Evidence map›Paper›PMID 27134138›Full record

Observational studyJournal of clinical epidemiology2016

Recurrent event frailty models reduced time-varying and other biases in evaluating transfusion protocols for traumatic hemorrhage.

Sangbum Choi, Mohammad H Rahbar, Jing Ning, Deborah J Del Junco, Elaheh Rahbar, Chuan Hong, Jin Piao, Erin E Fox, John B Holcomb

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of clinical epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sangbum ChoiDivision of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building, Suite 1100.05, Houston, TX 77030, USA; Department of Statistics, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
Mohammad H RahbarDivision of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building, Suite 1100.05, Houston, TX 77030, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Sciences Center at Houston, 1200 Pressler Street, Houston, TX 77030, USA. Electronic address: mohammad.h.rahbar@uth.tmc.edu.
Jing NingDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit Number: 1411, Houston, TX 77030, USA.
Deborah J Del JuncoCenter for Translational Injury Research, Division of Acute Care Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building, Houston, TX 77030, USA.
Elaheh RahbarDepartment of Biomedical Engineering, Wake Forest University Health Sciences, 575 N. Patterson Ave., Suite 120, Winston-Salem, NC 27101, USA.
Chuan HongDepartment of Biostatistics, School of Public Health, The University of Texas Health Sciences Center at Houston, 1200 Pressler Street, Houston, TX 77030, USA.
Jin PiaoDepartment of Biostatistics, School of Public Health, The University of Texas Health Sciences Center at Houston, 1200 Pressler Street, Houston, TX 77030, USA.
Erin E FoxCenter for Translational Injury Research, Division of Acute Care Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building, Houston, TX 77030, USA.
John B HolcombCenter for Translational Injury Research, Division of Acute Care Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building, Houston, TX 77030, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
U OF TEXAS HLTH SCI CTR HOUSTON CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCESUL1RR024148 · NCRR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2006 to 2010
$27.9M
Center for Clinical and Translational Sciences (CCTS)UL1TR000371 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$13.4M
Statistical Methodology Development in Blood Transfusion Protocol ResearchR21HL109479 · NHLBI · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI NING, JING, RAHBAR, MOHAMMAD HOSSEIN · 2013 to 2014
$418k
NCATS NIH HHS UL1 TR000371NCI NIH HHS P30 CA016672NCRR NIH HHS UL1 RR024148NHLBI NIH HHS R21 HL109479
6 · The paper itself

Abstract

objectiveTransfusion research seeks to improve survival for severely injured and hemorrhaging patients using optimal plasma and platelet ratios over red blood cells (RBCs). However, most published studies comparing different ratios are plagued with serious bias and ignore time-varying effects. We applied joint recurrent event frailty models to increase validity and clinical utility. STUDY DESIGN AND

settingUsing the PRospective Observational Multicenter Major Trauma Transfusion study data, our joint random-effects models estimated the association of (1) clinical covariates with transfusion rate intensities and (2) varying plasma:RBC and platelet:RBC ratios with survival over the 24 hours after hospital admission. Along with survival time, baseline patient vital signs, laboratory values, and longitudinal data on types and volumes of transfusions were included.

resultsBaseline systolic blood pressure, heart rate, pH, and hemoglobin were significantly associated with RBC transfusion rates. Increased transfusion rates (per hour) of plasma (P = 0.05), platelets (P < 0.001), or RBCs were associated with increased 24-hour mortality. Higher ratios of plasma:RBC (P = 0.107) and platelet:RBC (P < 0.001) were associated with reduced mortality in a time-varying pattern (P < 0.001).

conclusionsThe proposed joint analysis of transfusion rates and ratios offers a more valid statistical approach to evaluate survival effects in the presence of informative censoring by early death.

Indexed as

Blood TransfusionPractice Guidelines as TopicBiasHemorrhageHumansModels, StatisticalProspective StudiesReproducibility of ResultsTimeWounds and InjuriesHemorrhageJoint modelingMultivariate recurrent eventsSurvival analysisTransfusion ratioTrauma

Identifiers

PMID27134138
PMCPMC5086300

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Registered trials

None linked

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.