Evidence map›Paper›PMID 34011198›Full record

ArticleClinical trials (London, England)2021

Assessing the external validity of the VALIDATE-SWEDEHEART trial.

Rebecca T Rylance, Philippe Wagner, Elmir Omerovic, Claes Held, Stefan James, Sasha Koul, David Erlinge

Open access · hybridAbstract read
In one paragraph

Article in Clinical trials (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 53% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
  3. 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

7 authors at 3 institutions in 1 country.

Rebecca T RylanceDepartment of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.ORCID 0000-0002-5921-3786
Philippe WagnerCenter for Clinical Research, Uppsala University, Västerås, Sweden.
Elmir OmerovicDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Claes HeldDepartment of Medical Sciences and Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Stefan JamesDepartment of Medical Sciences and Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Sasha KoulDepartment of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
David ErlingeDepartment of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
Lund University · SEUppsala University · SESahlgrenska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe VALIDATE-SWEDEHEART trial was a registry-based randomized trial comparing bivalirudin and heparin in patients with acute myocardial infarction undergoing percutaneous coronary intervention. It showed no differences in mortality at 30 or 180 days. This study examines how well the trial population results may generalize to the population of all screened patients with fulfilled inclusion criteria in regard to mortality at 30 and 180 days.

methodsThe standardized difference in the mean propensity score for trial inclusion between trial population and the screened not-enrolled with fulfilled inclusion criteria was calculated as a metric of similarity. Propensity scores were then used in an inverse-probability weighted Cox regression analysis using the trial population only to estimate the difference in mortality as it would have been had the trial included all screened patients with fulfilled inclusion criteria. Patients who were very likely to be included were weighted down and those who had a very low probability of being in the trial were weighted up.

resultsThe propensity score difference was 0.61. There were no significant differences in mortality between bivalirudin and heparin in the inverse-probability weighted analysis (hazard ratio 1.11, 95% confidence interval (0.73, 1.68)) at 30 days or 180 days (hazard ratio 0.98, 95% confidence interval (0.70, 1.36)).

conclusionThe propensity score difference demonstrated that the screened not-enrolled with fulfilled inclusion criteria and trial population were not similar. The inverse-probability weighted analysis showed no significant differences in mortality. From this, we conclude that the VALIDATE results may be generalized to the screened not-enrolled with fulfilled inclusion criteria.

Indexed as

AnticoagulantsMyocardial InfarctionPercutaneous Coronary InterventionHemorrhageHeparinHirudinsHumansPeptide FragmentsRandomized Controlled Trials as TopicRecombinant ProteinsTreatment OutcomeAnticoagulantsbivalirudinHeparinHirudinsPeptide FragmentsRecombinant Proteinsanticoagulantsnationwide registry datapercutaneous coronary interventionreal-worldVALIDATE-SWEDEHEART

Identifiers

PMID34011198
PMCPMC8290983
OpenAlexW3083280917

What OpenQuestion holds

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Registered trials

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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.