Table 3, Clinical evidence summary: Intensive Care Unit - Emergency and acute medical care in over 16s: service delivery and organisation

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Table 3Clinical evidence summary: Intensive Care Unit

Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects
Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Risk with Unstructur ed handover	Risk difference with structured handover (95% CI)
Mortality	778 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 0.71 (0.43 to 1.17)	Moderate
Mortality	778 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 0.71 (0.43 to 1.17)	85 per 1000	26 fewer per 1000 (from 48 fewer to 14 more)
Re-admission <48hours	820 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 1.35 (0.7 to 2.63)	Moderate
Re-admission <48hours	820 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 1.35 (0.7 to 2.63)	36 per 1000	13 more per 1000 (from 11 fewer to 59 more)
ICU Length of Stay	820 (1 study)	⊕⊝⊝⊝ VERY LOW^a due to risk of bias	-	-	The mean length of stay in the intervention groups was 2.78 lower (4.68 to 0.88 lower)
Staff satisfaction	114 (1 study)	⊕⊝⊝⊝ VERY LOW^a due to risk of bias	RR 3.09 (1.7 to 5.61)	Moderate
Staff satisfaction	114 (1 study)	⊕⊝⊝⊝ VERY LOW^a due to risk of bias	RR 3.09 (1.7 to 5.61)	182 per 1000	380 more per 1000 (from 127 more to 839 more)
Staff satisfaction - Attending Physician	22 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 3 (0.77 to 11.74)	Moderate
Staff satisfaction - Attending Physician	22 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 3 (0.77 to 11.74)	182 per 1000	364 more per 1000 (from 42 fewer to 1000 more)
Staff satisfaction – Fellows	32 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 0.86 (0.37 to 1.99)	Moderate
Staff satisfaction – Fellows	32 (1 study)	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 0.86 (0.37 to 1.99)	438 per 1000	61 fewer per 1000 (from 276 fewer to 434 more)
Staff satisfaction – Nurses	60 (1 study)	⊕⊝⊝⊝ VERY LOW^a due to risk of bias	RR 11 (2.83 to 42.7)	Moderate
Staff satisfaction – Nurses	60 (1 study)	⊕⊝⊝⊝ VERY LOW^a due to risk of bias	RR 11 (2.83 to 42.7)	67 per 1000	670 more per 1000 (from 123 more to 1000 more)

a: All non-randomised studies automatically downgraded due to selection bias. Studies may be further downgraded by 1 increment if other factors suggest additional high risk of bias, or 2 increments if other factors suggest additional very high risk of bias
b: Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.

From: Chapter 32, Structured patient handovers

Emergency and acute medical care in over 16s: service delivery and organisation.

NICE Guideline, No. 94.

National Guideline Centre (UK).

London: National Institute for Health and Care Excellence (NICE); 2018 Mar.

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