Methods | Randomised, parallel‐group, open‐label paediatric study conducted in 2 centres in the United Kingdom. Trial conducted between 1981 and 1987 Four treatment arms: carbamazepine, sodium valproate, phenytoin, phenobarbitone |
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Participants | Children with newly‐diagnosed epilepsy (2 or more untreated partial or generalised tonic‐clonic seizures in the 12 months preceding the study) Number randomised: CBZ = 54, PHT = 54 64 children (59%) with partial epilepsy. 59 (55%) boys. Mean age (range): 9 (3 to 16) years Range of follow‐up: 3 to 88 (months) |
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Interventions | Monotherapy with PHT or CBZ. Median daily dose achieved: PHT = 175 mg/day, CBZ = 400 mg/day | |
Outcomes | Time to first seizure recurrence after start of therapy Time to 12‐month remission from all seizures Adverse effects and withdrawals due to adverse events |
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Notes | IPD provided for all randomised participants. All outcomes in this review calculated from IPD Funding: support provided by the Medical Research Council, the Health Promotion Trust, Ciba‐Geigy, Parke‐Davis, and Sanofi Conflicts of interest: None stated |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Randomisation list generated using permuted blocks of size 8 or 16 with stratification for centre, seizure type and presence of neurological signs |
Allocation concealment (selection bias) | Low risk | Allocation concealed via 4 batches of concealed opaque envelopes |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Unblinded; authors state masking of treatment would not be “practicable or ethical” and would “undermine compliance.” Unclear if lack of masking influenced outcome |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Unblinded; authors state masking of treatment would not be “practicable or ethical” and would “undermine compliance.” Unclear if lack of masking influenced outcome |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Attrition rates reported, all randomised participants analysed from IPD provided1 |
Selective reporting (reporting bias) | Low risk | All outcomes reported or calculated with IPD provided1 |
Other bias | Low risk | No other bias detected |