ICU sedation, delirium & recovery
Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review
Authors' conclusion
Mortality reduction shown by sRCTs is typically not replicated by mRCTs.
Study context
- Population
- Adult critically ill patients; sRCTs with significant mortality reduction published in NEJM, JAMA or Lancet until December 31, 201619 sRCTs
- Comparison
- Positive single-centre RCTs (sRCTs) vs subsequent multicentre RCTs (multicenter randomized controlled trials (mRCTs)) on the same question
- Outcome
- Replication of significant mortality reduction by subsequent mRCTs
Pooled result
As reported in the abstract
Concordance of mortality results between sRCTs and subsequent mRCTs
- sRCTs with at least one subsequent mRCT (24 mRCTs in total)
- 16
- sRCTs not yet addressed by a subsequent mRCT
- three
- sRCTs followed by mRCT replicating significant mortality reduction
- one out of 16 (6%)
- sRCTs followed by mRCTs with no mortality difference
- 14 (88%)
- sRCT (intensive glycemic control) contradicted by mRCT showing significant mortality increase
- one (6%)
Further pooled results
Guideline status of sRCTs referenced in international guidelines
- sRCTs referenced at least once in international guidelines
- 14
- Since removed or suggested against in most recent guidelines
- six (43%)
Original publication
Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review. Crit Care. Published 28 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →