ArticleIntensive care medicine2020
Contemporary strategies to improve clinical trial design for critical care research: insights from the First Critical Care Clinical Trialists Workshop.
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04663555 (Effect of Dexamethasone in Patients With ARDS and COVID-19 - Prospective, Multi-centre, Open-label, Parallel-group, Randomized Controlled Trial), which is not on this map. Cited by 41 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.
Effect of Dexamethasone in Patients With ARDS and COVID-19 - Prospective, Multi-centre, Open-label, Parallel-group, Randomized Controlled Trial (REMED Trial)
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Challenges and Recommendations for Integrating Circadian Medicine in Critical Care: A Roadmap.Chest · 2026Guideline
- A systematic review and meta-analysis of enrollment into ARDS and sepsis trials published between 2009 and 2019 in major journals.Critical care (London, England) · 2021Pooled it
- Association between urea trajectory and protein dose in critically ill adults: a secondary exploratory analysis of the effort protein trial (RE-EFFORT).Critical care (London, England) · 2024Trial
- Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: the AdrenOSS-2 phase 2a biomarker-guided trial.Intensive care medicine · 2021Trial
- Acute hypoxemic respiratory failure: from static severity to trajectory-based phenotyping.Intensive care medicine · 2026Article
- How much is enough? Reconsidering the role of sample size in critical care research.Anaesthesiology intensive therapy · 2026Article
- Clinical subphenotypes of sepsis based on mixed continuous and categorical data and differences in treatment effects: a cluster analysis of multicenter observational studies.Critical care (London, England) · 2026Observational
- Vancomycin-Induced Acute Kidney Injury in Intensive Care Patients: A Target Trial Emulation Study Using Multicenter Routinely Collected Data.Pharmacoepidemiology and drug safety · 2025Article
- Factors associated with women authorship over 25 years in high-impact critical care randomized controlled trials: the pipeline is still leaking.Critical care (London, England) · 2025Article
- Eliciting Patient Preferences for Pragmatic Critical Care Trials: A Qualitative Study.Annals of the American Thoracic Society · 2025Article
- Article
- Sepsis-associated encephalopathy: Mechanisms, Diagnosis, and Treatments update.International journal of biological sciences · 2025Review
- The times are changing: A primer on novel clinical trial designs and endpoints in critical care research.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024Article
- Enhancing sepsis biomarker development: key considerations from public and private perspectives.Critical care (London, England) · 2024Review
- Refining trial design in sepsis management: balancing realism with ideal outcomes.Intensive care medicine · 2024Article
- Personalizing renal replacement therapy initiation in the intensive care unit: a reinforcement learning-based strategy with external validation on the AKIKI randomized controlled trials.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Exploring disease axes as an alternative to distinct clusters for characterizing sepsis heterogeneity.Intensive care medicine · 2023Article
- Trend in Clinical Trial Participation During COVID-19: A Secondary Analysis of the I-SPY COVID Clinical Trial.Critical care explorations · 2023Article
- Elements of Statistical Power in Pediatric Critical Care Trials.Annals of the American Thoracic Society · 2023Article
- Pragmatic platform trials to improve the outcome of patients with acute kidney injury.Current opinion in critical care · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundConducting research in critically-ill patient populations is challenging, and most randomized trials of critically-ill patients have not achieved pre-specified statistical thresholds to conclude that the intervention being investigated was beneficial.
methodsIn 2019, a diverse group of patient representatives, regulators from the USA and European Union, federal grant managers, industry representatives, clinical trialists, epidemiologists, and clinicians convened the First Critical Care Clinical Trialists (3CT) Workshop to discuss challenges and opportunities in conducting and assessing critical care trials. Herein, we present the advantages and disadvantages of available methodologies for clinical trial design, conduct, and analysis, and a series of recommendations to potentially improve future trials in critical care.
conclusionThe 3CT Workshop participants identified opportunities to improve critical care trials using strategies to optimize sample size calculations, account for patient and disease heterogeneity, increase the efficiency of trial conduct, maximize the use of trial data, and to refine and standardize the collection of patient-centered and patient-informed outcome measures beyond mortality.
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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.