Evidence map›Paper›PMID 33997464›Full record

ArticleContemporary clinical trials communications2021

Study protocol for DICE trial: Video-assisted thoracoscopic surgery decortication versus interventional radiology guided chest tube insertion for the management of empyema.

Erin Williams, Nader Hanna, Alex Menard, Benedetto Mussari, Reza Nasirzadeh, Emidio Tarulli, Gurmohan Rob Dhillon, Ken Reid, Dimitri Petsikas, Jennifer Pereira and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Contemporary clinical trials communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 32% 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.

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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. What is new in pleural infections?Breathe (Sheffield, England) · 2026
    Review
  3. Article
  4. Enzymatic therapyERJ open research · 2025
    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

12 authors at 1 institution in 1 country.

Erin WilliamsDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Nader HannaDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Alex MenardDivision of Interventional Radiology, Department of Radiology, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Benedetto MussariDivision of Interventional Radiology, Department of Radiology, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Reza NasirzadehDivision of Interventional Radiology, Department of Radiology, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Emidio TarulliDivision of Interventional Radiology, Department of Radiology, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Gurmohan Rob DhillonDivision of Interventional Radiology, Department of Radiology, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Ken ReidDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Dimitri PetsikasDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Jennifer PereiraDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Paul HeffernanDivision of Respirology, Department of Medicine, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Wiley ChungDivision of Thoracic Surgery, Department of Surgery, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Queen's University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmpyema is a common thoracic surgery presentation, defined as pus in the pleural space. Despite the commonality of empyema, consensus on initial management remains ambiguous. Two standard of care treatment options include inserting a chest tube (thoracostomy) and the administration of intrapleural fibrinolytics, or an initial surgical approach, surgical decortication. Due to the complexity of this pleural space infection, often repeat interventions are required after initial management in order to achieve source control and resolution of clinical symptoms. This study aims to identify the most effective initial management option for empyema. STUDY

designWe present a study protocol for a randomized control trial (RCT) comparing adult individuals with empyema to one of two standard of care initial management options. Participants will be randomized into either interventional radiology guided chest tube insertion with intrapleural fibrinolytics (Dornase 5 mg and Alteplase 10 mg intrapleural twice daily for three days) or video-assisted thoracoscopic surgery (VATS) decortication.

methodsAll adults with empyema meeting inclusion criteria will be invited to participate. They will be randomized into one of two intervention groups; interventional radiology guided chest tube insertion with fibrinolytics or initial VATS decortication. Each intervention will take place within 48 hours of randomization. The primary outcome will be the rate of re-intervention within 30 days. Re-intervention is defined as repeat chest tube insertion, VATS decortication, or decortication via thoracotomy. Secondary outcomes include a change in the size of empyema, length of stay, morbidity, as well as 30-day and 90-day mortality, as well as quality of life measurements. ANTICIPATED IMPACT: This study is aimed at identifying the most effective initial management option for individuals with empyema.

Indexed as

Chest tubeDecorticationEmpyemaIntrapleural fibrinolytics video assisted thoracoscopic surgeryPleural spaceThoracic surgery

Identifiers

PMID33997464
PMCPMC8105624
OpenAlexW3156837387

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.