Evidence map›Paper›PMID 35583116›Full record

ArticleMedical decision making : an international journal of the Society for Medical Decision Making2022

Noninferiority Margin Size and Acceptance of Trial Results: Contingent Valuation Survey of Clinician Preferences for Noninferior Mortality.

Sandra Pong, Robert A Fowler, Nicholas Mitsakakis, Srinivas Murthy, Jeffrey M Pernica, Elaine Gilfoyle, Asha Bowen, Patricia Fontela, Winnie Seto, Michelle Science and 4 more

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

Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2022. 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
1.6field-weighted citation impact, top 11% 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, 7 citations in OpenAlex.

  1. Article
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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

14 authors at 8 institutions in 2 countries.

Sandra PongDepartment of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada.ORCID 0000-0003-2963-9601
Robert A FowlerInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto ON, Canada.
Nicholas MitsakakisChildren's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.ORCID 0000-0001-9041-9152
Srinivas MurthyDepartment of Pediatrics, Division of Critical Care, University of British Columbia, Vancouver, BC, Canada.
Jeffrey M PernicaDivision of Infectious Diseases, McMaster University, Hamilton, ON, Canada.
Elaine GilfoyleDepartment of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Asha BowenWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia Perth Children's Hospital, Nedlands, WA, Australia.
Patricia FontelaDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Winnie SetoDepartment of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada.
Michelle ScienceDivision of Infectious Diseases, Department of Paediatric Medicine, The Hospital for Children, Toronto, ON, Canada.
James S HutchisonDepartment of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Philippe JouvetPediatric Intensive Care Unit, Sainte-Justine Hospital University Center, Montreal, QC, Canada.
Asgar RishuCritical Care Research Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.ORCID 0000-0001-6779-3672
Nick DanemanDivision of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Hospital for Sick Children · CASunnybrook Health Science Centre · CAUniversity of Toronto · CACentre Hospitalier Universitaire Sainte-Justine · CAMcGill University · CAMcMaster University · CAThe Kids Research Institute Australia · AUUniversity of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe used modified contingent valuation methodology to determine how noninferiority margin sizes influence clinicians' willingness to accept clinical trial results that compare mortality in critically ill children.

methodsWe surveyed pediatric infectious diseases and critical care clinicians in Canada, Australia, and New Zealand and randomized respondents to review 1 of 9 mock abstracts describing a noninferiority trial of bacteremic critically ill children assigned to 7 or 14 d of antibiotics. Each scenario showed higher mortality in the 7-d group but met noninferiority criterion. We explored how noninferiority margins and baseline mortality rates influenced respondent acceptance of results.

resultsThere were 106 survey respondents: 65 (61%) critical care clinicians, 28 (26%) infectious diseases physicians, and 13 (12%) pharmacists. When noninferiority margins were 5% and 10%, 73% (24/33) and 79% (27/33) respondents would accept shorter treatment, compared with 44% (17/39) when the margin was 20% (

conclusionsClinicians are more likely to accept shorter treatment when noninferiority margins are ≤10%. However, nearly half of respondents who reviewed abstracts with 20% margins were still willing to accept shorter treatment. This is a novel application of contingent valuation methodology to elicit acceptance of research results among end users of the medical literature. HIGHLIGHTS: Clinicians are more likely to accept shorter treatment durations based on noninferior mortality results when the noninferiority margin is 5% or 10% than if the margin is 20%.However, nearly half of clinicians would still accept shorter-duration treatment as noninferior with margins of 20%.Baseline mortality does not independently predict acceptance of shorter-duration treatment.Contingent valuation is a novel approach to elicit the acceptance of research design parameters from the perspective of endusers of the medical literature.

Indexed as

Critical IllnessAustraliaCanadaChildClinical Trials as TopicHumansSurveys and Questionnairesantimicrobialscontingent valuationduration of therapyevidence uptakemortalitynoninferiority margin

Identifiers

PMID35583116
PMCPMC9277322
OpenAlexW4280622755

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.