Clinical efficacy of pharmacological and non-pharmacological interventions for constipation-predominant irritable bowel syndrome

Table 2 Certainty of evidence

Quality assessment							Summary of findings
Participants (studies) follow up	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	Overall quality of evidence	Study event rates (%)		Relative effect (95%CI)	Anticipated absolute effects
							With control	With outcomes		Risk with control	Risk difference with outcomes (95%CI)
CSBM (critical outcome; better indicated by lower values)
8318 (17 studies)	Serious	Serious	No serious indirectness	No serious imprecision	Undetected	Moderate due to risk of bias, inconsistency, large effect	4159	4159			The mean CSBM in the intervention groups was 1.1 higher (1.05 to 1.16 higher)
SBM (critical outcome; better indicated by lower values)
5706 (16 studies)	Serious	Serious	No serious indirectness	No serious imprecision	Undetected	Moderate due to risk of bias, inconsistency, large effect	2848	2858			The mean SBM in the intervention groups was 1.65 higher (1.58 to 1.72 higher)
BSFS (critical outcome; better indicated by lower values)
7689 (28 studies)	Serious	Serious	No serious indirectness	No serious imprecision	Undetected	Moderate due to risk of bias, inconsistency, large effect	3834	3855			The mean BSFS in the intervention groups was 0.97 higher (0.94 to 1.01 higher)
IBS-SSS (critical outcome; better indicated by lower values)
544 (9 studies)	Serious	Serious	No serious indirectness	No serious imprecision	Undetected	Moderate due to risk of bias, inconsistency, large effect	245	299			The mean IBS-SSS in the intervention groups was 37.34 lower (46.23 to 28.45 lower)
IBS-QOL (critical outcome; better indicated by lower values)
617 (11 studies)	Serious	No serious inconsistency	No serious indirectness	No serious imprecision	Undetected	High due to risk of bias, large effect	278	339			The mean IBS-QOL in the intervention groups was 7.27 higher (5.32 to 9.22 higher)
Adverse events (critical outcome)
16725 (36 studies)	Serious	Serious	No serious indirectness	No serious imprecision	Undetected	Moderate due to risk of bias, inconsistency, large effect	2720/8076 (33.7%)	3357/8649 (38.8%)	OR = 1.23 (1.15 to 1.32)	Study population
										337 per 1000	48 more per 1000 (from 32 more to 65 more)
										Moderate
										346 per 1000	48 more per 1000 (from 32 more to 65 more)

CI: Confidence interval; CSBM: Complete spontaneous bowel movement; SBM: Spontaneous bowel movement; BSFS: Bristol stool form scale; IBS-QOL: Irritable bowel syndrome quality of life; IBS-SSS: Irritable bowel syndrome severity scoring system.