Evidence map›Paper›PMID 30214821›Full record

ArticlePilot and feasibility studies2018

Oral prednisolone for acute otitis media in children: protocol of a pilot randomised, open-label, controlled study (OPAL study).

Respati W Ranakusuma, Amanda R McCullough, Eka D Safitri, Yupitri Pitoyo, Widyaningsih, Christopher B Del Mar, Elaine M Beller

Open access · goldAbstract read
In one paragraph

Article in Pilot and feasibility studies, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 29% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Respati W Ranakusuma1Centre for Research in Evidence-Based Practice Faculty of Health Sciences and Medicine Bond University, 14 University Drive, Robina, 4226 Queensland Australia.ORCID 0000-0002-6678-7876
Amanda R McCullough1Centre for Research in Evidence-Based Practice Faculty of Health Sciences and Medicine Bond University, 14 University Drive, Robina, 4226 Queensland Australia.
Eka D Safitri2Clinical Epidemiology and Evidence-Based Medicine Unit, Dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Diponegoro 71, Jakarta, 10430 Indonesia.
Yupitri Pitoyo2Clinical Epidemiology and Evidence-Based Medicine Unit, Dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Diponegoro 71, Jakarta, 10430 Indonesia.
Widyaningsih2Clinical Epidemiology and Evidence-Based Medicine Unit, Dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Diponegoro 71, Jakarta, 10430 Indonesia.
Christopher B Del Mar1Centre for Research in Evidence-Based Practice Faculty of Health Sciences and Medicine Bond University, 14 University Drive, Robina, 4226 Queensland Australia.
Elaine M Beller1Centre for Research in Evidence-Based Practice Faculty of Health Sciences and Medicine Bond University, 14 University Drive, Robina, 4226 Queensland Australia.
Bond University · AUUniversity of Indonesia · ID

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute otitis media (AOM) is an acute inflammation of the middle ear commonly found in children, for which antibiotics are frequently prescribed. However, antibiotics are beneficial for only one third of AOM cases, and then, with only modest benefit. Since antibiotic use leads to risk of side effects and resistance, effective alternative treatments are required. Corticosteroids are a candidate because of their anti-inflammatory effects, although evidence of their efficacy and harms is insufficient. Accordingly, we plan a large, rigorous clinical trial to test this. Initially, we will test pre-specified methods and procedures (including the overall process, resources, management, and scientific components) in a pilot study of corticosteroids for AOM, which will inform a future, definitive trial.

methodsThis is a pilot pragmatic, randomised, open-label, single-blind, controlled study of corticosteroids as either monotherapy or an addition to antibiotics in 60 children aged 6 months to 12 years with AOM in two cities (Jakarta and Bekasi) in Indonesia. We will randomise eligible children to prednisolone or control. We will also stratify by disease severity and randomise those with mild AOM to expectant observation plus prednisolone or observation alone and those with severe AOM to prednisolone plus antibiotic or antibiotic alone. Our outcomes are to determine (1) recruitment rates, (2) the success of the study procedures, (3) the ability to measure planned outcomes of the proposed main study, (4) the compliance to study visits and study medication, and (5) verification of the sample size calculation for the main study. We will also assess middle ear effusion using tympanometry as part of a mechanistic sub-study. DISCUSSION: This study will test all procedures in preparation for the main study, including several potential obstacles and challenges from the perspective of participating physicians, nurses, pharmacists, and the parents of eligible children. This information will be useful for developing strategies to overcome practical and procedural issues. This study may also provide information about the effects of corticosteroids on middle ear effusion in AOM.

trial registrationStudy registry number: ACTRN12618000049279. Name of registry: the Australian New Zealand Clinical Trials Registry (ANZCTR). Date of registration: 16 January 2018.

Indexed as

Acute otitis mediaAntibioticsCorticosteroidsMechanistic sub-studyMiddle ear effusionTrial protocolTympanometry

Identifiers

PMID30214821
PMCPMC6130070
OpenAlexW2892356123

What OpenQuestion holds

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Registered trials

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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.