Evidence map›Paper›PMID 10915127›Full record

SynthesisBMJ (Clinical research ed.)2000

Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review.

L Dumont, C Mardirosoff, M R Tramèr

Registry-linked trialOpen access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01536288 (Can Rhodiola Crenulata Intake Improve Oxygen Saturation and Decrease the Incidence of Acute Mountain Sickness.), which is not on this map. Cited by 33 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 7 pooled it
7.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01536288 phase2completednot on this mapstarted 2010, after this paper: background citation

Can Rhodiola Crenulata Intake Improve Oxygen Saturation and Decrease the Incidence of Acute Mountain Sickness.

TypeinterventionalSponsorChang Gung Memorial HospitalRan2010 to 2011Enrolled125ConditionsAcute Mountain Sickness, Environmental IllnessArmsRhodiola crenulata, placebo
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 7 syntheses or guidelines pooled it, 175 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Altitude sickness.BMJ clinical evidence · 2010
    Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Article
  14. Review
  15. Review
  16. Article
  17. Acute high-altitude sickness.European respiratory review : an official journal of the European Respiratory Society · 2017
    Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

L DumontDivision of Anaesthesiology, Department APSIC, University of Geneva Hospitals, CH-1211 Geneva 14, Switzerland. lionel.dumont@hcuge.ch
C Mardirosoff
M R Tramèr
University of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo quantify efficacy and harm of pharmacological prevention of acute mountain sickness. DATA SOURCES: Systematic search (Medline, Embase, Cochrane Library, internet, bibliographies, authors) in any language, up to October 1999. STUDY SELECTION: Randomised placebo controlled trials. DATA EXTRACTION: Dichotomous data on efficacy and harm from 33 trials (523 subjects received 13 different interventions, 519 a placebo). DATA SYNTHESIS: At above 4000 m the mean incidence of acute mountain sickness with placebo was 67% (range 25% to 100%); incidence depended on the rate of ascent, but not on the altitude or the mode of ascent. Across all ascent rates, dexamethasone 8-16 mg prevented acute mountain sickness (relative risk 2.50 (95% confidence interval 1.71 to 3.66); number needed to treat (NNT) 2.8 (2.0 to 4.6)), without evidence of dose responsiveness. Acetazolamide 750 mg was also efficacious (2.18 (1.52 to 3.15); NNT 2.9 (2.0 to 5.2)), but 500 mg was not. In two trials, adverse reaction (including depression) occurred after dexamethasone was stopped abruptly (4.45 (1.08 to 18); NNT 3.7 (2.5 to 6.9)). With acetazolamide, paraesthesia (4.02 (1.71 to 9.43); NNT 3.0 (2.0 to 6.0)) and polyuria (4.24 (1.92 to 9.37); NNT 3.6 (2.5 to 6.2)) were reported. Data were sparse on nifedipine, frusemide (furosemide), dihydroxyaluminium-sodium, spironolactone, phenytoin, codeine, phenformin, antidiuretic hormone, and ginkgo biloba.

conclusionsAt above 4000 m, with a high ascent rate, fewer than three subjects need to be treated with prophylactic dexamethasone 8-16 mg or acetazolamide 750 mg for one subject not to experience acute mountain sickness who would have done so had they all received a placebo. Acetazolamide 500 mg does not work.

Indexed as

AcetazolamideAcute DiseaseAltitude SicknessCalcium Channel BlockersConfidence IntervalsDexamethasoneDiureticsGlucocorticoidsHumansNifedipineRandomized Controlled Trials as TopicRiskAcetazolamideCalcium Channel BlockersDexamethasoneDiureticsGlucocorticoidsNifedipine

Identifiers

PMID10915127
PMCPMC27441
OpenAlexW2013426978

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.