Poor agreement in significant findings between meta-analyses and subsequent large randomized trials in perioperative medicine H Sivakumar, P.J. Peyton

Slides:

Advertisements

Similar presentations

Jacqueline A. Clauss, B.A., Jennifer Urbano Blackford, Ph.D.

Advertisements

Fig. 2. Comparative efficacy of thromboprophylaxis interventions in the prevention of deep vein thrombosis (DVT). (A) Estimated odds ratios (ORs) and 95%

Thomas F. O’Donnell, MD, Joseph Lau, MD Journal of Vascular Surgery

Chewing gum for the treatment of postoperative nausea and vomiting: a pilot randomized controlled trial J.N. Darvall, M Handscombe, K Leslie British.

Paravertebral block in paediatric abdominal surgery'a systematic review and meta- analysis of randomized trials E.A. Page, K.L. Taylor British Journal.

The Role of Systematic Reviews and Meta-analysis in Dermatology

Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: a meta-analysis of published studies S Dahmani, I.

Paul D. Stein, MD, Russell D. Hull, MBBS, MSc, Fadi Matta, MD, Abdo Y

F. Chung, R. Subramanyam, P. Liao, E. Sasaki, C. Shapiro, Y. Sun

Effect of beta-blockers on perioperative outcomes in vascular and endovascular surgery: a systematic review and meta-analysis S Hajibandeh, S Hajibandeh,

Effect of prolonged treatment with compression stockings to prevent post-thrombotic sequelae: A randomized controlled trial Markus Aschwanden, MD, Christina.

The efficacy and safety of retigabine and other adjunctive treatments for refractory partial epilepsy: A systematic review and indirect comparison Marrissa.

Benefits and risks of epidural analgesia in cardiac surgery†

SponTaneous Respiration using IntraVEnous anaesthesia and Hi-flow nasal oxygen (STRIVE Hi) maintains oxygenation and airway patency during management.

Non-opioid analgesics in adults after major surgery: systematic review with network meta-analysis of randomized trials V Martinez, H Beloeil, E Marret,

Bispectral index-guided induction of general anaesthesia in patients undergoing major abdominal surgery using propofol or etomidate: a double-blind, randomized,

Supplemental oxygen and surgical site infection: getting to the truth

Effect of combining tramadol and morphine in adult surgical patients: a systematic review and meta-analysis of randomized trials V. Martinez, L. Guichard,

Thomas F. O’Donnell, MD, Joseph Lau, MD Journal of Vascular Surgery

Howell S.J. , Sear J.W. , Foëx P British Journal of Anaesthesia

The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section–a systematic.

Rohini Rao, BSc, Tristan R. A. Lane, MRCS, Ian J

A meta-analysis of anticoagulation for calf deep venous thrombosis

Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis Leigh White, Alice Halpin, Marianne.

Changes in the effect of propofol in response to altered plasma protein binding during normothermic cardiopulmonary bypass E Takizawa, H Hiraoka, D Takizawa,

Predicting arterial blood gas and lactate from central venous blood analysis in critically ill patients: a multicentre, prospective, diagnostic accuracy.

Off-pump versus on-pump coronary artery bypass grafting: A systematic review and meta-analysis of propensity score analyses Oliver Kuss, PhD, Benita.

B. Saugel, M. Cecconi, J.Y. Wagner, D.A. Reuter

Preoperative heart rate and myocardial injury after non-cardiac surgery: results of a predefined secondary analysis of the VISION study T.E.F. Abbott,

Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: a systematic review and meta-analysis of randomized.

Evaluation of surgical conditions during laparoscopic surgery in patients with moderate vs deep neuromuscular block C.H. Martini, M. Boon, R.F. Bevers,

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries British Journal of Anaesthesia

A Systematic Review of Biocompatible Cardiopulmonary Bypass Circuits and Clinical Outcome Marco Ranucci, MD, Anna Balduini, AHA, Antonio Ditta, CCP,

Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and.

H. Yamauchi, S. Ito, H. Sasano, T. Azami, J. Fisher, K. Sobue

Liberal transfusion strategy improves survival in perioperative but not in critically ill patients. A meta-analysis of randomised trials E. Fominskiy,

Perioperative increase in global blood flow to explicit defined goals and outcomes after surgery: a Cochrane Systematic Review† M.P.W. Grocott, A Dushianthan,

Hisato Takagi, MD, PhD, Takuya Umemoto, MD, PhD

Angiographic outcomes of radial artery versus saphenous vein in coronary artery bypass graft surgery: A meta-analysis of randomized controlled trials

Role of therapeutic hypothermia in improving outcome after traumatic brain injury: a systematic review A.P. Georgiou, A.R. Manara British Journal of.

Effectiveness of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis Stijn de Jonge,

Steroids in cardiac surgery: a systematic review and meta-analysis

Yin-Shu Chang, MD, Jia-Xiang Wang, MD, PhD, Da-Wei Chang, PhD

Effects of high inspired oxygen fraction during elective Caesarean section under spinal anaesthesia on maternal and fetal oxygenation and lipid peroxidation†

G.R. Lorello, D.A. Cook, R.L. Johnson, R. Brydges

D. Fletcher, V. Martinez British Journal of Anaesthesia

Bispectral index is related to the spread of spinal sensory block in patients with combined spinal and general anaesthesia R Iida, K Iwasaki, J Kato,

Impact of balanced tetrastarch raw material on perioperative blood loss: a randomized double blind controlled trial† A Joosten, R Tircoveanu, S Arend,

Troponin elevations after non-cardiac, non-vascular surgery are predictive of major adverse cardiac events and mortality: a systematic review and meta-analysis

B. B. Abdelmalak, A Bonilla, E. J. Mascha, A Maheshwari, W. H

Comparison of 1% and 2% lidocaine epidural anaesthesia combined with sevoflurane general anaesthesia utilizing a constant bispectral index A Shono, S.

Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section† K.S. Khaw, W.D. Ngan.

Jon S. Matsumura, MD, Adnan Z. Rizvi, MD Journal of Vascular Surgery

Use of deep laryngeal oxygen insufflation during laryngoscopy in children: a randomized clinical trial J.W. Steiner, D.I. Sessler, N. Makarova, E.J.

Falls and major orthopaedic surgery with peripheral nerve blockade: a systematic review and meta-analysis R.L. Johnson, S.L. Kopp, J.R. Hebl, P.J. Erwin,

Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity? A systematic review with meta-analysis and trial sequential analysis

Thoracic paravertebral blocks in abdominal surgery – a systematic review of randomized controlled trials K. El-Boghdadly, C. Madjdpour, K.J. Chin British.

Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis E.D. McNicol,

Chewing gum for the treatment of postoperative nausea and vomiting: a pilot randomized controlled trial J.N. Darvall, M Handscombe, K Leslie British.

Individual patient data analysis of tidal volumes used in three large randomized control trials involving patients with acute respiratory distress syndrome

J.E. Spiegel, A. Vasudevan, Y. Li, P.E. Hess

Stress response during weaning after cardiac surgery

Evaluation of bispectral index and auditory evoked potentials for hypnotic depth monitoring during balanced xenon anaesthesia compared with sevoflurane

Effect of acute cigarette smoking on gastric contents in regular smoker volunteers. A prospective randomized cross-over study S. Lazaar, E. Boselli,

Levosimendan pre-treatment improves outcomes in patients undergoing coronary artery bypass graft surgery† L. Tritapepe, V. De Santis, D. Vitale, F. Guarracino,

Epinephrine and clonidine do not improve intrathecal sufentanil analgesia after total hip replacement† R. Fournier, E. Van Gessel, A. Weber, Z. Gamulin

Systematic review on the association between calcification in carotid plaques and clinical ischemic symptoms Robert M. Kwee, MD Journal of Vascular.

Association between day and time of admission to critical care and acute hospital outcome for unplanned admissions to adult general critical care units:

R.L. Johnson, E.K. Cannon, C.B. Mantilla, D.A. Cook

Anaesthetic drugs and survival: a Bayesian network meta-analysis of randomized trials in cardiac surgery G. Landoni, T. Greco, G. Biondi-Zoccai, C. Nigro.

Presentation transcript:

Poor agreement in significant findings between meta-analyses and subsequent large randomized trials in perioperative medicine H Sivakumar, P.J. Peyton British Journal of Anaesthesia Volume 117, Issue 4, Pages 431-441 (October 2016) DOI: 10.1093/bja/aew170 Copyright © 2016 The Author(s) Terms and Conditions

Fig 1 Study method flow diagram. RCT, Randomized controlled trial; MA, Meta-analysis; MAs, Meta-analyses. British Journal of Anaesthesia 2016 117, 431-441DOI: (10.1093/bja/aew170) Copyright © 2016 The Author(s) Terms and Conditions

Fig 2 Forest plots comparing the findings of large randomized controlled trials and those of all prior meta-analyses. Precise data are given in Supplementary Table S1. The findings of large randomized controlled trials (RCTs) and those of all prior meta-analyses for the effect of each clinical intervention vs control on major morbid endpoints identified in the study. These endpoints are listed on the vertical axis along with the corresponding study references. The horizontal axis is odds ratio (less than one favours the intervention effect). Square boxes represent point estimates for treatment effect in large RCTs; circles represent point estimates for meta-analyses; error bars represent confidence intervals. The most recent meta-analyses (as defined in Methods), which were included in the comparative statistical analysis (Analysis B), are indicated with an asterisk *. Those endpoints where a statistically significant difference in the point estimate was found between large RCTs and the most recent MA, are indicated by a cross=. GA, general anaesthesia; BIS, bispectral index; HES, hydroxy-ethyl starch ; PPF, plasma protein fraction; , inspired oxygen concentration; PAC, pulmonary artery catheter; DVT, deep venous thrombosis; PE, pulmonary embolism; ORTHO, orthopaedic surgery. British Journal of Anaesthesia 2016 117, 431-441DOI: (10.1093/bja/aew170) Copyright © 2016 The Author(s) Terms and Conditions

Fig 2 Forest plots comparing the findings of large randomized controlled trials and those of all prior meta-analyses. Precise data are given in Supplementary Table S1. The findings of large randomized controlled trials (RCTs) and those of all prior meta-analyses for the effect of each clinical intervention vs control on major morbid endpoints identified in the study. These endpoints are listed on the vertical axis along with the corresponding study references. The horizontal axis is odds ratio (less than one favours the intervention effect). Square boxes represent point estimates for treatment effect in large RCTs; circles represent point estimates for meta-analyses; error bars represent confidence intervals. The most recent meta-analyses (as defined in Methods), which were included in the comparative statistical analysis (Analysis B), are indicated with an asterisk *. Those endpoints where a statistically significant difference in the point estimate was found between large RCTs and the most recent MA, are indicated by a cross=. GA, general anaesthesia; BIS, bispectral index; HES, hydroxy-ethyl starch ; PPF, plasma protein fraction; , inspired oxygen concentration; PAC, pulmonary artery catheter; DVT, deep venous thrombosis; PE, pulmonary embolism; ORTHO, orthopaedic surgery. British Journal of Anaesthesia 2016 117, 431-441DOI: (10.1093/bja/aew170) Copyright © 2016 The Author(s) Terms and Conditions