Table 4 Comparisons of published meta-analyses

Adhikari et al.(2004) [9]

Three RCTs

Early high-dose corticosteroids had no effect on early mortality. Corticosteroids given for late phase ARDS reduced hospital mortality.

Study interest not focused on corticosteroids; few studies and small sample size.

Agarwal et al. (2007) [10]

Four RCTs and two cohort studies

Current evidence does not support a role for corticosteroids in the management of ARDS in either the early or late stages of the disease.

Excluding the RCTs of preventive use of corticosteroids; including high-dose corticosteroid study.

Peter et al. (2008) [11]

Nine RCTs (eight RCTs for mortality analysis)

A definitive role of corticosteroids in the treatment of ARDS in adults is not established.

Including the RCTs of preventive use of corticosteroids; excluding pneumonia studies; using Bayesian random effects models for data pooling.

Tang et al. (2009) [12]

Four RCTs (three ARDS studies and one pneumonia study) and five cohort studies

The use of low-dose corticosteroids was associated with improved mortality and morbidity outcomes without increased adverse reactions.

Including a RCT of pneumonia; excluding studies of high-dose and preventive use of corticosteroids.

Lamontagne et al. (2010) [13]

Twelve RCTs (six ARDS studies and six pneumonia studies)

Corticosteroids administered within 14 days of disease onset may reduce all-cause mortality.

Including six studies of pneumonia.