Evidence map›Paper›PMID 34006606›Full record

SynthesisBMJ open gastroenterology2021

Polyethylene glycol versus lactulose in the treatment of hepatic encephalopathy: a systematic review and meta-analysis.

Gilles Jadd Hoilat, Mohamad Fekredeen Ayas, Judie Noemie Hoilat, Ahmed Abu-Zaid, Ceren Durer, Seren Durer, Talal Adhami, Savio John

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 10% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 22 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Gilles Jadd HoilatInternal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA hoilatg@upstate.edu.ORCID 0000-0003-4493-9629
Mohamad Fekredeen AyasInternal Medicine, Ascension St John Hospital, Detroit, Michigan, USA.
Judie Noemie HoilatInternal Medicine, Loyola University Medical Center, Maywood, Illinois, USA.
Ahmed Abu-ZaidPharmacology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Ceren DurerInternal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Seren DurerInternal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Talal AdhamiGastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Savio JohnGastroenterology, SUNY Upstate Medical University, Syracuse, New York, USA.
SUNY Upstate Medical University · USCleveland Clinic · USLoyola University Medical Center · USSt. John Hospital & Medical Center · USUniversity of Tennessee Health Science Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatic encephalopathy (HE) is defined as brain dysfunction that occurs because of acute liver failure or liver cirrhosis and is associated with significant morbidity and mortality. Lactulose is the standard of care till this date; however, polyethylene glycol (PEG) has gained the attention of multiple investigators.

methodsWe screened five databases namely PubMed, Scopus, Web of Science, Cochrane Library and Embase from inception to 10 February 2021. Dichotomous and continuous data were analysed using the Mantel-Haenszel and inverse variance methods, respectively, which yielded a meta-analysis comparing PEG versus lactulose in the treatment of HE.

resultsFour trials with 229 patients were included. Compared with lactulose, the pooled effect size demonstrated a significantly lower average HE Scoring Algorithm (HESA) Score at 24 hours (Mean difference (MD)=-0.68, 95% CI (-1.05 to -0.31), p<0.001), a higher proportion of patients with reduction of HESA Score by ≥1 grade at 24 hours (risk ratio (RR)=1.40, 95% CI (1.17 to 1.67), p<0.001), a higher proportion of patients with a HESA Score of grade 0 at 24 hours (RR=4.33, 95% CI (2.27 to 8.28), p<0.0010) and a shorter time to resolution of HE group (MD=-1.45, 95% CI (-1.72 to -1.18), p<0.001) in favour of patients treated with PEG.

conclusionPEG leads to a higher drop in the HESA Score and thus leads to a faster resolution of HE compared with lactulose.

Indexed as

Hepatic EncephalopathyLactuloseHumansLiver CirrhosisPolyethylene GlycolsLactulosePolyethylene Glycolscirrhosishepatic encephalopathylactulose

Identifiers

PMID34006606
PMCPMC8137169
OpenAlexW3163872260

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.