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--- jc [2024/04/24 00:47] – [Statistical Issues] admin
+++ jc [2024/11/16 21:11] (current) – admin
@@ Line 1: / Line 1: @@
-  * [[https://doi.org/10.1016/j.jcin.2023.07.042 | Paper]]
+===== Ideas =====
-  * Primary Outcomes
+  * Airway
-  * Secondary Outcomes
+    * [[https://doi.org/10.1001/jama.2024.0762 | Hyperangulated VL vs Standard DL in Surgical Patients]]
-  * Reported Result
+      * **Finding**: First-pass intubation failure: hyperangulated VL 1.7% vs DL 7.6%
-    * "When compared with AC alone, CDT had lower mortality but high major bleeding and numerically higher ICH"
+      * **Significance**: More evidence VL is better as first-line?
-    * "The risk of morality and ICH was high with ST when compared with CDT.
+    * [[https://doi.org/10.1111/anae.15985 | Mac Geometry VL vs Mac DL]]
-    * Findings were similar when analysis was restricted to intermediate risk PE.
+      * **Finding:** VL had better first-pass success than DL
+  * CARDS
-===== Problems =====
+    * [[https://doi.org/10.1016/j.resuscitation.2024.110360 | IV vs IO for OHCA]]
-==== The Definition of Risk Groups is not Stated====
+      * Finding: IV assoc with better survival and neuro fav outcomes
-  * Uses "intermediate risk," "high risk", and "intermediate-high risk," thus mixing terminologies
+    * [[https://doi.org/10.1056/NEJMoa2307983 | MINT: Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia]]
-    * **2019 ESC:** low, intermediate-low, intermediate-high, high
+      * **Finding**: In patients with acute myocardial infarction and anemia, a liberal transfusion strategy did not significantly reduce the risk of recurrent myocardial infarction or death at 30 days.
-    * **2011 AHA:** massive, sub-massive, low risk
+  * CCM
-    * **2016 CHEST:** low high, PE without hypotension, PE with hypotension
+    * [[https://doi.org/10.1056/NEJMoa2404245 | Pantoprazole for MV GI bleed ppx]]
+      * **Finding**: reduces GIB, no mortality benefit
-==== Very few RCT patients got CDT====
+      * [[https://doi.org/10.1097/CCM.0000000000006376 | Calcium for hyperK]]
-^Total Papers (n=45)^^^
+      * **Finding**: not via membrane stabilization
-^patient_type^number^percent^
+  * MCS
-|AC|19976|24.4%|
+    * [[https://doi.org/10.1056/NEJMoa2312572 | DANGER-SHOCK]]
-|**CDT**|**9610**|**11.8%**|
+      * **Finding**: Impella CP reduces mortality
-|ST|52119|63.8%|
+      * **Significance**: First trial to show mortality benefit from MCS
-|total|81705|NA|
+  * PULM
+    * [[ https://www.nejm.org/doi/full/10.1056/NEJMoa2406673 | Depemokimab]]
+    * [[https://www.nejm.org/doi/full/10.1056/NEJMoa2409712 | Inebilizumab for Treatment of IgG4-Related Disease]]
-^Intermediate-Risk Papers (n=20)^^^
+  * GI
-^patient_type^number^percent^
+    * [[https://doi.org/10.1097/HEP.0000000000000817 | Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis]]
-|AC|8873|75.9%|
+      * **Finding**: in Child-Pugh B or C with UGIB, TXA improves bleeding control vs placebo
-|**CDT**|**1929**|**16.5%**|
+  * Trauma
-|ST|883|7.5%|
+    * [[https://doi.org/10.1001/jama.2023.20850 | UK-REBOA]]
-|total|11685|14.3% (of $n_{total}$)|
+      * **Finding**: In trauma patients with exsanguinating hemorrhage, a strategy of REBOA and standard care in the emergency department does not reduce, and may increase, mortality compared with standard care alone.
-^RCT Trials Only (n=17)^^^
-^patient_type^number^percent^
-|AC|1101|49.8%|
-|**CDT**|**78**|**3.5%**|
-|ST|1031|46.7%|
-|total|2210|2.7% (of $n_{total}$)|
-**__This means that the number of CDT patients from RCTs is only $\frac{n_{CDT}}{n_{total}}=\frac{78}{81611}=0.096\%$ of the study total!!__**
-====The Primary Outcome is not reported correctly====
-The paper utilized a network meta-analysis ([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5247317/|1]],[[https://training.cochrane.org/handbook/current/chapter-11|2]],[[https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099682|3]]).
-They list that ''"[t]he primary analysis compared CDT and systemic fibrinolysis with AC alone."''
-However, they report the CDT vs AC and ST vs AC outcomes, not the network of all three.
-==== Statistical Issues ====
-=== No attempts to control family-wise error rate ===
-===They had to change their statistical analysis strategy===
-Interestingly, they do NOT report p values for their efficacy outcome -- just 95% CI.
-Publication inconsistency for their efficacy outcome was significant ($p = 0.036$), but there was no inconsistency at the loop level using a loop inconsistency plot.
-Thus, they had to perform a direct meta-analysis. For this analysis, they reported p values (?!).
-Why would they only report p-values for a "backup" analysis method.

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