Network plot for the patient comfort on a support surface produced by STATA <i>networkplot</i> command.

<p>Six intervention groups (i.e., six nodes) are coded in the plot: SC = standard hospital surfaces, npReFoam = non-powered reactive foam surfaces, npReWater = non-powered reactive water surfaces, pActAir = powered active air-cells surfaces, pReAirfluid = powered reactive air-fluidised surfaces, pnpReAir = powered or non-powered reactive air-cells surfaces. Taking any two of the six nodes forms 15 network contrasts. The size of each node is proportional to the number of direct comparisons involving each intervention group. The six lines between nodes in the plot represent the only direct comparisons and line thickness is proportional to the number of studies involved in each direct comparison. The direct evidence arising from two or more comparisons can generate indirect evidence for contrasts that have not been compared in head-to-head RCTs (e.g., indirect evidence for the comparison of npReFoam vs. npReWater generated from comparisons of npReFoam vs. SC and npReWater vs. SC). In this way, indirect evidence informs nine of the 15 network contrasts. The risk of bias assessment was based on the most frequent level of bias recorded for studies included in that comparison and denoted using coloured lines (or links). A green link indicates no serious study limitation, yellow indicates serious limitations; and red very serious limitations.</p

Network plot for the incidence of pressure ulcers produced by STATA <i>networkplot</i> command.

<p>Fourteen intervention groups are coded in the plot (i.e., nodes): SC = standard hospital surfaces, npReFibre = non-powered reactive fibre surfaces, npReFoam = non-powered reactive foam surfaces, npReGel = non-powered reactive gel surfaces, npReSheepskin = non-powered reactive sheepskin surfaces, npReWater = non-powered reactive water surfaces, pActAir = powered active air-cells surfaces, pActAirnpReFoam = powered active air-cells surfaces plus non-powered reactive foam surfaces, pActLAL = powered active low-air-loss air surfaces, pHybridAir = powered hybrid air-cells surfaces, pHybridLAL = powered hybrid low-air-loss air surfaces, pReAirfluid = powered reactive air-fluidised surfaces, pnpReAir = powered or non-powered reactive air-cells surfaces, and pnpReLAL = powered or non-powered reactive low-air-loss air surfaces. Each node size is proportional to the number of direct comparisons involving each intervention group. Taking any two of the six nodes forms 91 network contrasts. 24 lines between nodes represent direct comparisons driven by RCTs; and line thickness is proportional to the number of studies involved in each direct comparison. Direct evidence of two or more comparisons can generate indirect evidence for contrasts that did not involve a head-to-head RCT (e.g., indirect evidence for the comparison of npReFoam vs. npReWater generated from comparisons, for example, of npReFoam vs. SC and npReWater vs. SC). In this way, indirect evidence informs the remaining 67 of the 91 network contrasts. The risk of bias assessment was based on the most frequent level of bias recorded for studies included in that comparison and denoted using coloured lines (or links). A green link indicates no serious study limitations; yellow indicates serious limitations; and red indicates very serious limitations.</p

Flow diagram of included studies.

<p>Flow diagram of included studies.</p

Results of pairwise meta-analyses via RevMan and network meta-analysis with consistency model via STATA for pressure ulcer incidence.

<p>Results of pairwise meta-analyses with the numbers of included studies and participants are presented above the diagonal cells (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0192707#pone.0192707.s007" target="_blank">S7 File</a>); network meta-analysis results and the corresponding certainty of evidence assessments are shown below the diagonal cells. The diagonal cells show the codes of intervention groups and their SUCRA values and rankings in brackets: SC = standard hospital surfaces, npReFibre = non-powered reactive fibre surfaces, npReFoam = non-powered reactive foam surfaces, npReGel = non-powered reactive gel surfaces, npReSheepskin = non-powered reactive sheepskin surfaces, npReWater = non-powered reactive water surfaces, pActAir = powered active air-cells surfaces, pActAirnpReFoam = powered active air-cells surfaces plus non-powered reactive foam surfaces, pActLAL = powered active low-air-loss air surfaces, pHybridAir = powered hybrid air-cells surfaces, pHybridLAL = powered hybrid low-air-loss air surfaces, pReAirfluid = powered reactive air-fluidised surfaces, pnpReAir = powered or non-powered reactive air-cells surfaces, and pnpReLAL = powered or non-powered reactive low-air-loss air surfaces. ⨁⨁⨁◯ = Moderate certainty of evidence; ⨁⨁◯◯ = Low certainty of evidence; and ⨁◯◯◯ = Very low certainty of evidence.</p

Characteristics of Included Studies.

<p>*Items are reported as frequency and proportion for categorical variables and are otherwise specified for continuous variables.</p>§<p>CONSORT was published in 1996 and revised twice in 2001 and 2010, respectively; the number of RCTs in each publication year is depicted in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0113002#pone.0113002.s004" target="_blank">Appendix S4</a>.</p>¶<p>There is a significant difference between the number of words used to describe interventions and controls,as indicated by two related-samples tests (Z = −21.192, P<0.001);</p><p>IQR indicates interquartile range.</p><p>Characteristics of Included Studies.</p

Flow diagram of included studies.

<p>Flow diagram of included studies.</p

Results of linear regression for predictors associated with CONSORT methodological score.

<p>Note: ^¶When data on “blinding” were deleted, two predictors associated with CONSORT score (i.e., publication year and ITT analysis) remained, and their P values were 0.005 and <0.001 respectively.</p><p>Results of linear regression for predictors associated with CONSORT methodological score.</p