Effect of Intraarrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Invasive Treatment : A Post Hoc Bayesian Reanalysis of a Randomized Clinical Trial

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F24%3A10479898" target="_blank" >RIV/00064165:_____/24:10479898 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/24:10479898 RIV/00216208:11320/24:10479898

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=cGWolPDD7m" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=cGWolPDD7m</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.chest.2023.07.030" target="_blank" >10.1016/j.chest.2023.07.030</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Effect of Intraarrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Invasive Treatment : A Post Hoc Bayesian Reanalysis of a Randomized Clinical Trial

Popis výsledku v původním jazyce

Evidence for the effect of extracorporeal cardiopulmonary resuscitation (ECPR) from randomized controlled trials (RCTs) on survival with a favorable neurologic outcome is inconclusive. The Prague Out-of-Hospital Cardial Arrest study was an RCT evaluating the use of an invasive strategy, including early intraarrest transport, ECPR, and immediate invasive management to standard resuscitation in refractory out-of-hospital cardiac arrest. The study enrolled 256 patients with a median age of 58 years, 83% were men, and the median time of resuscitation was 52.5 min. The primary outcome of 180 days&apos; survival with a favorable neurologic outcome (cerebral performance category 1 or 2) was reached in 31.5% of patients in the invasive strategy group and 22.0% of patients in the standard resuscitation strategy group (OR, 1.63; 95% CI, 0.93-2.85; absolute difference, 9.5%; 95% CI, -1.3% to 20.1%; P = .09). This difference was not statistically significant using the frequentist approach, and the primary outcome result was interpreted as neutral. An unreasonable, simplistic, yet common, practice is to label a trial as either positive or negative based on a difference in the primary outcome evaluated by a P value threshold of .05. Bayesian analysis may provide a comprehensive view of the data, especially when the benefits of an intervention are uncertain. Therefore, we performed a previously unplanned Bayesian reanalysis of the prespecified primary outcome while adhering to the intention to treat principle.

Název v anglickém jazyce

Effect of Intraarrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Invasive Treatment : A Post Hoc Bayesian Reanalysis of a Randomized Clinical Trial

Popis výsledku anglicky

Evidence for the effect of extracorporeal cardiopulmonary resuscitation (ECPR) from randomized controlled trials (RCTs) on survival with a favorable neurologic outcome is inconclusive. The Prague Out-of-Hospital Cardial Arrest study was an RCT evaluating the use of an invasive strategy, including early intraarrest transport, ECPR, and immediate invasive management to standard resuscitation in refractory out-of-hospital cardiac arrest. The study enrolled 256 patients with a median age of 58 years, 83% were men, and the median time of resuscitation was 52.5 min. The primary outcome of 180 days&apos; survival with a favorable neurologic outcome (cerebral performance category 1 or 2) was reached in 31.5% of patients in the invasive strategy group and 22.0% of patients in the standard resuscitation strategy group (OR, 1.63; 95% CI, 0.93-2.85; absolute difference, 9.5%; 95% CI, -1.3% to 20.1%; P = .09). This difference was not statistically significant using the frequentist approach, and the primary outcome result was interpreted as neutral. An unreasonable, simplistic, yet common, practice is to label a trial as either positive or negative based on a difference in the primary outcome evaluated by a P value threshold of .05. Bayesian analysis may provide a comprehensive view of the data, especially when the benefits of an intervention are uncertain. Therefore, we performed a previously unplanned Bayesian reanalysis of the prespecified primary outcome while adhering to the intention to treat principle.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30221 - Critical care medicine and Emergency medicine

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Chest

ISSN

0012-3692

e-ISSN

1931-3543

Svazek periodika

165

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

3

Strana od-do

368-370

Kód UT WoS článku

001171810100001

EID výsledku v databázi Scopus

2-s2.0-85174687454