Single-Dose Oral Dexamethasone in the Emergency Management of Children With Exacerbations of Mild to Moderate Asthma
Bibliographic record
Abstract
OBJECTIVE: To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. STUDY DESIGN: A prospective, randomized, double-blinded trial of children 2 to 16 years of age who presented to the emergency department (ED) with acute mild to moderate asthma exacerbations. Subjects received single-dose oral Dex (0.6 mg/kg to a maximum of 18 mg) or oral Pred (1 mg/kg per dose to a maximum of 30 mg) twice daily for 5 days. After discharge, subjects were contacted by telephone at 48 h to assess symptoms and reevaluated in the ED in 5 days. The primary outcome was the number of days needed for Patient Self Assessment Score to return to baseline (score of 0-0.5). MAIN RESULTS: Baseline characteristics of the 2 groups were similar. The mean number of days needed for Patient Self Assessment Score to return to baseline (0-0.5) in the Dex and Pred groups were 5.21 versus 5.22 days, respectively (mean difference, -0.01; confidence interval, -0.70, 0.68). Pulmonary index scores were similar in both groups at initial presentation, initial ED discharge and at the day 5 follow-up visit. At the first visit, mean time to discharge was 3.5 h (+/-1.93)for Dex and 4.3 h (+/-3.67) for Pred (mean difference, -0.8; confidence interval, -1.8, 0.2). Initial admission rate was 9% (Dex) versus 13.4% (Pred). There was no significant difference in the number of salbutamol therapies needed in the ED nor at home after discharge. For subjects discharged home, the admission rate after initial discharge was 4.9% (Dex) versus 1.8% (Pred), resulting in overall hospital admission rates of 13.4% (Dex) and 14.9% (Pred). CONCLUSION: A single dose of oral Dex (0.6 mg/kg) is no worse than 5 days of twice-daily prednisolone (1 mg/kg per dose) in the management of children with mild to moderate asthma.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".