المؤلفون: Digitale, Jean, Burns, Gregory, Fong, Nicholas, Boesel, Julian, Robba, Chiara, Stevens, Robert, Cinotti, Raphaël, Pirracchio, Romain

المصدر: BMJ Open. 13(9)

مصطلحات موضوعية: adult intensive & critical care, neurological injury, protocols & guidelines, trauma management, Humans, Delphi Technique, Respiration, Brain Injuries, Respiration, Artificial, Airway Extubation, Review Literature as Topic

الوصف: INTRODUCTION: There is little consensus and high heterogeneity on the optimal set of relevant clinical outcomes in research studies regarding extubation in neurocritical care patients with brain injury undergoing mechanical ventilation. The aims of this study are to: (1) develop a core outcome set (COS) and (2) reach consensus on a hierarchical composite endpoint for such studies. METHODS AND ANALYSIS: The study will include a broadly representative, international panel of stakeholders with research and clinical expertise in this field and will involve four stages: (1) a scoping review to generate an initial list of outcomes represented in the literature, (2) an investigator meeting to review the outcomes for inclusion in the Delphi surveys, (3) four rounds of online Delphi consensus-building surveys and (4) online consensus meetings to finalise the COS and hierarchical composite endpoint. ETHICS AND DISSEMINATION: This study received ethical approval from the French Society of Anesthesia and Critical Care Medicine Institutional Review Board (SFAR CERAR-IRB 00010254-2023-029). The study results will be disseminated through communication to stakeholders, publication in a peer-reviewed journal, and presentations at conferences. TRIAL REGISTRATION NUMBER: This study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) Initiative.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3wf3s67vTest

المؤلفون: Simon-Pimmel, Jeanne, Foucher, Yohann, Léger, Maxime, Feuillet, Fanny, Bodet-Contentin, Laetitia, Cinotti, Raphaël, Frasca, Denis, Dantan, Etienne

المساهمون: MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Medical Intensive Care, Angers University Hospital, Nantes, France, Biostatistics and Methodology Unit, University Hospital Centre Nantes, Nantes, Pays de la Loire, France, Intensive Care Unit, Regional University Hospital Centre Tours, Tours, Centre, France, Anesthesia and Critical Care Department, University Hospital Centre Poitiers, Poitiers, France, Dantan, Etienne, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques

المصدر: BMJ Open
BMJ Open, BMJ Publishing Group, 2021, 11 (9), pp.e047279. ⟨10.1136/bmjopen-2020-047279⟩
BMJ Open, 2021, 11 (9), pp.e047279. ⟨10.1136/bmjopen-2020-047279⟩
BMJ Open, Vol 11, Iss 9 (2021)

مصطلحات موضوعية: [STAT.ME] Statistics [stat]/Methodology [stat.ME], [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, statistics & research methods, Intensive Care, Prognosis, stroke, Intensive Care Units, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Medicine, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, neurosurgery, [STAT.ME]Statistics [stat]/Methodology [stat.ME], Intracranial Hemorrhages, adult intensive & critical care, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

الوصف: International audience; Objectives Patients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages. Data sources Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020. Study selection We included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage. Data extraction We evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools’ methodological reporting. Results Of the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages. Conclusions Although prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::c57616e92eba065f13f67594b545d646Test
https://pubmed.ncbi.nlm.nih.gov/34548347Test