Findings

What do systematic reviews say?

4,808 questions · 8,953 findings · 827 reviews · Headline outcomes only

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No studies found 1,891 · 21.1%GRADE not reported 380 · 4.2%Very low 2,100 · 23.5%Low 2,449 · 27.4%Moderate 1,684 · 18.8%High 449 · 5%

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Carbamazepine vs phenytoin

Time to treatment failure (any reason related to treatment) Subgroup: focal onset seizures Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to treatment failure (any reason related to treatment)… compared with phenytoin (time to treatment failure) (moderate certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 0.83 [0.61, 1.13]
3 studies · 428 participants
Moderate

Carbamazepine vs phenytoin

Time to treatment failure (any reason related to treatment) Subgroup: generalised onset seizures (tonic‐clonic only) Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine may leads to higher time to treatment failure (any reason related to treatment)… compared with phenytoin (time to treatment failure) (low certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 2.38 [1.04, 5.47]
2 studies · 118 participants
Low

Carbamazepine vs phenytoin

Time to first seizure (post‐randomisation) All participants Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to first seizure after randomisationAll participants Range of compared with phenytoin (secondary outcomes) (moderate certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 1.15 [0.94, 1.4]
4 studies · 582 participants
Moderate

Carbamazepine vs phenytoin

Time to first seizure (post‐randomisation) Subgroup: focal onset seizures Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to first seizure after randomisation Subgroup: focal onset… compared with phenytoin (secondary outcomes) (moderate certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 1.13 [0.89, 1.43]
4 studies · 432 participants
Moderate

Time to first seizure (post‐randomisation) ‐ stratified by epilepsy type: generalised onset seizures (tonic‐clonic only) Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to first seizure after randomisationSubgroup: generalisedonset… compared with phenytoin (secondary outcomes) (low certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 1.19 [0.81, 1.75]
3 studies · 150 participants
Low

Carbamazepine vs phenytoin

Time to achieve 12‐month remissionAll participants Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to achieve 12‐month remissionAll participants Range of compared with phenytoin (secondary outcomes) (moderate certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 1 [0.79, 1.26]
3 studies · 551 participants
Moderate

Carbamazepine vs phenytoin

Time to achieve 12‐month remission (seizure‐free period) Subgroup: focal onset seizures Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to achieve 12‐month remissionSubgroup: focal onset seizures… compared with phenytoin (secondary outcomes) (moderate certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 1.06 [0.8, 1.42]
3 studies · 430 participants
Moderate

Carbamazepine vs phenytoin

Time to 12‐month remission ‐ stratified by epilepsy type ‐ Generalized onset seizures (tonic‐clonic only) Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to achieve 12‐month remissionSubgroup: generalisedonset tonic… compared with phenytoin (secondary outcomes) (low certainty).

1 finding from 1 review

Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review 2019 · Cochrane Headline outcomes only
HR 0.88 [0.58, 1.33]
2 studies · 121 participants
Low

Fibrinolytics vs placebo

Mortality. · adult parapneumonic effusions and empyema

Fibrinolytics showed no clear difference in mortality. compared with placebo (moderate certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 1.16 [0.71, 1.91]
8 studies · 867 participants
Moderate

Alteplase vs urokinase

Referral for thoracic surgery (open or thorascopic) · adult parapneumonic effusions and empyema

Alteplase showed no clear difference in referral for thoracic surgery (open or thorascopic) compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 0.46 [0.04, 5.24]
1 study · 99 participants
Low

Alteplase vs urokinase

Serious adverse events · adult parapneumonic effusions and empyema

Alteplase may leads to higher serious adverse events compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 5.61 [1.16, 27.11]
1 study · 99 participants
Low

Fibrinolytics vs placebo

Referral for thoracic surgery (open or thorascopic) · adult parapneumonic effusions and empyema

Fibrinolytics may leads to lower referral for thoracic surgery. compared with placebo (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 0.37 [0.21, 0.68]
8 studies · 897 participants
Low

Fibrinolytics vs placebo

Serious adverse events · adult parapneumonic effusions and empyema

Fibrinolytics showed no clear difference in serious adverse events compared with placebo (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 1.28 [0.36, 4.57]
9 studies · 935 participants
Low

Streptokinase vs urokinase

All‐cause mortality · adult parapneumonic effusions and empyema

Streptokinase showed no clear difference in mortality compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 0.32 [0.01, 8.25]
1 study · 50 participants
Low

Streptokinase vs urokinase

Referral for thoracic surgery (open or thorascopic) · adult parapneumonic effusions and empyema

Streptokinase showed no clear difference in referral for thoracic surgery (open or thorascopic) compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 1 [0.13, 7.72]
1 study · 50 participants
Low

Streptokinase vs urokinase

Serious adverse events · adult parapneumonic effusions and empyema

Streptokinase showed no clear difference in serious adverse events compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 5.43 [0.25, 118.96]
1 study · 50 participants
Low

Alteplase vs urokinase

All‐cause mortality · adult parapneumonic effusions and empyema

Alteplase showed no clear difference in mortality compared with urokinase (low certainty).

1 finding from 1 review

Intra‐pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult… 2019 · Cochrane Headline outcomes only
OR 0.94 [0.18, 4.89]
1 study · 99 participants
Low

Summary of findings ‐ PEP vs PDPV

FEV1 % predicted: absolute change from baseline · adults and children with CF

1 finding from 1 review

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis 2019 · Cochrane Headline outcomes only
no estimate extracted
5 studies · 155 participants
Low

Summary of findings ‐ PEP vs oscillating PEP

Direct measures of mucus clearance · adults and children with CF

The review found no eligible studies for this question.

1 finding from 1 review

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Summary of findings ‐ PEP vs oscillating PEP

Exercise capacity · adults and children with CF

1 finding from 1 review

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis 2019 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 68 participants
Moderate