Evidence shows that quality of trial by Faupel et al is good and therefore should not be excluded

EDITOR—Gregson et al re-analyse the meta-analysis in the systematic review of corticosteroids for acute traumatic brain injury published in the BMJ in 1997, of which I was first author.12 They present an argument for excluding from the analysis the trial with the most beneficial results,3 thus making the point estimate for the meta-analysis move towards no effect. They use this to condemn the CRASH trial, which is aimed at resolving the uncertainty over the effects of steroids in brain injury.

The systematic review was also published in the Cochrane Library, where it is periodically updated to take account of the results of ongoing searches for studies.4 As well as identifying three more small trials presenting data on deaths, we have found more publications reporting the trial by Faupel et al. As …