Evidence map›Paper›PMID 30291376›Full record

Trial reportIntensive care medicine2018

Latent class analysis of ARDS subphenotypes: a secondary analysis of the statins for acutely injured lungs from sepsis (SAILS) study.

Pratik Sinha, Kevin L Delucchi, B Taylor Thompson, Daniel F McAuley, Michael A Matthay, Carolyn S Calfee, NHLBI ARDS Network

2 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 216 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
216citing papers in PubMed, 4 pooled it
24.2field-weighted citation impact, top 1% of its field
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.

NCT05311046 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Biomarker-enhanced Artificial Intelligence Based Pediatric Sepsis Screening Tool Towards Early Recognition and Personalized Therapeutics

TypeobservationalSponsorComputer Technology Associates, Inc.Ran2026 to 2029Enrolled12,961ConditionsSepsisArmsPediatric sepsis screening tool (either algorithmic or manual)
NCT07511582 phase2recruitingnot on this mapstarted 2026, after this paper: background citation

Efficacy, Safety, and Tolerability of Methylprednisolone in Critically Ill Patients With the Hyperinflammatory Phenotype: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase II Trial

TypeinterventionalSponsorBin DuRan2026 to 2028Enrolled150ConditionsSepsis, Acute Respiratory Distress SyndromeArmsMethylprednisolone (MP), Placebo
3 · Its place in the literature

Who cites it

216 citing papers in PubMed, 4 syntheses or guidelines pooled it, 356 citations in OpenAlex.

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  3. Between-trial heterogeneity in ARDS research.Intensive care medicine · 2021
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  11. Simvastatin in Critically Ill Patients with Covid-19.The New England journal of medicine · 2023
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156 more citing papers are in PubMed but not listed here.

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

7 authors at 3 institutions in 2 countries.

Pratik SinhaDepartment of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, 505 Parnassus Ave, Box 0111, San Francisco, CA, 94143-0111, USA. pratik.sinha@ucsf.edu.
Kevin L DelucchiDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
B Taylor ThompsonDepartment of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA, USA.
Daniel F McAuleyCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University of Belfast, Belfast, UK.
Michael A MatthayDepartment of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, 505 Parnassus Ave, Box 0111, San Francisco, CA, 94143-0111, USA.
Carolyn S CalfeeDepartment of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, 505 Parnassus Ave, Box 0111, San Francisco, CA, 94143-0111, USA.
NHLBI ARDS Network
University of California, San Francisco · USMassachusetts General Hospital · USUniversity of Ulster · GB

Funding

Precision Medicine in the Acute Respiratory Distress SyndromeR35HL140026 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2018 to 2024
$6.8M
Comprehensive Anesthesia Research TrainingT32GM008440 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Judith Hellman · 1996 to 2026
$5.5M
Molecular Endotypes of ARDS: Identification, Biology, and Differential Response to TherapyR01HL131621 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2016 to 2017
$806k
ARDS Endotypes: Expanded Analysis of Clinical and Biological Phenotypes and Evolution Over TimeK24HL133390 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2016 to 2017
$241k
Medical Research Council MC_G1002460NHLBI NIH HHS HL131621NHLBI NIH HHS HL133390NHLBI NIH HHS HL140026NHLBI NIH HHS K24 HL133390NHLBI NIH HHS R01 HL131621NHLBI NIH HHS R35 HL140026NIGMS NIH HHS T32 GM008440NIH HHS 2T32GM008440-21
6 · The paper itself

Abstract

purposeUsing latent class analysis (LCA), we have consistently identified two distinct subphenotypes in four randomized controlled trial cohorts of ARDS. One subphenotype has hyper-inflammatory characteristics and is associated with worse clinical outcomes. Further, within three negative clinical trials, we observed differential treatment response by subphenotype to randomly assigned interventions. The main purpose of this study was to identify ARDS subphenotypes in a contemporary NHLBI Network trial of infection-associated ARDS (SAILS) using LCA and to test for differential treatment response to rosuvastatin therapy in the subphenotypes.

methodsLCA models were constructed using a combination of biomarker and clinical data at baseline in the SAILS study (n = 745). LCA modeling was then repeated using an expanded set of clinical class-defining variables. Subphenotypes were tested for differential treatment response to rosuvastatin.

resultsThe two-class LCA model best fit the population. Forty percent of the patients were classified as the "hyper-inflammatory" subphenotype. Including additional clinical variables in the LCA models did not identify new classes. Mortality at day 60 and day 90 was higher in the hyper-inflammatory subphenotype. No differences in outcome were observed between hyper-inflammatory patients randomized to rosuvastatin therapy versus placebo.

conclusionsLCA using a two-subphenotype model best described the SAILS population. The subphenotypes have features consistent with those previously reported in four other cohorts. Addition of new class-defining variables in the LCA model did not yield additional subphenotypes. No treatment effect was observed with rosuvastatin. These findings further validate the presence of two subphenotypes and demonstrate their utility for patient stratification in ARDS.

Indexed as

Acute Lung InjuryAdultAgedCohort StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLatent Class AnalysisMaleMiddle AgedRespiratory Distress SyndromeRosuvastatin CalciumSepsisSurvival RateHydroxymethylglutaryl-CoA Reductase InhibitorsRosuvastatin CalciumARDSLatent class analysisStatinsSubphenotypes

Identifiers

PMID30291376
PMCPMC6317524
OpenAlexW2894810674

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.