Keh 2003.

Methods	Randomized controlled trial with cross‐over design 1 centre Dates study was conducted: from March 1997 through September 2000
Participants	Adults (n = 40) with vasopressor‐dependent septic shock Setting: intensive care unit Study location: Germany
Interventions	Hydrocortisone (100‐mg 30‐minute intravenous infusion followed by 10 mg/h continuous infusion for 3 days) Placebo All participants received hydrocortisone for 3 days preceded or followed by placebo for 3 days
Outcomes	Primary Immune response Secondary Improvement in haemodynamics and organ system failure Safety
Notes	We contacted study authors and obtained access to individual patient data Funding sources: Deutsche Forschungsgemeinschaft (expenses for analytes) and Pharmacia/Upjohn (expenses for patients’ insurance) Data were extracted by DA Risk of bias was assessed by DA and BR
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated randomization scheme
Allocation concealment (selection bias)	Low risk	Randomization list kept confidential by the pharmacist
Blinding (performance bias and detection bias) All outcomes	Low risk	Participants: yes Caregivers: yes Data collectors: yes Outcome assessors: yes Data analysts: yes
Incomplete outcome data (attrition bias) All outcomes	Low risk	Lost to follow‐up: none
Selective reporting (reporting bias)	Low risk	Access to study protocol
Other bias	Low risk	Full access to data including screening log