I'm a general pediatrician with interest in EBM since few months. I'm studying an article on
NEJM 2009 "Preemptive Use of High-Dose Fluticasone for Virus-Induced Wheezing in Young
Children" by Francine Ducharme et altr. In this study ( see slide attached) 48/129 patient
were non adherent to study protocol equivalent at 37%. We have patient who" discontinued
study drugs" 35/129 and patient who "discontinued study "( lost at follow-up ) 9/129. I
know the "rule of the thumb" to consider the limit of 20% for lost at follow up, but if the
adherence to protocol (people who discontinued study drugs) were so high the study is still
valid? Anyway even if the final result is clinically and statistically significant...can i transfer
in to my clinical practice these results, if , like in this study 37% of randomized are't
adherent ?
Thank you in advance for ...your patience and for your answer
Giovanni Simeone
General Pediatrician
National Health Service
Brindisi- Italy
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