Scolaris Content Display Scolaris Content Display

Study flow diagram.
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Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Metronidazole versus Placebo, outcome: 1.1 Malodour (Smell Score).
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Figure 4

Forest plot of comparison: 1 Metronidazole versus Placebo, outcome: 1.1 Malodour (Smell Score).

Comparison 1 Metronidazole versus Placebo, Outcome 1 Malodour (Smell Score).
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Analysis 1.1

Comparison 1 Metronidazole versus Placebo, Outcome 1 Malodour (Smell Score).

Summary of findings for the main comparison. Metronidazole compared to Placebo for treating malignant wounds

Metronidazole compared to Placebo for treating malignant wounds

Patient or population: treating malignant wounds
Setting: hospital
Intervention: metronidazole
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with Placebo

Risk with Metronidazole

Malodour (smell score measured on a scale of 0 to 3 with higher scores indicating a more offensive smell)

The mean malodour (smell score) was 3.33 (range 2.0 to 4.0)

MD 2.16 lower
(3.60 to 0.72 lower)

6
(1 RCT)

⊕⊝⊝⊝
very low 1

It is uncertain whether metronidazole leads to a reduction in malodour because the quality of the evidence is very low

Adverse effects

Study population

not estimable

6
(1 RCT)

NA

0 per 1000

0 per 1000
(0 to 0)

*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio; MD: mean difference.

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: 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.
Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

1 Downgraded 3 levels: serious limitation — insufficient details provided to make clear judgements on random sequence generation and allocation concealment. There was also a 33% loss to follow‐up; very serious imprecision; a small sample size of 6 participants.

2 Smell was independently assessed at each visit by the patient, doctor, and nurse, who graded the smell as "absent" (0), "not offensive" (1), "offensive but tolerable" (2), or "offensive and intolerable" (3), and an amalgamated score calculated.

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Summary of findings for the main comparison. Metronidazole compared to Placebo for treating malignant wounds
Comparison 1. Metronidazole versus Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Malodour (Smell Score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

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Comparison 1. Metronidazole versus Placebo