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. 2017 Feb 27;2017(2):CD001911. doi: 10.1002/14651858.CD001911.pub3
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
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)
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
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
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