Randomised control trials for delirium: Current evidence and statistical methods

Controlled trials of delirium

“…We agree with the observation of Tahir et al [1] that a placebo controlled trial published by their group was missed in the introduction section of the paper. The trial of Hu et al [3] had a control group besides the 2 active groups, i.e., a haloperidol group and an olanzapine group.…”

“…We are thankful to Tahir et al [1] for their interest in our paper in which we described a randomised controlled trial (RCT) that compared olanzapine, risperidone and haloperidol for treatment of delirium in a general hospital setting [2]. We agree with the observation of Tahir et al [1] that a placebo controlled trial published by their group was missed in the introduction section of the paper.…”

“…The control group did not receive any antipsychotic medication. Regarding 2 other trials pointed out by Tahir et al [1], it should be understood that our background information was limited to the data with respect to antipsychotic and not for rivastigmine. Further the study by Kim et al [4], was included in our background information as a trial comparing 2 antipsychotics.…”

“…Regarding the use of statistical methods, suggestions of Tahir et al [1] to use various models to overcome the missing data and trajectories to measure time to first delirium resolution are well taken. However, the authors themselves suggest the limitation of the trajectories at present due lack of standardised definition of delirium resolution.…”

Delirium

“…29 To date there are only three published placebo-controlled RCTs for treatment of delirium using antipsychotics, 30,35,36 only one of which took place in a general hospital setting. 37 Appropriate dosages, based on information from various RCTs, are presented in Table 3. A daily review for the first week is required to monitor progress ( Figure 1).…”