Table 4 Summary of evidence and recommendations for single interventions
Evidence | Recommendations | ||||||
|---|---|---|---|---|---|---|---|
Intervention | Type of interventions | Types of studies | Date | Findings | Certainty of the evidencea | Recommendations across reviewed documents | Strength of recommendationsa |
Vitamin D | Effectiveness of vit D supplementation for preventing nutritional rickets in term born children (clinical and radiological outcomes) | SR (4 trials, 1700 participants) RCT Surveillance data | SR 2007 Studies 1994 to 2004 | Vit D supplementation prevents from developing rickets | High quality evidence according to European global consensus | - WHO: acknowledges effectiveness, but requests further research for specific recommendations - PrevInfad, CDC, NICE, Global European consensus recommend | - WHO: category 2 intervention - PrevInfad: Grade B - European global consensus: strong |
Effectiveness of vit D supplementation for improving bone mineral density (BMD) | SR (6 RCTs, 884 participants) | SR 2010 Studies 2004 to 2008 | No effect on total body BMD or lumbar spinal BMD. Probably no effect on hip BMD and forearm BMD. | High certainty evidence Moderate certainty evidence | |||
Vitamin K | Effectiveness of vit K for preventing HDN (clinical outcome: bleeding) | SR (2 RCTs, only for classical HDN and IM) | Studies 1960’s | Effective | Not graded by Cochrane authors but referred as ‘poor methodological quality’ Graded as low-moderate by WHO | Recommended by all institutions | Strong (WHO, PrevInfad) |
Effectiveness of vit K for preventing HDN (biochemical outcomes) | SR (5 RCTs, only for classical HDN, IM and oral) | Studies 1990’s | Effective | ||||
Intramuscular versus oral | No RCT National surveillance data | Last 3 decades | Both intramuscular and oral effective | Not applicable | |||
Fluoride | Toothbrushing for preventing dental caries | SRs | SR 2019 Studies 1982 to 2014 | Effective | Moderate | Recommended by all institutions | B recommendation (USPSTF); strength of the evidence I (NHS) |