ArticleCritical care (London, England)2014
Intravenous immunoglobulin for severe sepsis and septic shock: clinical effectiveness, cost-effectiveness and value of a further randomised controlled trial.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Health Economic Evaluations in Intensive Care: An Updated Systematic Review.Critical care explorations · 2025Pooled it
- Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis.Journal of translational medicine · 2023Pooled it
- The Efficacy of IgM-Enriched Immunoglobulin (eIg) Administration for Treatment of Sepsis and Septic Shock in Adult Surgical Patients: A Single-Center, Retrospective, Observational Study.Journal of clinical medicine · 2026Article
- Plasma proteomics identifies molecular subtypes in sepsis.Critical care (London, England) · 2025Article
- The hexapeptide functionalized gold nanoparticles protect against sepsis-associated encephalopathy by forming specific protein corona and regulating macrophage activation.Materials today. Bio · 2025Article
- Review
- Using a scenario approach to assess for the current and future demand of immunoglobulins: An interview and literature study from The Netherlands.Transfusion medicine (Oxford, England) · 2022Review
- Epidemiology of intravenous immune globulin in septic shock: a retrospective cohort analysis of the Premier Healthcare Database.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Intravenous immune globulin in septic shock: a Canadian national survey of critical care medicine and infectious disease specialist physicians.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Health economic evaluations of sepsis interventions in critically ill adult patients: a systematic review.Journal of intensive care · 2020Article
- Targeting the Blood-Brain Barrier to Prevent Sepsis-Associated Cognitive Impairment.Journal of central nervous system disease · 2019Review
- Immune therapy in sepsis: Are we ready to try again?Journal of the Intensive Care Society · 2018Review
- The HIV Cure Research Agenda: The Role of Mathematical Modelling and Cost-Effectiveness Analysis.Journal of virus eradicationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
introductionPrior to investing in a large, multicentre randomised controlled trial (RCT), the National Institute for Health Research in the UK called for an evaluation of the feasibility and value for money of undertaking a trial on intravenous immunoglobulin (IVIG) as an adjuvant therapy for severe sepsis/septic shock.
methodsIn response to this call, this study assessed the clinical and cost-effectiveness of IVIG (using a decision model), and evaluated the value of conducting an RCT (using expected value of information (EVI) analysis). The evidence informing such assessments was obtained through a series of systematic reviews and meta-analyses. Further primary data analyses were also undertaken using the Intensive Care National Audit & Research Centre Case Mix Programme Database, and a Scottish Intensive Care Society research study.
resultsWe found a large degree of statistical heterogeneity in the clinical evidence on treatment effect, and the source of such heterogeneity was unclear. The incremental cost-effectiveness ratio of IVIG is within the borderline region of estimates considered to represent value for money, but results appear highly sensitive to the choice of model used for clinical effectiveness. This was also the case with EVI estimates, with maximum payoffs from conducting a further clinical trial between £ 137 and £ 1,011 million.
conclusionsOur analyses suggest that there is a need for a further RCT. Results on the value of conducting such research, however, were sensitive to the clinical effectiveness model used, reflecting the high level of heterogeneity in the evidence base.
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What OpenQuestion holds
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.