Studies of resuscitation conducted in the intensive care unit (ICU) setting were included in the resuscitation review. The search for evidence for fluid replacement included patients with diabetes mellitus. More information about “Indirectness” is available in section 3.3.7 in the full version of the original guideline document. Laboratory studies were excluded because the populations used (healthy volunteers, animals or in vitro) and settings are artificial and not comparable to the population we are making recommendations for. These studies would undoubtedly be of extremely low quality as assessed by GRADE and therefore randomized controlled trials (RCTs), cohort studies or GDG consensus opinion was considered preferable. Literature reviews, letters and editorials, foreign language publications and unpublished studies were excluded. Number of Source Documents Not stated Methods Used to Assess the Quality and Strength of the Evidence Weighting According to a Rating Scheme (Scheme Given) Rating Scheme for the Strength of the Evidence Overall Quality of Outcome Evidence in Grading of Recommendations Assessment, Development and Evaluation (GRADE) Level Description High Further research is very unlikely to change confidence in the estimate of effect Moderate Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate Very Low Any estimate of effect is very uncertain Methods Used to Analyze the Evidence Meta-Analysis of Randomized Controlled Trials Systematic Review with Evidence Tables Description of the Methods Used to Analyze the Evidence Note from the National Guideline Clearinghouse (NGC): This guideline was developed by the National Clinical Guideline Centre (NCGC) on behalf of the National Institute for Health and Care Excellence (NICE). See the “Availability of Companion Documents” field for the full version of this guidance. Evidence of Effectiveness the Research Fellow: Critically appraised relevant studies using the appropriate checklist as specified in The Guidelines Manual. Extracted key information about the study’s methods and results into evidence tables (see evidence tables included in Appendix E in the full version of the original guideline document). Generated summaries of the evidence by outcome (included in the relevant chapter write-ups in the full version of the original guideline document): Randomized studies: meta analyzed, where appropriate and reported in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) profiles (for clinical studies) Observational studies: data presented as a range of values in GRADE profiles Qualitative studies: each study summarized in a table where possible, otherwise presented in a narrative. Methods of Combining Clinical Studies Data Synthesis for Intervention Reviews Where possible, meta-analyses were conducted to combine the results of studies for each review question using Cochrane Review Manager (RevMan5) software. Fixed-effects (Mantel-Haenszel) techniques were used to calculate risk ratios (relative risk) for the binary outcomes.
