Evidence map›Paper›PMID 18042961›Full record

SynthesisBMJ (Clinical research ed.)2008

Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review.

Tom Jefferson, Ruth Foxlee, Chris Del Mar, Liz Dooley, Eliana Ferroni, Bill Hewak, Adi Prabhala, Sree Nair, Alex Rivetti

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01249625 (Incidence of Respiratory Illness in Outpatient Healthcare Workers Who Wear Respirators or Medical Masks While Caring for Patients), which is not on this map. Cited by 137 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01249625 nacompletednot on this mapstarted 2010, after this paper: background citation

Incidence of Respiratory Illness in Outpatient Healthcare Workers Who Wear Respirators or Medical Masks While Caring for Patients

TypeinterventionalSponsorJohns Hopkins UniversityRan2010 to 2018Enrolled2,862ConditionsInfluenza, Respiratory Syncytial Viruses, Paramyxoviridae Infections, CoronavirusArmsN95 Respirator, Medical/surgical mask
3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  2. A Review of Filtration Performance of Protective Masks.International journal of environmental research and public health · 2023
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  12. Uptake and effectiveness of facemask against respiratory infections at mass gatherings: a systematic review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2016
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77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Tom JeffersonCochrane Vaccines Field, Alessandria, Italy.
Ruth Foxlee
Chris Del Mar
Liz Dooley
Eliana Ferroni
Bill Hewak
Adi Prabhala
Sree Nair
Alex Rivetti

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo systematically review evidence for the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. DATA EXTRACTION: Search strategy of the Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without language restriction, for any intervention to prevent transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). Study designs were randomised trials, cohort studies, case-control studies, and controlled before and after studies. DATA SYNTHESIS: Of 2300 titles scanned 138 full papers were retrieved, including 49 papers of 51 studies. Study quality was poor for the three randomised controlled trials and most of the cluster randomised controlled trials; the observational studies were of mixed quality. Heterogeneity precluded meta-analysis of most data except that from six case-control studies. The highest quality cluster randomised trials suggest that the spread of respiratory viruses into the community can be prevented by intervening with hygienic measures aimed at younger children. Meta-analysis of six case-control studies suggests that physical measures are highly effective in preventing the spread of SARS: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat=4, 95% confidence interval 3.65 to 5.52); wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03); wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06); wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41); wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12); and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease the spread of respiratory disease remains uncertain. The lack of proper evaluation of global measures such as screening at entry ports and social distancing prevent firm conclusions being drawn.

conclusionRoutine long term implementation of some physical measures to interrupt or reduce the spread of respiratory viruses might be difficult but many simple and low cost interventions could be useful in reducing the spread.

Indexed as

Hand DisinfectionQuarantineGloves, ProtectiveHumansMasksProtective ClothingRespiratory Tract InfectionsVirus Diseases

Identifiers

PMID18042961
PMCPMC2190272

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.