Trial reportPLoS medicine2011
A randomised controlled trial of ion-exchange water softeners for the treatment of eczema in children.
Trial report in PLoS medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The association between water hardness and xerosis-Results from the Danish Blood Donor Study.PloS one · 2021Pooled it
- Prospective registration and outcome-reporting bias in randomized controlled trials of eczema treatments: a systematic review.The Journal of investigative dermatology · 2012Pooled it
- Trial
- Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness.BMJ (Clinical research ed.) · 2018Trial
- Silk garments plus standard care compared with standard care for treating eczema in children: A randomised, controlled, observer-blind, pragmatic trial (CLOTHES Trial).PLoS medicine · 2017Trial
- Bath additives for the treatment of childhood eczema (BATHE): protocol for multicentre parallel group randomised trial.BMJ open · 2015Trial
- Trial
- Supporting self-care for families of children with eczema with a Web-based intervention plus health care professional support: pilot randomized controlled trial.Journal of medical Internet research · 2014Trial
- Defining "Flares" in Atopic Dermatitis: A Narrative Review.American journal of clinical dermatology · 2025Review
- Atopic Dermatitis Across Shades of Skin.American journal of clinical dermatology · 2023Review
- Water hardness and atopic dermatitis in the first year of life in the New Hampshire Birth Cohort Study.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2023Article
- The association between domestic hard water and eczema in adults from the UK Biobank cohort study.The British journal of dermatology · 2022Article
- Detecting Eczema Areas in Digital Images: An Impossible Task?JID innovations : skin science from molecules to population health · 2022Article
- Celebrating 20 years of the UK Dermatology Clinical Trials Network. Part 1: Developing and delivering high-quality independent clinical trials.Clinical and experimental dermatology · 2022Review
- Atopic dermatitis and bathing.Canadian family physician Medecin de famille canadien · 2021Article
- Do patient characteristics matter when calculating sample size for eczema clinical trials?Skin health and disease · 2021Article
- The Role of Environmental Exposures in Atopic Dermatitis.Current allergy and asthma reports · 2020Review
- TCM treatment of allergy induced by stainless steel implants for tibiofibular fracture: A case report.Allergologie select · 2019Article
- Measuring long-term disease control in patients with atopic dermatitis: A validation study of well-controlled weeks.The Journal of allergy and clinical immunology · 2017Article
- Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundEpidemiological studies and anecdotal reports suggest a possible link between household use of hard water and atopic eczema. We sought to test whether installation of an ion-exchange water softener in the home can improve eczema in children. METHODS AND
findingsThis was an observer-blind randomised trial involving 336 children (aged 6 months to 16 years) with moderate/severe atopic eczema. All lived in hard water areas (≥200 mg/l calcium carbonate). Participants were randomised to either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone. The primary outcome was change in eczema severity (Six Area Six Sign Atopic Dermatitis Score, SASSAD) at 12 weeks, measured by research nurses who were blinded to treatment allocation. Analysis was based on the intent-to-treat population. Eczema severity improved for both groups during the trial. The mean change in SASSAD at 12 weeks was -5.0 (20% improvement) for the water softener group and -5.7 (22% improvement) for the usual care group (mean difference 0.66, 95% confidence interval -1.37 to 2.69, p = 0.53). No between-group differences were noted in the use of topical corticosteroids or calcineurin inhibitors.
conclusionsWater softeners provided no additional benefit to usual care in this study population. Small but statistically significant differences were found in some secondary outcomes as reported by parents, but it is likely that such improvements were the result of response bias, since participants were aware of their treatment allocation. A detailed report for this trial is also available at http://www.hta.ac.uk.
trial registrationCurrent Controlled Trials ISRCTN71423189 Please see later in the article for the Editors' Summary.
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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.