Preventive effect of probiotics on infections following colorectal cancer surgery: An umbrella meta-analysis

Table 3 Strength of evidence according to the GRADE

Outcome	No. of studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Relative risk (95%CI)	Quality	Importance
Total infections	6 studies	Meta-analysis of RCTs	No serious	Serious2	No serious	No serious	None	0.40 (0.31-0.51)	Moderate (+)(+)(+)	Critical
Urinary tract infections	5 studies	Meta-analysis of RCTs	Serious1	No serious	No serious	No serious	None	0.44 (0.31-0.61)	Moderate (+)(+)(+)	Important
Bacteremia	3 studies	Meta-analysis of RCTs	No serious	No serious	No serious	No serious	None	0.41 (0.30-0.56)	High (+)(+)(+)(+)	Important
Sepsis	5 studies	Meta-analysis of RCTs	No serious	No serious	No serious	No serious	None	0.35 (0.25-0.44)	High (+)(+)(+)(+)	Critical
Surgical site infection	10 studies	Meta-analysis of RCTs	No serious	No serious	No serious	No serious	None	0.56 (0.49-0.63)	High (+)(+)(+)(+)	Critical
Pneumonia	8 studies	Meta-analysis of RCTs	No serious	No serious	No serious	No serious	None	0.38 (0.30-0.48)	High (+)(+)(+)(+)	Critical
Central line infection	2 studies	Meta-analysis of RCTs	No serious	No serious	No serious	Serious3	None	0.34 (0.14-0.81)	Moderate (+)(+)(+)	Critical
Peritoneal infection	2 studies	Meta-analysis of RCTs	No serious	No serious	No serious	Serious3	None	0.42 (0.18-1.01)	Moderate (+)(+)(+)	Critical
Intra-abdominal infection	3 studies	Meta-analysis of RCTs	No serious	No serious	No serious	Serious3	None	0.51 (0.25-1.04)	Moderate (+)(+)(+)	Critical

¹Significant publication bias.

²Significant heterogeneity.

³CI include null effect or include appreciable harm or benefit.

RR: Relative risk; RCTs: Randomized clinical trials.