Vecht 1989.

Study characteristics
Methods	Randomised, multi‐centre controlled trial Study duration: 1 week
Participants	37 participants (22 high‐dose, 15 low‐dose) with metastatic spinal cord compression (SCC)
Interventions	High‐dose: 100 mg dexamethasone dissolved in glycerol and water Low‐dose: 10 mg dexamethasone dissolved in glycerol and water, both delivered immediately following diagnosis of SCC by myelography
Outcomes	NRS for pain (0 to 10) Ambulatory status (grade 1, walking independently – grade 5, no power in legs) Bladder function
Notes	High‐dose versus low‐dose dexamethasone plus radiotherapy for SCC No difference seen in pain, ambulation or bladder function
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised Not specified how the random sequence was generated 22 patients received high‐dose and 15 low‐dose (no explanation given)
Allocation concealment (selection bias)	Low risk	Coded ampoules blindly administered
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Code broken by statistician at final analysis
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Code broken by statistician at final analysis
Incomplete outcome data (attrition bias) All outcomes	Low risk	40 patients randomised, 3 had insufficient data for analysis
Selective reporting (reporting bias)	Low risk	None detected
Other bias	High risk	Sample size: 37 participants; < 50 participants per treatment arm