ArticleChest2023
Emulating Target Trials Comparing Early and Delayed Intubation Strategies.
Article in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Observational studies of early versus late salvage therapies in critical care exhibit intrinsic selection bias: two meta-analyses.Critical care (London, England) · 2025Pooled it
- Impact of an ROX index-guided intubation strategy on mortality in patients receiving high-flow nasal cannula: a target trial emulation.Journal of intensive care · 2026Article
- Airway management strategies in critical care.American journal of respiratory and critical care medicine · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Patterns and outcomes of real-world high-flow nasal cannula use: a multi-hospital retrospective cohort study.Critical care science · 2026Observational
- A predictive model for early intubation in patients with COVID-19-induced acute hypoxemic respiratory failure under awake prone position.Annals of intensive care · 2025Article
- Comparative Weight Change With Initiation and Adherence to Common Medications for Type 2 Diabetes.Obesity (Silver Spring, Md.) · 2025Article
- Federated target trial emulation using distributed observational data for treatment effect estimation.NPJ digital medicine · 2025Article
- Federated Target Trial Emulation using Distributed Observational Data for Treatment Effect Estimation.medRxiv : the preprint server for health sciences · 2025Article
- Effect of immediate initiation of invasive ventilation on mortality in acute hypoxemic respiratory failure: a target trial emulation.Critical care (London, England) · 2024Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundWhether intubation should be initiated early in the clinical course of critically ill patients remains a matter of debate. Results from prior observational studies are difficult to interpret because of avoidable flaws including immortal time bias, inappropriate eligibility criteria, and unrealistic treatment strategies. RESEARCH QUESTION: Do treatment strategies that intubate patients early in the critical care admission improve 30-day survival compared with strategies that delay intubation? STUDY DESIGN AND
methodsWe estimated the effect of strategies that require early intubation of critically ill patients compared with those that delay intubation. With data extracted from the Medical Information Mart for Intensive Care-IV database, we emulated three target trials, varying the flexibility of the treatment strategies and the baseline eligibility criteria.
resultsUnder unrealistically strict treatment strategies with broad eligibility criteria, the 30-day mortality risk was 7.1 percentage points higher for intubating early compared with delaying intubation (95% CI, 6.2-7.9). Risk differences were 0.4 (95% CI, -0.1 to 0.9) and -0.9 (95% CI, -2.5 to 0.7) percentage points in subsequent target trial emulations that included more realistic treatment strategies and eligibility criteria.
interpretationWhen realistic treatment strategies and eligibility criteria are used, strategies that delay intubation result in similar 30-day mortality risks compared with those that intubate early. Delaying intubation ultimately avoids intubation in most patients.
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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.