, performance bias, detection bias, attrition bias, and reporting bias. ^bInconsistency (high heterogeneity). ^cIf there were factors present related to the participants, interventions, or findings that constrained the generalizability of the results, the grade would be downgraded. ^dLarge confidence interval. ^eDowngraded if there was evidence of publication bias using a funnel plot that affected overall results detecting by trim and fill analysis. ^fThe confidence of the evidence was graded as high for all outcomes since all included studies were randomized controlled trials, and it was then downgraded following predetermined criteria. Quality was graded as high, moderate, low, and very low.