SCCM Resource Library-Critical Care Research: Old Trials Through New Lenses

Video Transcription

Video Summary

The video consists of two presentations on the topic of interpreting clinical trials in critical care through both frequentist and Bayesian approaches. The first speaker, Alex Flannery, discusses the challenges of interpreting critical care literature using traditional frequentist methods. He emphasizes the importance of nuances in analyzing and presenting data that can influence clinicians' interpretation and decision-making. He highlights examples of trials from the frequentist standpoint, focusing on issues such as sample sizes, treating syndromes in critical care, high mortality rates, and the use of composite outcomes like ventilator-free days. Flannery also mentions the concept of fragility index, which measures how many non-events in a trial group would need to become events for a previously statistically significant result to become insignificant. He concludes by questioning the continued use of mortality as the primary endpoint in critical care trials.  The second speaker, Fernando Zimperi, introduces the Bayesian approach as an alternative way to interpret clinical trials. He compares frequentist and Bayesian methods, highlighting the limitations of frequentist approaches such as p-values and the reproducibility crisis. Zimperi explains that in Bayesian reasoning, the data is fixed while the effect size is assumed to be random, and prior beliefs are incorporated into the analysis. He demonstrates how Bayesian analysis can be used to estimate the probability of various effect sizes and interpret trial results. Zimperi presents reanalysis examples of trials like ECMO in ARDS and perfusion targets in septic shock, showing how Bayesian analysis can provide more meaningful and interpretable results for clinicians. He concludes that Bayesian methods can aid trial interpretation and suggests that different approaches can coexist as long as they are used properly.

Asset Subtitle

Research, Quality and Patient Safety, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Identify best practices for analysis in critical care literature and downstream effects of nonadherence to these analyses in particular situations
Recognize instances in critical care research in which frequentist and Bayesian interpretations of the same clinical trial may be at odds with each other
Interpret the results of a Bayesian analysis given the prior probability reference frame

Common Challenges With Interpretation of Critical Care Literature
Alexander H. Flannery

Viewing Through a Different Lens: A Bayesian Approach
Fernando Zampieri

Meta Tag

Content Type Presentation

Knowledge Area Research

Knowledge Area Quality and Patient Safety

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Outcomes Research

Tag Mortality

Tag Scoring Systems

Year 2021

Keywords

interpreting clinical trials

frequentist approach

Bayesian approach

critical care literature

sample sizes

composite outcomes

fragility index

reproducibility crisis

Bayesian analysis

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.