Applying GRADE for diagnosis 97 2 Antihistamines versus placebo Question: Antihistamines compared to placebo for patients with allergic rhinitis Bibliography: Compalati, 2011; Compalati, 2013 [9, 10] Certainty assessment Summary of findings № of participants (studies) Risk of bias Inconsistency Indirectness Imprecision Publication bias Overall certainty of evidence Study event rates (%) Relative effect (95% CI) Anticipated absolute effects With placebo With antihistamines Risk with placebo Risk difference with antihistamines Symptom score (fexofenadine) (follow up: range 24 hours to 24 hours; assessed with: 24-hour reflective total symptom score; Scale from: -1.00 to 1.00) 1434 (3 RCTs) seriousa not serious not serious not serious none ⨁⨁⨁◯ MODERATE 718 716 - - SMD 0.42 SD lower (0.49 lower to 0.35 lower) Total nasal symptom reduction (rupatidine) (Scale from: -1.00 to 1.00) 1178 (7 RCTs) seriousbnot serious not serious not serious none ⨁⨁⨁◯ MODERATE 595 583 - - SMD 0.36 SD lower (0.48 lower to 0.25 lower) Ocular symptoms (rupatidine) (assessed with: itchy eyes; Scale from: -1.00 to 1.00) 683 (4 RCTs) seriousbnot serious not serious not serious none ⨁⨁⨁◯ MODERATE 345 338 - - SMD 0.29 SD lower (0.45 lower to 0.14 lower) CI: Confidence interval; SMD: Standardised mean difference; SD: standard deviation a. Medium risk of bias in the included studies, based on judgement of review authors b. Unclear risk of selection bias and possible selective reporting, based on judgement of review authors
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