Perspective: Assessment Criteria Judgements Research evidence Additional considerations Problem Is there a The evidence used to answer this question comes These are small studies (total ○ No from 3 RCT's: 1) Page 2013 ; 2) Girard 2010 patients in meta-analysis include problem (haloperidol arm); 3) Atalan 2013 . This 132, and 133 patients ○ priority? Probably no evidence revealed no statistically significant effect in haloperidol and comparator of haloperidol compared to placebo/comparison arms respectively. These trials ○ Uncertain treatment with regard to ICU length of stay, days of also include haloperidol open mechanical ventilation, delirium duration, or label rescue administration and ○ Probably yes mortality. so it is possible that larger trials It is important to note that the patients in both of without rescue medication might Yes these studies included those with prevalent delirium, demonstrate a difference as well as subsyndromal and no delirium at entry employing such a strategy. ○ Varies into the trial. These estimates are not as specific to the populations as the questions specify. Implications are that the estimates are biased to the null hypothesis. Benefits & harms of What is the ○ No included studies The relative importance or values the options overall certainty ○ outcomes of interest: of this evidence? Very low Low
Perspective: Assessment Criteria Judgements Research evidence Additional considerations Problem Is there a problem priority? ○ No ○ Probably no ○ Uncertain ○ Probably yes Yes ○ Varies The evidence used to answer this question comes from 3 RCT's: 1) Page 2013 ; 2) Girard 2010 (haloperidol arm); 3) Atalan 2013 . This evidence revealed no statistically significant effect of haloperidol compared to placebo/comparison treatment with regard to ICU length of stay, days of mechanical ventilation, delirium duration, or mortality. It is important to note that the patients in both of these studies included those with prevalent delirium, as well as subsyndromal and no delirium at entry into the trial. These estimates are not as specific to the populations as the questions specify. Implications are that the estimates are biased to the null hypothesis. These are small studies (total patients in meta-analysis include 132, and 133 patients in haloperidol and comparator arms respectively. These trials also include haloperidol open label rescue administration and so it is possible that larger trials without rescue medication might demonstrate a difference employing such a strategy. Benefits & harms of the options What is the overall certainty of this evidence? ○ No included studies ○ Very low Low The relative importance or values outcomes of interest: