Antiepileptic drug prophylaxis in severe traumatic brain injury
| Autor: | N. Latronico, E. Cagnazzi, B. S. Chang, D. H. Lowenstein |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Selection bias
Phenytoin medicine.medical_specialty Randomization business.industry medicine.drug_class Traumatic brain injury media_common.quotation_subject Antiepileptic drug medicine.disease Sedative Anesthesia medicine In patient Neurology (clinical) Intensive care medicine business Brain trauma media_common medicine.drug |
| Zdroj: | Neurology. 61:1161-1162 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.61.8.1161-a |
| Popis: | To the Editor: Chang and Lowenstein1 conclude that phenytoin should be started as soon as possible after brain trauma (BT) to decrease the risk of early post-traumatic seizures (EPTS). We think that this conclusion is based on their incorrect scoring of selected studies. Furthermore, their conclusion does not consider the current use of sedative agents in patients with severe BT. The authors classified the studies by Young et al.2 and Temkin et al.3 as class I studies. However, neither specifies the randomization method. Proper randomization is crucial in high-quality trials, because it balances the groups for prognostic factors, known or unknown, provided large samples are used.4 Furthermore, physicians responsible for entering the patients into the study are unaware of which treatment the next patient will receive, thus eliminating selection bias. Inappropriate or unclear randomization may yield inflated treatment effects.4 Experts suggest a “guilty until proven” approach … |
| Databáze: | OpenAIRE |
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