Table 18, GRADE findings for predictive value of a reactive trace for adverse neonatal outcomes - Addendum to intrapartum care: care for healthy women and babies

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Quality assessment	Definition of outcome	Stage of labour	Total number of women & baby pairs	Measure of diagnostic accuracy (95% CI)	Quality
Reactivity (presence of at least 2 accelerations (NICHD classification 2008) within a 20-minute period)
1 study (Graham 2014)	Case control	Very serious¹	No serious inconsistency	No serious indirectness	No serious imprecision	Whole-body hypothermia treatment for suspected moderate to severe encephalopathy	Last 1 hour tracing before birth	117	41.0% (26.0 to 57.8)^a	38.5% (27.9 to 50.2)^a	0.67 (0.44 to 1.01)^a	1.53 (1.13 to 2.07)^a	Very low

Quality assessment

Definition of outcome

Stage of labour

Total number of women & baby pairs

Measure of diagnostic accuracy (95% CI)

Quality

Number of studies

Design

Risk of bias

Inconsistency

Indirectness

Imprecision

Sensitivity

Specificity

Positive likelihood ratio

Negative likelihood ratio

Reactivity (presence of at least 2 accelerations (NICHD classification 2008) within a 20-minute period)

1 study

Case control

Very serious¹

No serious inconsistency

No serious indirectness

No serious imprecision

Whole-body hypothermia treatment for suspected moderate to severe encephalopathy

Last 1 hour tracing before birth

117

41.0%

(26.0 to 57.8)^a

38.5%

(27.9 to 50.2)^a

0.67

(0.44 to 1.01)^a

1.53

(1.13 to 2.07)^a

Very low

: CI confidence interval; NICHD National Institute of Child Health and Human Development
a: Calculated by the 2017 NGA technical team
1: High risk of bias due to patient selection and timing

Addendum to intrapartum care: care for healthy women and babies.

Clinical Guideline, No. 190.1.

National Guideline Alliance (UK).

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