ArticleAnnals of the American Thoracic Society2020
The REMAP-CAP (Randomized Embedded Multifactorial Adaptive Platform for Community-acquired Pneumonia) Study. Rationale and Design.
Registry-linked trialOpen access · greenAbstract readClinical Trial Protocol
In one paragraph
Article in Annals of the American Thoracic Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07491419 (The Impact of Fast Antimicrobial Sensitivity Testing Tools on Stewardship Antibiotic and Clinical Outcome), which is not on this map. Cited by 236 papers, 14 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
236citing papers in PubMed, 14 pooled it
39.6field-weighted citation impact, top 1% of its field
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.
The Impact of Fast Antimicrobial Sensitivity Testing Tools on Stewardship Antibiotic and Clinical Outcome: a Randomized Clinical Trial Within an Adaptive Platform Trial for Patients With Bloodstream Infections
Who cites it
236 citing papers in PubMed, 14 syntheses or guidelines pooled it, 424 citations in OpenAlex.
- Kidney Disease and Heart Failure: Recent Advances and Current Challenges: Conclusions From a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.JACC. Heart failure · 2026Guideline
- Assessing Monoclonal and Polyclonal Antibodies in Sepsis and Septic Shock: A Systematic Review of Efficacy and Safety.International journal of molecular sciences · 2025Pooled it
- Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis.Scientific reports · 2024Pooled it
- Operational complexities in international clinical trials: a systematic review of challenges and proposed solutions.BMJ open · 2024Pooled it
- Methodology and design of platform trials: a meta-epidemiological study.Journal of clinical epidemiology · 2023Pooled it
- Anakinra for the treatment of COVID-19 patients: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- A rapid review of community engagement and informed consent processes for adaptive platform trials and alternative design trials for public health emergencies.Wellcome open research · 2023Pooled it
- Systemic corticosteroids for the treatment of COVID-19: Equity-related analyses and update on evidence.The Cochrane database of systematic reviews · 2022Pooled it
- Pooled it
- Antibiotics for the treatment of COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- A Research Agenda for Precision Medicine in Sepsis and Acute Respiratory Distress Syndrome: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2021Guideline
- SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- Systemic corticosteroids for the treatment of COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- Corticosteroids in COVID-19 and non-COVID-19 ARDS: a systematic review and meta-analysis.Intensive care medicine · 2021Pooled it
- Ivermectin for Critically and Noncritically Ill Hospitalized Patients With COVID-19: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP).Critical care medicine · 2026Trial
- Trial
- Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia : The REMAP-CAP Corticosteroid Domain Randomized Clinical Trial.Intensive care medicine · 2025Trial
- Simvastatin in Critically Ill Patients with Covid-19.The New England journal of medicine · 2023Trial
- Trial
- Leflunomide treatment for patients hospitalised with COVID-19: DEFEAT-COVID randomised controlled trial.BMJ open · 2023Trial
176 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
38 authors at 20 institutions in 11 countries.
Derek C AngusThe Clinical Research Investigation and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.ORCID 0000-0002-7026-5181
Scott BerryBerry Consultants, LLC, Austin, Texas.
Roger J LewisBerry Consultants, LLC, Austin, Texas.ORCID 0000-0002-0020-4869
Farah Al-BeidhDivision of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare National Health Service Trust, London, United Kingdom.ORCID 0000-0003-4701-463X
Yaseen ArabiIntensive Care Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Wilma van Bentum-PuijkJulius Center for Health Sciences and Primary Care.
Zahra BhimaniLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Marc BontenJulius Center for Health Sciences and Primary Care.
Kristine BroglioBerry Consultants, LLC, Austin, Texas.
