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PRISMA Study flow diagram
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Figure 1

PRISMA Study flow diagram

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

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

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

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Forest plot of comparison: 1 Nausea, outcome: 1.1 Nausea at 8 days.
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Figure 4

Forest plot of comparison: 1 Nausea, outcome: 1.1 Nausea at 8 days.

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Comparison 1 Nausea, Outcome 1 Nausea at 8 days.
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Analysis 1.1

Comparison 1 Nausea, Outcome 1 Nausea at 8 days.

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Summary of findings for the main comparison. Dexamethasone compared to placebo for adult patients with advanced cancer who have nausea and vomiting (not related to chemo‐ or radiotherapy, or surgery)

Dexamethasone compared to placebo for adult patients with advanced cancer who have nausea and vomiting not related to chemotherapy, radiotherapy, or surgery

Patient or population: participants with advanced cancer who have nausea and vomiting not related to chemotherapy, radiotherapy, or surgery
Settings: inpatients and outpatients
Intervention: dexamethasone

Comparison: placebo

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Placebo

Dexamethasone

Nausea at 8 days
Scale from: 0 to 10; lower score = less nausea.

The mean difference in the intensity of nausea at day 8 in the control groups ranged from ‐0.45 to 5.7

The mean difference in the intensity of nausea at day 8 in the intervention groups was, on average, ‐0.48 (from ‐1.53 lower to 0.57 higher)

127
(2 studies)

⊕⊝⊝⊝
very low1

Number of vomiting episodes

No data

No data

‐

‐

‐

‐

Adverse events

No data

No data

‐

‐

‐

‐

Quality of life

No data

No data

‐

‐

‐

‐

Patient satisfaction

No data

No data

‐

‐

‐

‐

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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

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 confident that the true effect lies close to that of the estimate of the effect.
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 We downgraded the quality of evidence by three levels due to imprecision, likely selection bias, attrition bias, and the small number of participants in the included studies.

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Summary of findings for the main comparison. Dexamethasone compared to placebo for adult patients with advanced cancer who have nausea and vomiting (not related to chemo‐ or radiotherapy, or surgery)
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Table 1. Primary sites of disease

Breast

Head, neck, and lung

Gastrointestinal

Gynaecological

Genitourinary

Sarcoma

Other

Bruera 2004

x

x

x

x

x

x

Mystakidou 1998

x

x

x

x

Yennurajalingam 2013

x

x

x

x

x

x

x
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Table 1. Primary sites of disease
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Comparison 1. Nausea

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Nausea at 8 days Show forest plot

2

127

Mean Difference (IV, Random, 95% CI)

‐0.48 [‐1.53, 0.57]
Figuras y tablas -
Comparison 1. Nausea
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