Evidence map›Paper›PMID 34183579›Full record

Trial reportThe American journal of gastroenterology2021

Association Between Diarrhea Duration and Severity and Probiotic Efficacy in Children With Acute Gastroenteritis.

David Schnadower, Karen J O'Connell, John M VanBuren, Cheryl Vance, Phillip I Tarr, Suzanne Schuh, Katrina Hurley, Alexander J Rogers, Naveen Poonai, Cindy G Roskind and 10 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The American journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 30% 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

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Pathogen-Specific Effects of Probiotics in Children With Acute Gastroenteritis Seeking Emergency Care: A Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Trial
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 15 institutions in 2 countries.

David SchnadowerDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Karen J O'ConnellDivision of Emergency Medicine, Children's National Hospital, Department of Pediatrics and Emergency Medicine, The George Washington School of Medicine and Health Sciences, Washington, DC, USA.
John M VanBurenDepartment of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Cheryl VanceDepartments of Emergency Medicine and Pediatrics, University of California, Davis, School of Medicine, Sacramento, California, USA.
Phillip I TarrDivision of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Suzanne SchuhDivision of Pediatric Emergency Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto and Research Institute, Toronto, Ontario, Canada.
Katrina HurleyDivision of Pediatric Emergency Medicine, IWK Health Centre, Halifax, Nova Scotia, Canada.
Alexander J RogersDepartments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
Naveen PoonaiDepartment of Pediatrics, Schulich School of Medicine and Dentistry, and Children's Health Research Institute, London Health Sciences Centre, London, Canada.
Cindy G RoskindDivision of Emergency Medicine, Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, New York, USA.
Seema R BhattDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Serge GouinDepartment of Pediatric Emergency Medicine, Centre Hopital Universitaire (CHU) Ste-Justine, Université de Montréal, Montreal, Quebec, Canada.
Prashant MahajanDepartments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
Cody S OlsenDepartment of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Elizabeth C PowellDivision of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Ken FarionDepartments of Pediatrics and Emergency Medicine, University of Ottawa, and Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada.
Robert E SapienDepartment of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
Thomas H ChunDepartment of Emergency Medicine, Rhode Island Hospital/Hasbro Children's Hospital and Brown University, Providence, Rhode Island, USA.
Stephen B FreedmanSections of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics and Emergency Medicine, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Pediatric Emergency Care Applied Research Network and Pediatric Emergency Research Canada
University of Michigan–Ann Arbor · USUniversity of Utah · USBrown University · USChildren’s Health Research Institute · CACincinnati Children's Hospital Medical Center · USColumbia University · USIzaak Walton Killam Health Centre · CANorthwestern University · USSickKids Foundation · CAUniversité de Montréal · CAUniversity of California, Davis · USUniversity of Cincinnati · USUniversity of New Mexico · USUniversity of Ottawa · CAWashington University in St. Louis · US

Funding

Washington University DDRCC Supplemental Equipment RequestP30DK052574 · NIDDK · WASHINGTON UNIVERSITY · PI Jeffrey Wade Brown · 2000 to 2026
$30.8M
Impact of Emergency Department Probiotic Treatment of Pediatric GastroenteritisR01HD071915 · NICHD · WASHINGTON UNIVERSITY · PI FREEDMAN, STEPHEN BRADLEY, SCHNADOWER, DAVID · 2014 to 2018
$3.6M
CIHR 286384CIHR 325412NICHD NIH HHS R01 HD071915NIDDK NIH HHS P30 DK052574
6 · The paper itself

Abstract

introductionIt is unclear whether the alleged efficacy of probiotics in childhood acute gastroenteritis depends on the duration and severity of symptoms before treatment.

methodsPreplanned secondary analysis of 2 randomized placebo-controlled trials in children 3-48 months of age was conducted in 16 emergency departments in North America evaluating the efficacy of 2 probiotic products (Lactobacillus rhamnosus GG and a combination probiotic: L. rhamnosus and L. helveticus). Participants were categorized in severity groups according to the duration (<24, 24-<72, and ≥72 hours) and the frequency of diarrhea episodes in the 24 hours (≤3, 4-5, and ≥6) before presentation. We used regression models to assess the interaction between pretreatment diarrhea severity groups and treatment arm (probiotic or placebo) in the presence of moderate-to-severe gastroenteritis (Modified Vesikari Scale score ≥9). Secondary outcomes included diarrhea frequency and duration, unscheduled healthcare provider visits, and hospitalization.

resultsA total of 1,770 children were included, and 882 (50%) received a probiotic. The development of moderate-to-severe gastroenteritis symptoms after the initiation of treatment did not differ between groups (probiotic-18.4% [162/882] vs placebo-18.3% [162/888]; risk ratio 1.00; 95% confidence interval 0.87, 1.16; P = 0.95). There was no evidence of interaction between baseline severity and treatment (P = 0.61) for the primary or any of the secondary outcomes: diarrhea duration (P = 0.88), maximum diarrheal episodes in a 24-hour period (P = 0.87), unscheduled healthcare visits (P = 0.21), and hospitalization (P = 0.87). DISCUSSION: In children 3-48 months with acute gastroenteritis, the lack of effect of probiotics is not explained by the duration of symptoms or frequency of diarrheal episodes before presentation.

Indexed as

Child, PreschoolDiarrheaFemaleGastroenteritisHumansInfantLacticaseibacillus rhamnosusLactobacillus helveticusMaleProbioticsSeverity of Illness IndexTime FactorsTreatment Outcome

Identifiers

PMID34183579
PMCPMC8259780
OpenAlexW3163530709

What OpenQuestion holds

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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.