Sumarmo 1982

Methods	Study design: randomized controlled trial Study dates: February 1978 to May 1979 Diagnostics: clinical and serological or virological: Haemagluttinin Inhibition (HI) test on acute and convalescent paired sera, technique of Clarke and Casals. Virus isolation by mosquito inoculation, technique of Rose and Gubler for patients with a fourfold increase of the HI antibody titre or patients who died.
Participants	Number of participants: randomized: 97 enrolled (47 in corticosteroid group; 50 in placebo group) Age: 0.9 to 10 years Inclusion criteria: children with serologically confirmed dengue shock syndrome Exclusions: not specified
Interventions	1. Hydrocortisone hemisuccinate: 50 mg/kg, single intravenous dose in addition to fluid replacement 2. Placebo: sodium chloride 0.9% with same colour and turbidity
Outcomes	1. Death 2. Duration of shock 3. Requirement of fluid replacement (mL)
Notes	Location: Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia Transmission: not specified Funding: WHO Project ICPRPD 001
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "divided group using a simple random assignment method", no more detail about the method of sequence generation
Allocation concealment (selection bias)	Unclear risk	Not specified
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "Double blind" and "Placebo packaged in indistinguishable coded vials"
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not specified
Incomplete outcome data (attrition bias) All outcomes	Low risk	No losses to follow‐up were reported
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting
Other bias	Low risk	No other bias identified