SynthesisCritical care (London, England)2017
Effect sizes in ongoing randomized controlled critical care trials.
Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Research without prior consent procedure and intervention effect on mortality in critical care: a meta-epidemiological study of randomized controlled trials.Critical care (London, England) · 2025Pooled it
- Major Publications in the Critical Care Pharmacotherapy Literature: 2022.Critical care explorations · 2023Pooled it
- Haloperidol for the treatment of delirium in critically ill patients: an updated systematic review with meta-analysis and trial sequential analysis.Critical care (London, England) · 2023Pooled it
- Haloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID-ICU trial.Intensive care medicine · 2023Trial
- Simulation study of frailty as a baseline confounder: the need to improve reporting intensive care trials.Critical care (London, England) · 2026Review
- Sample size requirements and intra-cluster correlations for stepped wedge cluster randomised trials in intensive care medicine: A practical guide.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Insights into systematic reviews and meta-analyses: Are we judgmental enough?German medical science : GMS e-journal · 2026Review
- INCEPT: The Intensive Care Platform Trial-Design and protocol.Acta anaesthesiologica Scandinavica · 2025Article
- The importance of plausibility.Intensive care medicine · 2023Article
- Causal inference for planning randomised critical care trials: Protocol for a scoping review.Acta anaesthesiologica Scandinavica · 2022Article
- Agents intervening against delirium in the intensive care unit trial-Protocol for a secondary Bayesian analysis.Acta anaesthesiologica Scandinavica · 2022Article
- Randomised clinical trials in critical care: past, present and future.Intensive care medicine · 2022Review
- Higher vs Lower Doses of Dexamethasone in Patients with COVID-19 and Severe Hypoxia (COVID STEROID 2) trial: Protocol for a secondary Bayesian analysis.Acta anaesthesiologica Scandinavica · 2021Article
- Powering Bias and Clinically Important Treatment Effects in Randomized Trials of Critical Illness.Critical care medicine · 2020Article
- Opportunities and challenges of clustering, crossing over, and using registry data in the PEPTIC trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2020Article
- Vasopressin in septic shock: what we know and where to next?Intensive care medicine · 2019Article
- Are systematic reviews and meta-analyses still useful research? We are not sure.Intensive care medicine · 2018Article
- Designing and Evaluating Bayesian Advanced Adaptive Randomised Clinical Trials: A Practical Guide.Pharmaceutical statisticsArticle
- Effects of duration of follow-up and lag in data collection on the performance of adaptive clinical trials.Pharmaceutical statisticsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn important limitation of many critical care trial designs is that they hypothesize large, and potentially implausible, reductions in mortality. Interpretation of trial results could be improved by systematic assessment of the plausibility of trial hypotheses; however, such assessment has not been attempted in the field of critical care medicine. The purpose of this study was to determine clinicians' views about prior probabilities and plausible effect sizes for ongoing critical care trials where the primary endpoint is landmark mortality.
methodsWe conducted a systematic review of clinical trial registries in September 2015 to identify ongoing critical care medicine trials where landmark mortality was the primary outcome, followed by a clinician survey to obtain opinions about ten large trials. Clinicians were asked to estimate the probability that each trial would demonstrate a mortality effect equal to or larger than that used in its sample size calculations.
resultsEstimates provided by individual clinicians varied from 0% to 100% for most trials, with a median estimate of 15% (IQR 10-20%). The median largest absolute mortality reduction considered plausible was 4.5% (IQR 3.5-5%), compared with a median absolute mortality reduction used in sample size calculations of 5% (IQR 3.6-10%) (P = 0.27).
conclusionsFor some of the largest ongoing critical care trials, many clinicians regard prior probabilities as low and consider that plausible effects on absolute mortality are less than 5%. Further work is needed to determine whether pooled estimates obtained by surveying clinicians are replicable and accurate or whether other methods of estimating prior probability are preferred.
Indexed as
Identifiers
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.