Eboriadou 2010.

Methods	Randomised double‐blinded controlled trial
Participants	Study period: January 2000 to December 2001 Setting: emergency department at a hospital in Greece Inclusion criteria: children aged 6 months to 5 years presenting to the emergency department with a clinical diagnosis of viral croup by a history of a short period of viral upper respiratory symptoms followed by hoarseness or barking cough and clinical evidence of hoarseness, barking cough, or stridor in the emergency department; modified Downes and Raphaelly croup score ≥ 2; could be managed as outpatients Exclusion criteria: known structural airways anomalies; acute epiglottitis; bacterial tracheitis; pneumonia; foreign body aspiration or past history of laryngoscopy; history of prior intubation; chronic airway obstruction; received steroids in the past 24 hours; required more than 1 treatment with nebulised L‐epinephrine or hospitalisation Baseline characteristics (N = 64): proportion males: treatment 1: 80%; treatment 2: 58%; treatment 3: 65% mean age in years: treatment 1: 2.6; treatment 2: 3.2; treatment 3: 3.4 mean modified Downes and Raphaelly croup score: treatment 1: 5.13; treatment 2: 5.89; treatment 3: 3.95
Interventions	Treatment 1 (N = 25): single 5 mL (1:1000 mg/mL) dose of nebulised L‐epinephrine via nebuliser with oxygen at a rate of 5 L/minute Treatment 2 (N = 19): single 0.60 mg/kg (maximum 8 mg) dose of intramuscular dexamethasone Treatment 3 (N = 20): single 200 µg dose of inhaled beclomethasone dipropionate delivered via AeroChamber device Supplemental oxygen was used for children with oxygen saturation values < 95%.
Outcomes	Change in modified Downes and Raphaelly croup score from baseline to 2 hours; return visits to the emergency department
Notes	Funding source: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "patients were assigned by a random numbers table to receive..."
Allocation concealment (selection bias)	Unclear risk	Comment: insufficient information provided to judge.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: described as "double‐blind", though the interventions were clearly distinguishable, and the mechanism of blinding was not described
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: no description of a third‐party outcome assessor. Carried over judgement from blinding of participants and personnel
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: no missing outcome data
Selective reporting (reporting bias)	Unclear risk	Comment: no protocol identified. All prespecified outcomes from methods appear in results.
Other bias	Low risk	Comment: no other sources of bias identified.
Overall risk of bias All outcomes	High risk	Comment: at least 1 domain judged as high risk.