Frank BrunkhorstCenter for Clinical Studies and Center for Sepsis Control and Care, Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.ORCID 0000-0002-8132-8651
Allen C ChengInfection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia.ORCID 0000-0003-3152-116X
Jean-Daniel ChicheMedical Intensive Care Unit, Hôpital Cochin, Paris Descartes University, Paris, France.ORCID 0000-0002-6433-6254
Menno De JongDepartment of Medical Microbiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0002-8380-4738
Michelle DetryBerry Consultants, LLC, Austin, Texas.ORCID 0000-0002-2794-1439
Herman GoossensDepartment of Microbiology, Antwerp University Hospital, Antwerp, Belgium.ORCID 0000-0003-4891-4031
Anthony GordonDivision of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare National Health Service Trust, London, United Kingdom.ORCID 0000-0002-0419-547X
Cameron GreenAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Alisa M HigginsAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-8295-7559
Sebastiaan J HullegieJulius Center for Health Sciences and Primary Care.ORCID 0000-0003-0274-7936
Peter KrugerIntensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.ORCID 0000-0002-3216-2958
Francois LamontagneUniversité de Sherbrooke, Sherbrooke, Quebec, Canada.ORCID 0000-0002-0360-3427
Edward LittonSchool of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia.ORCID 0000-0002-5125-6829
John MarshallLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-7902-6291
Anna McGlothlinBerry Consultants, LLC, Austin, Texas.ORCID 0000-0002-9079-6166
Shay McGuinnessAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0003-0620-4787
Paul MounceyClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Srinivas MurthyUniversity of British Columbia School of Medicine, Vancouver, British Columbia, Canada.ORCID 0000-0002-9476-839X
Alistair NicholAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-4689-1238
Genevieve K O'NeillAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-6060-5966
Rachael ParkeCardiothoracic and Vascular Intensive Care Unit and.ORCID 0000-0003-4209-0334
Jane ParkerAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-7066-2558
Gernot RohdeDepartment of Respiratory Medicine, University Hospital Frankfurt, Frankfurt, Germany.
Kathryn RowanClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Anne TurnerMedical Research Institute of New Zealand, Wellington, New Zealand.ORCID 0000-0002-4092-1424
Paul YoungMedical Research Institute of New Zealand, Wellington, New Zealand.ORCID 0000-0002-3428-3083
Lennie DerdeJulius Center for Health Sciences and Primary Care.ORCID 0000-0002-3577-5629
Colin McArthurDepartment of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.ORCID 0000-0003-0370-0080
Steven A WebbAustralian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-9134-9045
Berry & Associates (United States) · USMonash University · AUOklahoma State University Center for Health Sciences · USIntensive Care National Audit & Research Centre · GBNational Health Service · GBSt. Michael's Hospital · CAAlfred Health · AUAntwerp University Hospital · BEAuckland City Hospital · NZGoethe University Frankfurt · DEIntensive Care Society · GBJena University Hospital · DEKing Saud bin Abdulaziz University for Health Sciences · SAMedical Research Institute of New Zealand · NZPrincess Alexandra Hospital · AUSt John of God Subiaco Hospital · AUThe University of Western Australia · AUUniversité de Sherbrooke · CAUniversité Paris Cité · FRUniversity College Dublin · IE
Funding
Department of Health RP-2015-06-018
Abstract
There is broad interest in improved methods to generate robust evidence regarding best practice, especially in settings where patient conditions are heterogenous and require multiple concomitant therapies. Here, we present the rationale and design of a large, international trial that combines features of adaptive platform trials with pragmatic point-of-care trials to determine best treatment strategies for patients admitted to an intensive care unit with severe community-acquired pneumonia. The trial uses a novel design, entitled "a randomized embedded multifactorial adaptive platform." The design has five key features:
Indexed as
Community-Acquired InfectionsCoronavirus InfectionsInfluenza, HumanPneumoniaPneumonia, ViralAdaptive Clinical Trials as TopicAnti-Bacterial AgentsAntiviral AgentsBetacoronavirusCOVID-19Evidence-Based MedicineHumansPandemicsPoint-of-Care SystemsPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicAnti-Bacterial AgentsAntiviral AgentsBayesian adaptivecommunity-acquired pneumoniacoronavirus disease 2019master protocolplatform trialrandomized clinical trial
Identifiers
What OpenQuestion holds
Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390
Registered trials
NCT07491419ClinicalTrials.gov
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.