Evidence map›Paper›PMID 33227237›Full record

ReviewThe Lancet. Respiratory medicine2021

Clinical trials in critical care: can a Bayesian approach enhance clinical and scientific decision making?

Christopher J Yarnell, Darryl Abrams, Matthew R Baldwin, Daniel Brodie, Eddy Fan, Niall D Ferguson, May Hua, Purnema Madahar, Danny F McAuley, Laveena Munshi and 8 more

Registry-linked trialOpen access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The Lancet. Respiratory medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06409351 (Multi-mOdal Training Program to Promote Physical actIVity After sTrokE), which is not on this map. Cited by 54 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 7 pooled it
7.6field-weighted citation impact, top 2% 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.

NCT06409351 narecruitingnot on this mapstarted 2024, after this paper: background citation

Multi-mOdal Training Program to Promote Physical actIVity After sTrokE: MOTIVATE

TypeinterventionalSponsorSingapore General HospitalRan2024 to 2027Enrolled120ConditionsStroke, Physical InactivityArmsIntervention group
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 7 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Between-trial heterogeneity in ARDS research.Intensive care medicine · 2021
    Pooled it
  8. Trial
  9. A Bayesian re-analysis of the DANFLU-1 trial.Human vaccines & immunotherapeutics · 2025
    Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Article
  17. Review
  18. Reporting of second-generationContemporary clinical trials communications · 2026
    Article
  19. Article
  20. Article
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

18 authors at 13 institutions in 3 countries.

Christopher J YarnellInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Critical Care Medicine, Mount Sinai Hospital, Toronto, ON, Canada. Electronic address: christopher.yarnell@sinaihealth.ca.
Darryl AbramsCenter for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Matthew R BaldwinDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Daniel BrodieCenter for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Respirology, University Health Network and Sinai Health System, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada.
Niall D FergusonInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Respirology, University Health Network and Sinai Health System, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada.
May HuaDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
Purnema MadaharCenter for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Danny F McAuleyWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK; Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, UK.
Laveena MunshiInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Critical Care Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
Gavin D PerkinsWarwick Clinical Trials Unit and University Hospitals Birmingham, University of Warwick, Coventry, UK.
Gordon RubenfeldInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Arthur S SlutskyInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
Hannah WunschInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Robert A FowlerInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
George TomlinsonInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network and Sinai Health System, Toronto, ON, Canada.
Jeremy R BeitlerCenter for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Ewan C GoligherInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Respirology, University Health Network and Sinai Health System, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada.
University of Toronto · CAColumbia University · USNewYork–Presbyterian Hospital · USHealth Sciences Centre · CAInstitute for Clinical Evaluative Sciences · CAMount Sinai Hospital · CANew York Hospital Queens · USPresbyterian Hospital · USSinai Health System · CAToronto General Hospital · CAToronto General Hospital Research InstituteUniversity of Birmingham · GBUniversity of Ulster · GB

Funding

Breath stacking dyssynchrony in acute respiratory distress syndromeK23HL133489 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BEITLER, JEREMY R. · 2017 to 2021
$871k
Determinants of Critical Care Intensity for Hospitalized Older Adults: the Effect of Hospital-based Palliative Care ServicesK08AG051184 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HUA, MAY · 2015 to 2019
$863k
Measuring lung stress to identify occult ventilation-induced lung injury in ARDSR21HL145506 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BEITLER, JEREMY R. · 2019 to 2020
$243k
CIHR AR7­-162822Medical Research Council MC_G1002460NHLBI NIH HHS K23 HL133489NHLBI NIH HHS R21 HL145506NIA NIH HHS K08 AG051184NIA NIH HHS L30 AG053861Wellcome Trust
6 · The paper itself

Abstract

Recent Bayesian reanalyses of prominent trials in critical illness have generated controversy by contradicting the initial conclusions based on conventional frequentist analyses. Many clinicians might be sceptical that Bayesian analysis, a philosophical and statistical approach that combines prior beliefs with data to generate probabilities, provides more useful information about clinical trials than the frequentist approach. In this Personal View, we introduce clinicians to the rationale, process, and interpretation of Bayesian analysis through a systematic review and reanalysis of interventional trials in critical illness. In the majority of cases, Bayesian and frequentist analyses agreed. In the remainder, Bayesian analysis identified interventions where benefit was probable despite the absence of statistical significance, where interpretation depended substantially on choice of prior distribution, and where benefit was improbable despite statistical significance. Bayesian analysis in critical care medicine can help to distinguish harm from uncertainty and establish the probability of clinically important benefit for clinicians, policy makers, and patients.

Indexed as

Research DesignBayes TheoremClinical Decision-MakingClinical Trials as TopicCritical CareHumansProbability

Identifiers

PMID33227237
PMCPMC8439199
OpenAlexW3109761717

What OpenQuestion holds

Textmetadata
LicenceTDM
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.