TY - JOUR
T1 - The steroid-croup controversy
T2 - An analytic review of methodologic problems
AU - Lietman, Paul S.
AU - Tunnessen, Walter W.
AU - Feinstein, Alvan R.
N1 - Funding Information:
From the Robert Wood Johnson Clinical Scholar Program, and the Departments of Pediatrics, Medicine, and Epidemiology, Yale University School of Medicine. Supported in part by Grant Number HS 02764from the National Center for Health Services Research, OASH. *Reprint address: Department of Pediatrics, Upstate Medical Center, 750 E. Adams St., Syracuse, NY 13210.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1980/4
Y1 - 1980/4
N2 - The reasons for the controversy regarding the use of corticosteroids to treat croup were reviewed by evaluating nine studies for their adequacy in meeting eight methodologic standards essential for reducing bias and distortion in clinical trials. Five studies employed diagnostic criteria for croup but none stratified patients with croup into acute laryngotracheitis and spasmodic croup, the two forms which account for the large majority of cases of croup. Only four studies used adequate doses of steroids, defined as 100 mg of cortisone or an equivalent. Only two studies developed clinically relevant choices for the outcome event. Although steroids may be helpful in certain types of croup, it is impossible to reach a definite conclusion about the efficacy of steroids, since all of the studies have major inadequacies in clinical trial design.
AB - The reasons for the controversy regarding the use of corticosteroids to treat croup were reviewed by evaluating nine studies for their adequacy in meeting eight methodologic standards essential for reducing bias and distortion in clinical trials. Five studies employed diagnostic criteria for croup but none stratified patients with croup into acute laryngotracheitis and spasmodic croup, the two forms which account for the large majority of cases of croup. Only four studies used adequate doses of steroids, defined as 100 mg of cortisone or an equivalent. Only two studies developed clinically relevant choices for the outcome event. Although steroids may be helpful in certain types of croup, it is impossible to reach a definite conclusion about the efficacy of steroids, since all of the studies have major inadequacies in clinical trial design.
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U2 - 10.1016/S0022-3476(80)80761-X
DO - 10.1016/S0022-3476(80)80761-X
M3 - Article
C2 - 7359289
AN - SCOPUS:0018819968
SN - 0022-3476
VL - 96
SP - 751
EP - 756
JO - The Journal of pediatrics
JF - The Journal of pediatrics
IS - 4
ER -