Evidence map›Paper›PMID 40476887›Full record

ReviewAnesthesiology and perioperative science2023

Statistical fragility of reporting hemidiaphragmatic paralysis after brachial plexus blocks in randomized controlled trials: a systematic review.

Quehua Luo, Yang Liu, Yi Zhu, Zhipeng Wang, Junyi Zheng, Weifeng Yao

Abstract readReview
In one paragraph

Review in Anesthesiology and perioperative science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

6 authors.

Quehua Luo *Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Yang Liu *Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072 China.
Yi ZhuDepartment of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Zhipeng WangDepartment of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Junyi ZhengDepartment of Anesthesiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405 China.
Weifeng YaoDepartment of Anesthesiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To characterize the fragility index (FI) of statistically significant results reported in randomized controlled trials (RCTs) investigating the incidence of hemidiaphragmatic paralysis (HDP) after brachial plexus blocks. A systematic review of RCTs retrieved from the PubMed-Medline, Embase, and Web of Science electronic databases was conducted. All alternative RCTs published between January 2012 and October 2022 were identified. Only RCTs with two parallel arms designs, and reporting HDP as the primary outcome, statistical significance, and superiority results were selected. The FI was calculated according to Fisher's exact test using previously described methods. In addition, the risk of bias was evaluated using the Cochrane Risk-of-Bias tool for randomized trials. The 23 RCTs that fulfilled the inclusion criteria had a median FI of 4 (interquartile range [IQR]2-8) and a median Fragility Quotient of 0.077 (IQR 0.038- 0.129). However, in 13 (56.5%) trials, the calculated FI value was ≤ 4. In 3/23 (13.0%) trials, the number of patients who dropped-out exceeded the FI value. Most trials (91.3%) had an overall low risk of bias. This systematic review revealed that the statistical results of RCTs investing HDP after brachial plexus blocks have tended to be fragile in the past decade. The FI should be an important aid in the interpretation of clinical results in combination with the P-value, particularly when statistically significant results are dependent on a small number of events. Future RCTs with larger sample sizes are needed to obtain more robust results in this field.

Indexed as

Brachial plexus blockFragility indexHemidiaphragmatic paralysisRandomized controlled trials

Identifiers

PMID40476887
PMCPMC10123017

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.