BACKGROUND: Growth in antidepressant prescribing is a well-recognised phenomenon in developed countries. In stroke care, the evidence of effectiveness from systematic reviews is surprisingly weak. We therefore decided to undertake a randomised controlled trial comparing fluoxetine to placebo. METHODS: Double blind placebo-controlled trial. Cases were high-scorers on the GHQ-28 and we applied minimal exclusion criteria. RESULTS: Despite screening 614 patients we were able to randomise only one into the trial. High rates of refusal to participate and exclusions due to physical ill health were coupled with high rates of prescribing among stroke clinicians, to cause this recruitment problem. CONCLUSIONS: In addition to the predicted practical problems of conducting an RCT in an elderly frail population, it became clear that most clinicians are not in equipoise about the value of antidepressant medication despite the lack of strong evidence for its effectiveness. Copyright (c) 2007 John Wiley & Sons, Ltd.
RCT Entities:
BACKGROUND: Growth in antidepressant prescribing is a well-recognised phenomenon in developed countries. In stroke care, the evidence of effectiveness from systematic reviews is surprisingly weak. We therefore decided to undertake a randomised controlled trial comparing fluoxetine to placebo. METHODS: Double blind placebo-controlled trial. Cases were high-scorers on the GHQ-28 and we applied minimal exclusion criteria. RESULTS: Despite screening 614 patients we were able to randomise only one into the trial. High rates of refusal to participate and exclusions due to physical ill health were coupled with high rates of prescribing among stroke clinicians, to cause this recruitment problem. CONCLUSIONS: In addition to the predicted practical problems of conducting an RCT in an elderly frail population, it became clear that most clinicians are not in equipoise about the value of antidepressant medication despite the lack of strong evidence for its effectiveness. Copyright (c) 2007 John Wiley & Sons, Ltd.
Authors: Karin Friedli; Ayman Guirguis; Michael Almond; Clara Day; Joseph Chilcot; Maria Da Silva-Gane; Andrew Davenport; Naomi A Fineberg; Benjamin Spencer; David Wellsted; Ken Farrington Journal: Clin J Am Soc Nephrol Date: 2017-01-26 Impact factor: 8.237
Authors: Richard Holubkov; J Michael Dean; John Berger; Kanwaljeet J S Anand; Joseph Carcillo; Kathleen Meert; Jerry Zimmerman; Christopher Newth; Rick Harrison; Douglas F Willson; Carol Nicholson Journal: Pediatr Crit Care Med Date: 2009-07 Impact factor: 3.624