Mortality in Multicenter Critical Care Trials

医学 致盲 随机对照试验 心理干预 样本量测定 梅德林 临床试验 概化理论 数据监测委员会 随机化 内科学 精神科 政治学 数学 统计 法学
作者
Giovanni Landoni,Marco Comis,Massimiliano Conte,Gabriele Finco,Marta Mucchetti,Gianluca Paternoster,Antonio Pisano,Laura Ruggeri,Gabriele Alvaro,Manuela Angelone,P Bergonzi,Speranza Bocchino,Giovanni Borghi,Tiziana Bove,Giuseppe Buscaglia,Luca Cabrini,Lino Callegher,Fabio Caramelli,Sergio Colombo,Laura Corno,Paolo Del Sarto,Paolo Feltracco,Alessandro Forti,Marco Ganzaroli,Massimiliano Greco,Fabio Guarracino,Rosalba Lembo,Rosetta Lobreglio,Roberta Meroni,Fabrizio Monaco,Mario Musu,Giovanni Pala,Laura Pasin,Marina Pieri,Stefania Pisarra,Giuseppe Ponticelli,Agostino Roasio,Francesco Santini,Simona Silvetti,Andrea Székely,Massimo Zambon,Martina Zucchetti,Alberto Zangrillo,Rinaldo Bellomo
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
卷期号:43 (8): 1559-1568 被引量:79
标识
DOI:10.1097/ccm.0000000000000974
摘要

Objectives: We aimed to identify all treatments that affect mortality in adult critically ill patients in multicenter randomized controlled trials. We also evaluated the methodological aspects of these studies, and we surveyed clinicians’ opinion and usual practice for the selected interventions. Data Sources: MEDLINE/PubMed, Scopus, and Embase were searched. Further articles were suggested for inclusion from experts and cross-check of references. Study Selection: We selected the articles that fulfilled the following criteria: publication in a peer-reviewed journal; multicenter randomized controlled trial design; dealing with nonsurgical interventions in adult critically ill patients; and statistically significant effect in unadjusted landmark mortality. A consensus conference assessed all interventions and excluded those with lack of reproducibility, lack of generalizability, high probability of type I error, major baseline imbalances between intervention and control groups, major design flaws, contradiction by subsequent larger higher quality trials, modified intention to treat analysis, effect found only after adjustments, and lack of biological plausibility. Data Extraction: For all selected studies, we recorded the intervention and its comparator, the setting, the sample size, whether enrollment was completed or interrupted, the presence of blinding, the effect size, and the duration of follow-up. Data Synthesis: We found 15 interventions that affected mortality in 24 multicenter randomized controlled trials. Median sample size was small (199 patients) as was median centers number (10). Blinded trials enrolled significantly more patients and involved more centers. Multicenter randomized controlled trials showing harm also involved significantly more centers and more patients (p = 0.016 and p = 0.04, respectively). Five hundred fifty-five clinicians from 61 countries showed variable agreement on perceived validity of such interventions. Conclusions: We identified 15 treatments that decreased/increased mortality in critically ill patients in 24 multicenter randomized controlled trials. However, design affected trial size and larger trials were more likely to show harm. Finally, clinicians view of such trials and their translation into practice varied.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
寒梅恋雪完成签到,获得积分10
1秒前
自觉的凛完成签到,获得积分10
1秒前
天天快乐应助源来是洲董采纳,获得10
1秒前
75986686完成签到,获得积分10
2秒前
4秒前
学好久完成签到 ,获得积分10
5秒前
a24017完成签到,获得积分10
8秒前
YG完成签到,获得积分10
9秒前
yue完成签到,获得积分10
13秒前
淼队完成签到,获得积分10
14秒前
14秒前
落叶解三秋完成签到,获得积分10
15秒前
Crystal完成签到 ,获得积分10
18秒前
小小酥完成签到,获得积分10
18秒前
等待蚂蚁完成签到 ,获得积分10
19秒前
zgt01发布了新的文献求助10
19秒前
心心完成签到 ,获得积分10
20秒前
123完成签到,获得积分10
21秒前
温超完成签到,获得积分10
21秒前
量子星尘发布了新的文献求助10
21秒前
22秒前
23秒前
Menta1y完成签到,获得积分10
23秒前
czzlancer完成签到,获得积分10
24秒前
汶溢完成签到,获得积分10
24秒前
xsss完成签到,获得积分10
25秒前
TAN完成签到,获得积分10
25秒前
通通通发布了新的文献求助10
26秒前
liudw完成签到,获得积分10
26秒前
丹丹子完成签到 ,获得积分10
27秒前
时光完成签到,获得积分10
27秒前
28秒前
充电宝应助vsvsgo采纳,获得10
30秒前
123完成签到 ,获得积分10
32秒前
Ammr完成签到 ,获得积分10
32秒前
无限的依波完成签到,获得积分10
32秒前
姽婳wy发布了新的文献求助10
33秒前
lemon完成签到,获得积分10
33秒前
传奇3应助duckspy采纳,获得30
34秒前
陈木木完成签到,获得积分10
35秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038235
求助须知:如何正确求助?哪些是违规求助? 3575992
关于积分的说明 11374009
捐赠科研通 3305760
什么是DOI,文献DOI怎么找? 1819276
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022