Evidence map›Paper›PMID 32650126›Full record

ArticleAnaesthesia, critical care & pain medicine2020

Quality of evidence supporting Surviving Sepsis Campaign Recommendations.

Jordi Rello, Sofia Tejada, Elena Xu, Candela Solé-Lleonart, Laura Campogiani, Despoina Koulenti, João Ferreira-Coimbra, Jeff Lipman

Abstract read
In one paragraph

Article in Anaesthesia, critical care & pain medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
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

8 authors.

Jordi RelloClinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institut of Research (VHIR), Barcelona, Spain; Centro de Investigacion Biomedica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Scientifical Research, CHU Nîmes, University Montpellier-Nîmes, Nîmes, France.
Sofia TejadaClinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institut of Research (VHIR), Barcelona, Spain; Centro de Investigacion Biomedica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: stmagraner@gmail.com.
Elena XuUQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia.
Candela Solé-LleonartIntensive Care Unit. Hospital Universitari de Vic, Barcelona, Spain.
Laura CampogianiClinical Infectious Diseases, Department of System Medicine, Tor Vergata University, Rome, Italy.
Despoina KoulentiUQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Critical Care II, Attikon University Hospital, Athens, Greece.
João Ferreira-CoimbraInternal Medicine Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Jeff LipmanScientifical Research, CHU Nîmes, University Montpellier-Nîmes, Nîmes, France; UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Surviving Sepsis Campaign (SSC) guidelines, released in 2017, are a combination of expert opinion and evidence-based medicine, adopted by many institutions as a standard of practice. The aim was to analyse the quality of evidence supporting recommendations on the management of sepsis.

methodsThe strength and quality of evidence (high, moderate, low-very low and best practice statements) of each recommendation were extracted. Randomised controlled trials were required to qualify as high-quality evidence.

resultsA total of 96 recommendations were formulated, and 87 were included. Among thirty-one (43%) strong recommendations, only 15.2% were supported by high-quality evidence. Overall, thirty-seven (42.5%) recommendations were based on low-quality evidence, followed by 28 (32.2%) based on moderate-quality, 15 (17.2%) were best practice statements and only seven (8.0%) were supported by high-quality evidence. Randomised controlled trials supported 21.4%, 9.5% and 8.6% recommendations on mechanical ventilation, resuscitation, and management/adjuvant therapy, respectively. In contrast, none high-quality evidence recommendation supported antimicrobial/source control (82.4% were low-very low evidence or best practice statements), and nutrition.

conclusionsIn the SSC guidelines most recommendations were informed by indirect evidence and non-systematic observations. While awaiting trials results, Delphi-like approaches or multi-criteria decision analyses should guide recommendations.

Indexed as

SepsisShock, SepticAnti-Bacterial AgentsHumansRespiration, ArtificialResuscitationAnti-Bacterial AgentsAntimicrobial administrationClinical practice guidelinesHaemodynamic resuscitationMechanical ventilationSeptic shock

Identifiers

PMID32650126
PMCPMC7340061

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.