Skip to main content

Table 3 Summary of Findings (SoF) for the comparison antipsychotics versus placebo –dichotomous outcomes

From: Impact of antipsychotics in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

Antipsychotics versus no antipsychotics – dichotomous outcomes

Population: children and adolescents with ASD

Setting: outpatients and inpatients

Intervention: Antipsychotics

Comparator: no Antipsychotics

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect (95% CI)

№ of participants (studies)

Certainty of the evidence (GRADE)

Comments

Risk with no Antipsychotics

Risk with Antipsychotics

Serious adverse events

16 per 1.000

17 per 1.000 (8 to 39)

RR 1.07 (0.48 a 2.43)

1057 (13 RCTs)

LOW a,b

Antipsychotics may increase the risk of severe adverse events slightly

Adverse events

657 per 1.000

781 per 1.000 (703 to 867)

RR 1.19 (1.07 a 1.32)

924 (10 RCTs)

MODERATE c

Antipsychotics probably increase the risk of adverse events

Dropout due to any cause

244 per 1.000

149 per 1.000 (117 to 190)

RR 0.61 (0.48 a 0.78)

1124 (15 RCTs)

MODERATE d

Antipsychotics probably reduce the risk of dropout due to any cause

Drop-out due to adverse events

39 per 1.000

39 per 1.000 (22 to 70)

RR 0.99 (0.55 to 1.79)

1010 (12 RCTs)

LOW b,e

Antipsychotics may have little or no effect on the risk of dropouts due to adverse events

  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). CI: Confidence interval; SMD: Standardised mean difference; RR: Risk ratio
  2. GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  3. 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
  4. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  5. 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
  6. Explanations
  7. a. Downgraded by one level because most studies showed an unclear risk for selection bias, three studies were at high risk for attrition bias, one study was at high risk for selection bias and one study was at high risk for reporting bias
  8. b. Downgraded by one level because the 95%CI for SMD goes from considerable beneficial effects to considerable undesirable effects
  9. c. Downgraded by one level because most studies showed an unclear risk of bias for selection bias and two studies were at high risk for attrition bias
  10. d. Downgraded by one level because most studies showed an unclear risk for selection bias, four studies were at high risk for attrition bias, one study was at high risk for selection bias and one study was at high risk for reporting bias
  11. e. Downgraded by one level because most studies showed an unclear risk for selection bias, four studies were at high risk for attrition bias, one was at high risk for selection bias and one was at high risk for reporting bias