Evidence map›Paper›PMID 14734433›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2004

Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT).

Claudio M Martin, Gordon S Doig, Daren K Heyland, Teresa Morrison, William J Sibbald, Southwestern Ontario Critical Care Research Network

3 registry-linked trialsAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 89 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02740205 nacompletednot on this mapstarted 2014, after this paper: background citation

Efficacy and Safety of the Implementation of an Algorithm for Enteral Nutrition Support Compared With Traditional Practice in Non-critical Patients: Randomized Clinical Trial, Simple Blind.

TypeinterventionalSponsorInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranRan2014 to 2020Enrolled90ConditionsMalnutritionArmsAlgorithm for enteral nutrition support
NCT03442946 completednot on this mapstarted 2018, after this paper: background citation

International Nutrition Survey 2018

TypeobservationalSponsorRWTH Aachen UniversityRan2018 to 2019Enrolled280ConditionsCardiovascular Surgery
NCT04242966 phase3withdrawnnot on this mapstarted 2020, after this paper: background citation

The Effect of Higher Protein Dosing in Critically Ill Patients: A Multicenter Registry-based Randomized Trial: The EFFORT Ultrasound a Sub-study

TypeinterventionalSponsorClinical Evaluation Research Unit at Kingston General HospitalRan2020 to 2022Enrolled0ConditionsCritical Illness, MalnutritionArmsUsual Care, Higher Protein/Amino Acid Group, Ultrasound measure
3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  5. Nutrition support in hospitalised adults at nutritional risk.The Cochrane database of systematic reviews · 2017
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  19. Effectiveness of disseminating consensus management recommendations for ulcer bleeding: a cluster randomized trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2013
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29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Claudio M MartinDepartment of Medicine, Faculty of Medicine, University of Western Ontario, London, Ont. drcm@rogers.com
Gordon S Doig
Daren K Heyland
Teresa Morrison
William J Sibbald
Southwestern Ontario Critical Care Research Network

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe provision of nutritional support for patients in intensive care units (ICUs) varies widely both within and between institutions. We tested the hypothesis that evidence-based algorithms to improve nutritional support in the ICU would improve patient outcomes.

methodsA cluster-randomized controlled trial was performed in the ICUs of 11 community and 3 teaching hospitals between October 1997 and September 1998. Hospital ICUs were stratified by hospital type and randomized to the intervention or control arm. Patients at least 16 years of age with an expected ICU stay of at least 48 hours were enrolled in the study (n = 499). Evidence-based recommendations were introduced in the 7 intervention hospitals by means of in-service education sessions, reminders (local dietitian, posters) and academic detailing that stressed early institution of nutritional support, preferably enteral.

resultsTwo hospitals crossed over and were excluded from the primary analysis. Compared with the patients in the control hospitals (n = 214), the patients in the intervention hospitals (n = 248) received significantly more days of enteral nutrition (6.7 v. 5.4 per 10 patient-days; p = 0.042), had a significantly shorter mean stay in hospital (25 v. 35 days; p = 0.003) and showed a trend toward reduced mortality (27% v. 37%; p = 0.058). The mean stay in the ICU did not differ between the control and intervention groups (10.9 v. 11.8 days; p = 0.7).

interpretationImplementation of evidence-based recommendations improved the provision of nutritional support and was associated with improved clinical outcomes.

Indexed as

Nutritional SupportAdolescentAdultAgedAlgorithmsAPACHECluster AnalysisCritical CareEnteral NutritionEvidence-Based MedicineFemaleHospital MortalityHumansIntensive Care UnitsMaleMiddle Aged

Identifiers

PMID14734433
PMCPMC315525

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.