Evidence map›Paper›PMID 40583938›Full record

ArticleCanadian journal of kidney health and disease2025

Bayesian Analysis of Time-To-Event Data in a Cluster-Randomized Trial: Major Outcomes With Personalized Dialysate TEMPerature (MyTEMP) Trial.

Yongdong Ouyang, Bin Luo, Stephanie N Dixon, Ahmed A Al-Jaishi, P J Devereaux, Michael Walsh, Ron Wald, Merrick Zwarenstein, Sierra Anderson, Amit X Garg

Abstract read
In one paragraph

Article in Canadian journal of kidney health and disease, 2025. 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. Review
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

10 authors.

Yongdong OuyangChild Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-8692-2991
Stephanie N DixonICES, ON, Canada.ORCID https://orcid.org/0000-0002-7566-6574
Ahmed A Al-JaishiSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0003-0376-2214
P J DevereauxDepartments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
Michael WalshDepartments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8292-2014
Ron WaldDivision of Nephrology, St. Michael's Hospital, University of Toronto, ON, Canada.
Merrick ZwarensteinICES, ON, Canada.
Sierra AndersonICES, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: MyTEMP was a cluster-randomized trial to assess the effect of using a personalized cooler dialysate compared to standard temperature dialysate for potential cardiovascular benefits in patients receiving maintenance hemodialysis in Ontario, Canada. Objective: To conduct Bayesian analyses of the MyTEMP trial, which sought to determine whether adopting a center-wide policy of personalized cooler dialysate is superior to a standard dialysate temperature of 36.5°C in reducing the risk of a composite outcome of cardiovascular-related deaths or hospitalizations. Design: Secondary analysis of a parallel-group cluster-randomized trial. Setting: In total, 84 dialysis centers in Ontario, Canada, were randomly allocated to the 2 groups. Patients: Adult outpatients receiving in-center maintenance hemodialysis from dialysis centers participating in the trial. Measurements: The primary composite outcome was cardiovascular-related death or hospital admission with myocardial infarction, ischemic stroke, or congestive heart failure during the 4-year trial period. Methods: MyTEMP trial data were analyzed using Bayesian cause-specific parametric Weibull methods to model the survival time with 6 pre-defined reference priors of normal distributions on the log hazard ratio for the treatment effect (strongly enthusiastic, moderately enthusiastic, non-informative, moderately skeptical, skeptical, strongly skeptical). For each analysis, we reported the posterior mean, 2nd, 50th, and 98th percentiles of the treatment effects (hazard ratios) and 96% credible interval (CrI). We also reported the estimated posterior probabilities for different magnitudes of treatment effects. Results: Regardless of priors, Bayesian analysis yielded consistent posterior means and a 96% CrI. The posterior distribution of the hazard ratio was concentrated between 0.95 and 1.05, indicating there was probably no substantial difference between the 2 trial arms. Limitations: The interpretation of Bayesian methods highly depends on the prior distributions. In our study, the prior distributions were determined by 2 experts without a formal elicitation method. A formal elicitation is encouraged in future trials to better quantify experts' uncertainty about the treatment effect. In addition, we used cause-specific parametric Weibull methods to model survival time, as semi-parametric methods were not available in the standard Bayesian statistical software package at the time of analysis. Conclusions: Our Bayesian analysis indicated that implementing personalized cooler dialysate as a center-wide policy is unlikely to yield meaningful benefits in reducing the composite outcome of cardiovascular-related deaths and hospitalizations, regardless of prior expectations, whether optimistic or skeptical, about the intervention's effectiveness.

Indexed as

Bayesiancardiovascular eventscluster-randomized trialpersonalized dialysate temperaturepragmatic trial

Identifiers

PMID40583938
PMCPMC12206259

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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.