Bundgaard 2021.
Study characteristics | ||
Methods | Investigator‐initiated, nationwide, unblinded, randomised controlled trial stratified by the 5 regions of Denmark | |
Participants | Inclusion criteria: community‐dwelling adults aged 18 years or older without current or prior symptoms or diagnosis of COVID‐19 reported being outside the home amongst others for at least 3 hours per day, and who did not wear masks during their daily work. Exclusion criteria: previously tested positive for SARS‐CoV‐2 and wear face masks at work |
|
Interventions | Exposure: mask (N = 2392) Control group: no mask (N = 2470) Both groups received materials and instructions for antibody testing on receipt and at 1 month; materials and instructions for collecting an oropharyngeal/nasal swab sample for polymerase chain reaction (PCR) testing at 1 month and whenever symptoms compatible with COVID‐19 occurred during follow‐up. They registered symptoms and results of the antibody test in the online REDCap system. Written instructions and instructional videos guided antibody testing, oropharyngeal/nasal swabbing, and proper use of masks, and a help line was available to participants. See Table 4 for details. |
|
Outcomes | Study duration: 1 month Effectiveness: primary outcome (composite) SARS‐CoV‐2 infection, defined as a positive result on an oropharyngeal/nasal swab test for SARS‐CoV‐2, development of a positive SARS‐CoV‐2 antibody test result (IgM or IgG) during the study period, or a hospital‐based diagnosis of SARS‐CoV‐2 infection or COVID‐19. Secondary outcome: PCR evidence of infection with other respiratory viruses Safety: adverse reaction: 14% in mask group (no further descriptions) |
|
Notes | The authors conclude that inconclusive results, missing data, variable adherence, patient‐reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.
Funding: the primary funding source was The Salling Foundations. Disclsure can be viewed at www.acponline.org /authors/icmje/ConflictOfInterestForms.do?msNum=M20‐6817. |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computer algorithm stratified by the 5 regions of Denmark |
Allocation concealment (selection bias) | Unclear risk | Insufficient information reported |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Not blinded |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Not blinded. Patient reported symptoms, POCT testing, patient‐reported findings on home tests. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Participant flow chart showed acceptable attrition |
Selective reporting (reporting bias) | Low risk | All pre‐specified outcomes reported. |