Exact(24)
On average there was little or no difference between the two locations (RR 1.04, 95% CI 0.91 to 1.17; three trials, 1034 participants, moderate quality evidence; Analysis 2.2).
There was little or no difference between community and family observation (RR 1.02, 95% CI 0.86 to 1.21; two trials, 1493 participants, moderate quality evidence; Analysis 3.1).
There was no difference between TQ and PQ groups with regard to serious adverse events (two trials, 323 participants, low quality evidence; Analysis 2.2).
There was little or no difference between community and family observation (RR 1.05, 95% CI 0.90 to 1.22; two trials, 1493 participants, low quality evidence; Analysis 3.2).
On average there was little or no difference between the two strategies (RR 1.02, 95% CI 0.88 to 1.18; four trials, 1556 participants, moderate quality evidence; Analysis 2.1).
Most data were from high income countries (IRR 0.70, 95% CI 0.58 to 0.85; nine trials, 4664 participants; high quality evidence; Analysis 1.1), with only two trials from LMICs (IRR 0.66, 95% CI 0.43 to 0.99; two trials, 45,380 participants; low quality evidence; Analysis 1.1).
Similar(36)
Our conclusion that the human data were sufficient was based on "moderate" quality evidence, a meta-analysis estimating a decrement in birth weight in relation to PFOA exposure in which we judged that the confidence bounds were narrow, and our confidence that a new study would be unlikely to have an effect estimate that would change the overall effect estimate of the meta-analysis.
The trials and the meta-analyses are underpowered to confidently detect or exclude effects on spontaneous abortion, stillbirth, perinatal deaths, or neonatal deaths, but restricting the analysis to trials of SP did not substantially change the estimates of effect (see Analysis 2.7; Analysis 2.8; Analysis 2.9; Analysis 2.10; low quality evidence).
An additional two CBA studies evaluated POU chlorination but only provide very low quality evidence of any effect (Analysis 3.1, Table 8).
Population benefits for the infants were not demonstrated for pre-term birth (two trials, 1174 participants, Analysis 1.13, low quality evidence), low birthweight (four trials, 3644 participants, Analysis 1.14, low quality evidence), or mean birthweight (five trials, 6007 participants, Analysis 1.15, moderate quality evidence).
22 24 28 Based on moderate quality evidence that included meta-analysis of two studies with over 2500 patients, 22 28 the mean total consultation time in the nurse practitioner group was 4.1 min longer per patient (95% CI 3.7 to 4.5; p<0.0001).
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