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首页> 外文期刊>Indian Journal of Critical Care Medicine >How Robust are the Evidences that Formulate Surviving Sepsis Guidelines? An Analysis of Fragility and Reverse Fragility of Randomized Controlled Trials that were Referred in these Guidelines
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How Robust are the Evidences that Formulate Surviving Sepsis Guidelines? An Analysis of Fragility and Reverse Fragility of Randomized Controlled Trials that were Referred in these Guidelines

机译：制定潜伏期的败血症指南的证据是多么强大？ 在这些指导方针中提到的随机对照试验的脆弱性和逆向脆弱性分析

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Objectives:"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016" provides guidelines in regard to prompt management and resuscitation of sepsis or septic shock. The study is aimed to assess the robustness of randomized controlled trials (RCTs) that formulate these guidelines in terms of fragility index and reverse fragility index.Method:RCTs that contributed to these guidelines having parallel two-group design, 1:1 allocation ratio, and at least one dichotomous outcome were included in the study. The median fragility index was calculated for RCTs with significant statistical outcomes, whereas the median reverse fragility index was calculated for RCTs with nonsignificant statistical results.Results:Hundred RCTs that met the inclusion criteria were analyzed. The median fragility index was 5.5 [95% confidence interval (CI) 1-30] and median reverse fragility index was 13 (95% CI 12.07-16.8) at a p value of 0.05. The median reverse fragility index was 16 (95% CI 10-26) at a p value of 0.01. Most of the RCTs included in this analysis were of good quality, having a median Jadad score of 6.Conclusion:This analysis found that the surviving sepsis guidelines were based on highly robust RCTs with statistically insignificant results and on some moderately robust RCTs with statistically significant results. RCTs with statistically insignificant results were more robust than RCTs with statistically significant results in regard to these guidelines.Highlights:The study assessed the robustness of randomized controlled trials (RCTs) that were used to formulate surviving sepsis guidelines. Most RCTs showed statistically nonsignificant results. RCTs with statistically significant results were moderately fragile whereas RCTs with nonsignificant results were more robust.How to cite this article:Choupoo NS, Das SK, Saikia P, Dey S, Ray S. How Robust are the Evidences that Formulate Surviving Sepsis Guidelines? An Analysis of Fragility and Reverse Fragility of Randomized Controlled Trials that were Referred in these Guidelines. Indian J Crit Care Med 2021;25(7):773-779.Copyright ? 2021; Jaypee Brothers Medical Publishers (P) Ltd.
机译：目的：“苏州苏联竞选：败血症管理的国际指南：2016”为迅速管理和复苏的败血症或脓毒症休克提供指导。该研究旨在评估随机对照试验（RCT）的稳健性，该试验（RCT）在脆弱指数和逆转脆弱指数方面制定这些指导..方法：RCT，导致这些指南的平行双组设计，1：1分配比例，在研究中包含至少一种二分结节。对于具有显着统计结果的RCT的RCT计算了中值脆弱指数，而具有非显着统计结果的RCT计算中位数的反向脆性指数。分析了符合纳入标准的数百个RCT。中值脆性指数为5.5 [95％置信区间（CI）1-30]，中位逆脆性指数为13（95％CI 12.07-16.8），P值为0.05。中位反向脆性指数为16（95％CI 10-26），P值为0.01。这种分析中包括的大多数RCT都具有良好的质量，具有中位数的Jadad评分为6.结论：该分析发现幸存的败血症指南基于具有统计上微不足道的结果的高度强大的RCT，以及一些具有统计学意义的中等强大的RCT结果。具有统计学微不足道的结果的RCT比对这些指南的统计上显着结果的RCT剧烈稳健更加强劲。实验：该研究评估了随机对照试验（RCT）的稳健性，用于制定潜存败血症指南。大多数RCT都显示出统计学上的结果。具有统计学上显着的结果的RCT是适度脆弱的，而具有无情的结果的RCT更加稳定。我才能引用本文：Choupoo NS，Das Sk，Saikia P，Dey S，Ray S.制定潜存败血症指南的证据如何有多强劲？在这些准则中提到的随机对照试验的脆弱性和逆向脆性分析。印度j crit care med 2021; 25（7）：773-779.copyright？ 2021; Jaypee Brothers Medical Publishers（P）有限公司

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