Intended for healthcare professionals


Design of CRASH trial

BMJ 1999; 319 doi: (Published 16 October 1999) Cite this as: BMJ 1999;319:1068

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

  1. Phil Alderson, associate director (
  1. UK Cochrane Centre, Oxford OX2 7LG
  2. On behalf of the CRASH Trial Management Group, CRASH Coordinating Centre, Institute of Child Health, London WC1N 1EH

    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 …

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