Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

149 questions · 155 findings · 39 reviews · Headline outcomes only

No studies found 20 · 12.9%GRADE not reported 3 · 1.9%Very low 29 · 18.7%Low 45 · 29%Moderate 52 · 33.5%High 6 · 3.9%

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Adverse effects [2 weeks to 6 months] · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in adverse effects [2 weeks to 6 months] compared with control plus antibiotic (low certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Hearing loss · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in hearing loss [2 months]1 compared with control plus antibiotic (moderate certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

OME resolution at short‐term · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic leads to higher OME resolution at short‐term compared with control plus antibiotic (high certainty).

1 finding from 1 review

Self‐management interventions vs usual care

Courses of oral corticosteroids · patients with chronic obstructive pulmonary disease

Self‐management interventions including action plans for exacerbations showed no clear difference in courses of oral steroids compared with usual care (low certainty).

1 finding from 1 review

Maintenance LTRA vs placebo

Number of participants experiencing one or more episode requiring treatment with oral steroids · episodic viral wheeze in children

Maintenance LTRA showed no clear difference in number of participants experiencing one or more episode requiring… compared with placebo (moderate certainty).

1 finding from 1 review

Intermittent LTRA vs placebo

Number of participants experiencing one or more episode requiring treatment with oral steroids · episodic viral wheeze in children

Intermittent LTRA showed no clear difference in number of participants experiencing one or more episode requiring… compared with placebo (moderate certainty).

1 finding from 1 review

MHRV vs placebo

Mean exacerbations requiring a course of oral corticosteroids · asthmatics with sensitivity to house dust mite

MHRV showed no clear difference in exacerbations needing oral steroids compared with placebo (moderate certainty).

1 finding from 1 review

160/4.5 mcg BDF single inhaler therapy vs current best practice

Rate of exacerbations requiring systemic corticosteroids · adults with asthma not well controlled on ICS

160/4.5 mcg BDF single inhaler therapy probably leads to lower patients with exacerbations treated with oral steroids compared with current best practice (moderate certainty).

1 finding from 1 review

Single inhaler therapy vs fixed dose ICS

Rate of exacerbations requiring systemic corticosteroids · adults with asthma not well controlled on ICS

Single inhaler therapy leads to lower patients with exacerbations treated with oral steroids compared with fixed dose ICS (high certainty).

1 finding from 1 review

SiT for maintenance/relief vs higher‐dose ICS/LABA + SABA

Exacerbations requiring oral corticosteroids ‐ adults · Studies recruited adults and adolescents aged 12 and older with chronic asthma

SiT for maintenance/relief leads to lower patients with exacerbations requiring oral steroids compared with higher‐dose ICS/LABA + SABA (high certainty).

1 finding from 1 review

Long‐acting beta2‐agonists vs placebo

Moderate exacerbations (course of antibiotics or oral steroids) · patients with chronic obstructive pulmonary disease

Long‐acting beta2‐agonists probably leads to lower moderate exacerbations (course of antibiotics or oral steroids) compared with placebo (moderate certainty).

1 finding from 1 review

Systemic or topical corticosteroids vs placebo or control

Short‐term visual acuity between 20/20 and 20/40 ≤ 2 weeks after treatment; oral corticosteroids · people with traumatic hyphema

Systemic or topical corticosteroids showed no clear difference in short‐term visual acuity between 20/20 and 20/40 ≤ 2 weeks after… compared with placebo or control treatment (low certainty).

1 finding from 1 review

Systemic or topical corticosteroids vs placebo or control

Final visual acuity between 20/20 and 20/40 at end of treatment; oral corticosteroids · people with traumatic hyphema

Systemic or topical corticosteroids showed no clear difference in final visual acuity between 20/20 and 20/40 at end of treatment;… compared with placebo or control treatment (low certainty).

1 finding from 1 review

Oral corticosteroids vs placebo or NSAID

Proportion of patients with resolution or improved symptoms at days 3 to 7 · patients with acute sinusitis

Oral corticosteroids probably leads to higher proportion of patients with resolution or improved symptoms at days… compared with placebo or NSAID (moderate certainty).

3 findings from 1 review

Oral corticosteroids vs placebo or NSAID

Proportion of patients with resolution or improved symptoms at days 4 to 14 · patients with acute sinusitis

Oral corticosteroids probably leads to higher proportion of patients with resolution or improved symptoms at days… compared with placebo or NSAID (moderate certainty).

2 findings from 1 review