ICU · Statistics & evidence
Statistics & Evidence — Trial Design, Interpretation, Appraisal and the Landmark ICU Trials
Also known as Statistics and evidence · Critical appraisal · Trial design · p-value · Confidence interval · Number needed to treat · Forest plot · GRADE · Landmark ICU trials
The statistics and the evidence for the ICU — the hierarchy of the study design (the case series, the case-control, the cohort, the RCT, the systematic review and the meta-analysis), the RCT design elements (the PICO, the randomisation, the allocation concealment, the blinding, the intention-to-treat), the bias and the confounding, the statistical inference (the null hypothesis, the type-I and the type-II error, the power, the p-value, the confidence interval), the effect sizes (the relative risk, the odds ratio, the absolute risk reduction, the number needed to treat, the hazard ratio), the meta-analysis (the forest plot, the heterogeneity, the I-squared), the critical appraisal (the GRADE), and the landmark ICU trials as the worked examples (the ARMA, the SOAP II, the VASST, the ProCESS and the ARISE, the ACURASYS and the ROSE, the Surviving Sepsis Campaign).
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Meet the patient — the journal-club question
Your registrar presents the ROSE trial: routine 48-hour cisatracurium in severe ARDS, and it found no benefit — contradicting the ACURASYS trial a decade earlier that everyone had believed. She asks whether you will change your practice.[5]
The question that decides your answer is the question that decides every trial: is this result real, is it important, and does it apply to my patients? Hold those three questions and the whole appraisal toolkit slots into place.[4]
References29ShowHide
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