| Measure | Quality assessment | No. (%) of participants | Effect | Quality | Importance | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of studies | Design | Serious risk of bias | Serious inconsistency | Serious indirectness | Serious imprecision | Other bias | Treatment | Control | Relative risk (95% CI) | Absolute effect per million | ARR or ARI | NNS (95% CI) | |||
| Referral rates to intervention (screening tool ASQ-II), 18-mo follow-up | |||||||||||||||
| Screening with office support | 1 | RCT18 | Noa | Nob | Yesc | Nod | Noe | 140/704 (19.9) | 71/695 (10.2) | 1.95 (1.49-2.54) | 96 703 more (range 50 313 more to 157 211 more) | 9.67% | 10 (6-20) | Moderate | Critical |
| Screening without office support | 1 | RCT18 | Noa | Nob | Yesc | Nof | Noe | 121/693 (17.5) | 71/695 (10.2) | 1.71 (1.30-2.25) | 72 440 more (range 30 668 more to 127 361 more) | 7.24% | 14 (8-33) | Moderate | Critical |
| Time to referral (screening tool ASQ-II), 18-mo follow-up | |||||||||||||||
| Screening with office support | 1 | RCT18 | Noa | Nob | Yesc | Nog | Noe | -/704 | -/695 | 0.30 (0.19-0.48) | - | - | - | Moderate | Critical |
| Screening without office support | 1 | RCT18 | Noa | Nob | Yesc | Noh | Noe | -/693 | -/695 | 0.36 (0.23-0.59) | - | - | - | Moderate | Critical |
| Academic performance, by outcome measures (VTO screening), 81-mo follow-up | |||||||||||||||
| Attendance at special school | 1 | RCT19 | Yesi | Nob | Noj | Yesk | Noe | 83/3118 (2.7) | 85/2288 (3.7) | 0.71 (0.48-1.04) | 10 762 fewer (range 19 144 fewer to 1 523 more) | - | - | Low | Critical |
| Grade repeated | 1 | RCT19 | Yesi | Nob | Noj | Yesl | Noe | 443/3084 (14.4) | 318/2250 (14.1) | 0.99 (0.81-1.21) | 1 413 fewer (range 26 754 fewer to 29 553 more) | - | - | Low | Critical |
| Grade repeated (language problems) | 1 | RCT19 | Yesi | Nob | Noj | Yesm | Noe | 146/2401 (6.1) | 84/1721 (4.9) | 1.26 (0.89-1.80) | 12 807 more (range 5 511 fewer to 38 871 more) | - | - | Low | Critical |
| < 10th percentile of oral tests | 1 | RCT19 | Yesi | Nob | Noj | Yesn | Noe | 112/1270 (8.8) | 90/925 (9.7) | 0.88 (0.63-1.23) | 11 685 fewer (range 36 068 fewer to 22 398 more) | - | - | Low | Critical |
| < 10th percentile of reading tests | 1 | RCT19 | Yesi | Nob | Noj | Yeso | Noe | 86/1844 (4.7) | 62/1328 (4.7) | 1.00 (0.72-1.40) | 0 fewer (range 13 231 fewer to 18 460 more) | - | - | Low | Critical |
| < 10th percentile of spelling tests | 1 | RCT19 | Yesi | Nob | Noj | Yesp | Noe | 48/1728 (2.8) | 52/1225 (4.2) | 0.68 (0.41-1.13) | 13 592 fewer (range 25 079 fewer to 5 489 more) | - | - | Low | Critical |
Note: ARI = absolute risk increase, ARR = abosolute risk reduction, ASQ-II = Ages and Stages Questionnaire II, CI = confidence interval, GRADE = Grading of Recommendations Assessment, Development and Evaluation, NNS = number needed to screen, RCT = randomized controlled trial, VTO = VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument.
See Table 4 for footnotes.