Glucocorticoids for the treatment of anaphylaxis
Bibliographic record
Abstract
Abstract Background Anaphylaxis is a serious hypersensitivity reaction that is rapid in onset and may result in death. Anaphylaxis guidelines recommend glucocorticoids for the treatment of people experiencing anaphylaxis. Objectives We sought to assess the benefits and harms of glucocorticoid treatment during episodes of anaphylaxis. Search methods In our previous version we searched the literature until September 2009. In this version we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library2011, Issue 3), MEDLINE (Ovid) (1956 to September 2011), EMBASE (Ovid) (1982 to September 2011), CINAHL (EBSCOhost) (to September 2011). We also searched the UK National Research Register and websites listing ongoing trials, and contacted international experts in anaphylaxis in an attempt to locate unpublished material. Selection criteria We planned to include randomized and quasi‐randomized controlled trials comparing glucocorticoids with any control (either placebo, adrenaline (epinephrine), an antihistamine, or any combination of these). Data collection and analysis Two authors independently assessed articles for inclusion. Main results We found no studies that satisfied the inclusion criteria. Authors' conclusions We are, based on this review, unable to make any recommendations for the use of glucocorticoids in the treatment of anaphylaxis. Glucocorticoids for the treatment of anaphylaxis Anaphylaxis is a serious allergic reaction that is rapid in onset and may result in death. It is commonly triggered by a food, insect sting, medication, or natural rubber latex. The reaction typically occurs without warning and can be a frightening experience both for those at risk and their families and friends. Steroids (glucocorticoids) are often recommended for use in the management of people experiencing anaphylaxis. However, the evidence base in support of the use of steroids is unclear. We therefore conducted a systematic review of the literature, searching key databases for high quality published and unpublished material on the use of steroids for the emergency treatment of anaphylaxis. In addition, we contacted experts in this health area and the relevant pharmaceutical companies. We were unable to find any randomized controlled trials on this subject through our searches. We conclude that there is no evidence from high quality studies for the use of steroids in the emergency management of anaphylaxis. Therefore, we can neither support nor refute the use of these drugs for this purpose.
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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 | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.002 |
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".