Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Children or adults with acute cough due to the common cold in community setting
Intervention: OTC medications (topical mentholated ointment or oral agave nectar)ᵃ
Comparison: Placebo
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Topical mentholated ointment versus placebo | ||
Change in cough frequencyᵇ | No statistically significant difference | Low |
Change in cough severityᵇ | No statistically significant difference | Low |
Agave nectar versus placebo | ||
Change in cough frequencyᶜ | No statistically significant difference | Low |
Change in cough severityᶜ | No statistically significant difference | Low |
Recommendations as stated in the source guideline For adult and pediatric patients with cough due to the common cold, we suggest against the use of OTC cough and cold medicines until they have been shown to make cough less severe or resolve sooner.
Note ᵃ The guideline committee concluded that there was no evidence to support or refute the use of OTC antitussive agents, expectorants, mucolytic agents, or combination treatments for reducing cough in adults or children with the common cold. These interventions were assessed for effectiveness (and one systematic review, search date March 2014, was identified), but pooling of the evidence was not possible due to conflicting/variable results, heterogeneity, and differing drug preparations and dosing frequencies. ᵇ Results are based on one randomized controlled trial which included a total of 138 children. ᶜ Results are based on one randomized controlled trial which included a total of 119 children.
This evidence table is related to the following section/s:
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Children with a cough associated with the common cold
Intervention: Honey
Comparison: Dextromethorphan, diphenhydramine, no treatment, or placebo
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Honey versus dextromethorphan | ||
Frequency of cough | No statistically significant difference | Very Low |
Severity of cough | No statistically significant difference | Very Low |
Honey versus diphenhydramine | ||
Frequency of cough | Favors intervention | Very Low |
Severity of cough | Favors intervention | Very Low |
Honey versus no treatment | ||
Frequency of cough | Favors intervention | Very Low |
Severity of cough | Favors intervention | Very Low |
Honey versus placebo | ||
Frequency of cough | Favors intervention | Low |
Severity of cough | Favors intervention | Low |
Recommendations as stated in the source guideline In pediatric patients (aged 1-18 years) with cough due to the common cold, we suggest honey may offer more relief for cough symptoms than no treatment, diphenhydramine, or placebo, but it is not better than dextromethorphanᵃ.
Note ᵃ The guideline committee noted that children <1 year of age should not be given honey and children <2 years of age should not be given dextromethorphan for cough symptoms.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- Can physical interventions help reduce the spread of respiratory viruses?
- Is there randomized controlled trial evidence to support the use of non-steroidal anti-inflammatory drugs in people with the common cold?
- How do point‐of‐care diagnostic tests for acute respiratory infection affect antibiotic prescribing behavior in primary care?
- What are the effects of homeopathic medicinal products for treating acute respiratory tract infections in children?
- What are the effects of homeopathic medicinal products for preventing acute respiratory tract infections in children?
- What are the effects of probiotics to prevent acute upper respiratory tract infections (URTIs)?
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