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Table 4 Evidence profile for Bach flower remedies

From: Bach Flower Remedies for psychological problems and pain: a systematic review

Number of studies (patients) Design Risk of bias Consistency of results Directness Size of effect Other modifying factors Strength of the collective evidence
Outcome: Reduction in examination anxiety compared with control
3 (272) RCT High Yes Yes Similar treatment effects and efficacy between BFR and control groups in STAI and TAI-G. None Low
Outcome: Reduction in item 15 "anxiety" on VAS compared with control in psychiatric patients suffering anxiety as the main symptom
1 (98) RCT Cannot assess N/A Yes No significant difference between treatment (27.40 ┬▒ 30.45) and placebo (21.73 ┬▒ 27.28) None Very low
Outcome: Improvement in Connor's score compared with control (ADHD)
1 (40) RCT High N/A Yes 4.69 points reduction in Connor's score, no significant difference between treatment and placebo None Very low
Outcome: Attenuation of stress
No evidence
Outcome: Depression
No evidence
Outcome: Pain relief
No evidence
Outcome: Quality of life
No evidence
Outcome: Adverse events
6 (468) RCT, case series High Yes Yes 3 experimental group subjects had side effects None Very low
  1. STAI: State-Trait Anxiety Inventory, TAI-G: German version of the Test Anxiety Inventory, VAS: Visual Analogue Scale, ADHD: Attention-deficit/Hyperactivity Disorder, RCT: Randomized Controlled Trial; N/A: not applicable
  2. Strength of the evidence (GRADE approach): High: further research is very unlikely to change our confidence in the estimate of effect; Moderate: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; Low: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; Very Low: any estimate of effect is very uncertain.