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Acta Anaesthesiol Scand · Sep 2019
Effects of simulated sample sizes on mortality estimates-Protocol for a study in 3 randomised ICU trials.
- A Kofoed, A Perner, S Marker, N Haase, L B Holst, and M H Møller.
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- Acta Anaesthesiol Scand. 2019 Sep 1; 63 (8): 1098-1101.
BackgroundAn increasing number of trials are stopped earlier than originally planned. It has been suggested that trials stopped pre-maturely overestimate the treatment effect. With the outlined observational study, we aim to simulate the results of stopping trials before they reach their planned sample size to assess the effects on mortality estimates.Methods And StatisticsBased on 3 international, randomised clinical trials (RCTs) in critical care: Scandinavian Starch for Severe Sepsis and Septic Shock (6S) trial, the Transfusion Requirements in Septic Shock (TRISS) trial and the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial, we will estimate relative risks with 95% confidence intervals for the primary outcome 90-day mortality after the inclusion of each individual patient in each RCT. This will be presented graphically with the primary outcome as a function of the number of included patients.DiscussionThe outlined study will provide important knowledge about the effects of stopping critical care trials early. This may have important implications for patients, relatives, clinicians, researchers, guideline committee members and policy makers.Ethics And DisseminationWe will use data from consenting patients enrolled in RCTs approved by the relevant ethical committees; this study requires no further permissions. We will report the results in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and submit the final approved manuscript to a peer-reviewed journal.© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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