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Table 3 Summary of Findings (SoF) for the comparison PUFAs versus healthy diet

From: Impact of polyunsaturated fatty acids on patient-important outcomes in children and adolescents with autism spectrum disorder: a systematic review

Summary of findings:

Should polyunsaturated fatty acids versus healthy diet be used for the treatment of children and adolescents with autism spectrum disorder?

Patient or population: children and adolescents with autism spectrum disorder

Setting: outpatients

Intervention: polyunsaturated fatty acids

Comparison: healthy diet

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect (95% CI)

№ of participants (studies)

Certainty of the evidence (GRADE)

Comments

Risk with healthy diet

Risk with polyunsaturated fatty acids

Quality of Sleep

SMD 1.11 higher (0.21 higher to 2 higher)

23 (1 RCT)

VERY LOW a,b

(lower scores indicate improvement)

Aggression

SMD 0 (0.83 lower to 0.82 higher)

23 (1 RCT)

VERY LOW a,c

(lower scores indicate improvement)

Anxiety

SMD 0.16 lower (0.99 lower to 0.66 higher)

23 (1 RCT)

VERY LOW a,c

(lower scores indicate improvement)

Attention

SMD 0.53 lower (1.37 lower to 0.31 higher)

23 (1 RCT)

VERY LOW a,c

(lower scores indicate improvement)

Social interaction

SMD 0.81 lower (1.67 lower to 0.05 higher)

23 (1 RCT)

VERY LOW a,c

(lower scores indicate improvement)

Communication

SMD 0.36 higher (0.47 lower to 1.19 higher)

23 (1 RCT)

VERY LOW a,c

(lower scores indicate worsening)

  1. *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  2. a Downgraded of two levels because the study was at high risk of bias for random sequence generation and performance bias and unclear risk of bias for allocation concealment, incomplete outcome data and reporting of data
  3. b Downgraded of one level because the sample size is very small and the 95%CI for SMD goes from small effect (0.21) to a very large effect (2)
  4. c Downgraded of two levels because the sample size is very small and the 95%CI includes no effect
  5. CI Confidence interval, RR Risk ratio, SMD Standardized mean difference.
  6. GRADE Working Group grades of evidence.
  7. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
  8. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
  9. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
  10. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.