Dexamethasone saves lives in the Recovery Trial June 2020

The Recovery Trial has published early results today showing the benefits of Dexamethasone on Mortality. 

The first Cates plot below shows how many people on ventilators for Covid-19 had their lives saved (the 14 yellow faces) when 100 people were given Dexamethasone in this trial.

Cates Plot Covid-19
In the control group 41 people out of 100 died over 28 days, compared to 27 (95% CI 20 to 36) out of 100 for the dexamethasone group.

The second Cates plot below shows how many people on oxygen for Covid-19  had their lives saved (the 4 yellow faces) when 100 people were given Dexamethasone in this trial.

Cates Plot Covid-19
In the control group 25 people out of 100 died over 28 days, compared to 21 (95% CI 18 to 24) out of 100 for the dexamethasone group.

You can view the RECOVERY Trial dexamethasone statement here.

The images have been generated by Visual Rx based on the clinical data in this preliminary report.

Critical Reading

The articles in this section come from a series of articles that I wrote for Update magazine in 2005/6 and for Pulse in 2001 as well as a few other articles which are relevant when critically appraising the medical literature.

AKT (Applied Knowledge Test for MRCGP exam)

These are short articles that I have written which may be helpful to anyone revising for the AKT exam. For a more in depth look at Systematic Reviews there is a longer article here.

Visual Rx Example Articles Overview

Clinical Articles Overview

Systematic Reviews Articles Overview

Further Statistics Articles Overview

Evidence & Practice Articles Overview

Vitamin D for people with asthma (Cochrane review 2016)

The Cochrane Airways review on Vitamin D for asthma has been the subject of considerable interest from the press including the BBC Online, Guardian and the NHS ‘Behind the Headlines’.

Vitamin D reduced the risk of emergency department visits or hospitalisation for asthma from 6% to 3% over six to twelve months, and also reduced the risk of less serious asthma attacks from 29% to 18%. These results are illustrated in the Cates plots shown below:

People with an asthma attacks leading to ED visit or hospitalisation

 

In the control group 6 out of 100 people had a visit to ED or hospitalisation over 8 months, compared to 3 (95% CI 1 to 5) out of 100 on vitamin D (mostly evidence from trials on 658 adults).

People with one or more asthma attacks (as defined in each trial)

In the control group 29 out of 100 people had a study-defined exacerbation over 7 months, compared to 18 (95% CI 10 to 29) out of 100 on Vitamin D (from trials in 658 adults and 341 children).

For full details of the review please follow this link. The evidence from children is still rather limited and we do not know for sure what dose of Vitamin D is needed or what blood level of Vitamin D determines whether people benefit. Vitamin D is not a substitute for normal preventer treatment.