Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: People (age range 5-65 years where reported) with early-stage dengue infection
Intervention: Corticosteroids (administered intravenously or orally)
Comparison: Placebo or no corticosteroids
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Mortality (trial duration 1-3 years) | See note ᵃ | Low |
Dengue‐related shock (trial duration 1-2 years) | No statistically significant difference | Very Low |
Bleeding: severe (trial duration 1-2 years) | No statistically significant difference | Very Low |
Bleeding: any (trial duration 2-3 years) | Favors intervention | GRADE assessment not performed for this outcome |
Severe thrombocytopenia (trial duration 2 years) | No statistically significant difference | Very Low |
Ascites (trial duration 3 years) | No statistically significant difference | Very Low |
Hospital admission (trial duration 3 years) | No statistically significant difference | GRADE assessment not performed for this outcome |
ICU admission (trial duration 1-2 years) | No statistically significant difference | Very Low |
Adverse effects | No statistically significant difference | GRADE assessment not performed for this outcome |
Serious adverse effects | No statistically significant difference | GRADE assessment not performed for this outcome |
Note The Cochrane Clinical Answer (CCA) notes that most analyses were underpowered due to low event rates. ᵃ Four RCTs (664 people) reported no deaths in either group.
This evidence table is related to the following section/s:
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Children admitted to hospital with dengue-related shock
Intervention: Intravenous corticosteroids
Comparison: Placebo or no corticosteroids
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Mortality (trial duration 1-2 years) | No statistically significant difference | Very Low |
Blood transfusion (trial duration 1-2 years) | No statistically significant difference | Very Low |
Duration of shock | See note ᵃ | GRADE assessment not performed for this outcome |
Duration of hospital stay | No statistically significant difference | Very Low |
Pulmonary hemorrhage (1 year) | No statistically significant difference | Very Low |
Convulsions (1 year) | No statistically significant difference | Very Low |
Adverse effects | - | None of the studies identified by the review assessed this outcome |
Note The Cochrane Clinical Answer (CCA) notes that all of the analyses were too underpowered to detect differences between treatment groups. ᵃ Three RCTs (221 people) reported on this outcome but it was not possible to carry out a meta-analysis. One study favored corticosteroids whilst the other two found no significant difference. See the CCA for more details.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- Does the deployment of Wolbachia‐carrying Aedes aegypti mosquitoes in a dengue endemic setting prevent dengue infection?
- What are the effects of corticosteroids in people with early stage dengue infection?
- What are the effects of corticosteroids in children with dengue-related shock?
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