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. 2020 Apr 6;2020(4):CD004198. doi: 10.1002/14651858.CD004198.pub4

Serjeant 1985.

Methods Double‐blind, placebo‐controlled cross‐over trial, with two 14‐day treatment periods. Allocation concealment and method of randomisation was unclear.
Participants 11 males with stuttering priapism and homozygous sickle cell (SS) disease were randomised. 9 completed the trial, 1 participant defaulted after baseline and 1 participant had a painful crisis which aborted the priapism before any tablets were taken. Participants came from the sickle cell clinic of the University Hospital of the West Indies, Kingston, Jamaica.
Interventions Stilboestrol 5 mg daily versus placebo.
Outcomes Reduction in frequency of stuttering priapism. Return of priapism.
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not described.
Allocation concealment (selection bias) Unclear risk Not described.
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Described as double blind.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Not described if outcome assessors were blinded.
Incomplete outcome data (attrition bias) 
 All outcomes Unclear risk 1 participant defaulted, and in two participants the attacks of stuttering priapism ceased spontaneously during the baseline observation period. There was a fourth participant who initially did not take the placebo because a painful crisis aborted the stuttering priapism prior to taking the assigned tablet. In this participant (identified as patient 9) attacks of priapism recurred 2 weeks later and data on a second baseline period were collected.
The paper did not discuss an ITT analysis.
Selective reporting (reporting bias) Low risk No protocol available therefore outcomes reported in the results section against the methods section of the paper; no discrepancies found.
Other bias Low risk None identified.

BP: blood pressure
 ITT: intention‐to‐treat
 SCD: sickle cell disease