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一项评估在重症监护病房中实施床边基于证据的脑死亡潜在器官供者临床管理检查表对提高器官捐献效果的整群随机试验的统计分析计划:DONORS(优化器官恢复研究捐赠网络)。

Statistical analysis plan for a cluster-randomised trial assessing the effectiveness of implementation of a bedside evidence-based checklist for clinical management of brain-dead potential organ donors in intensive care units: DONORS (Donation Network to Optimise Organ Recovery Study).

机构信息

Research Projects Office, Hospital Moinhos de Vento (HMV), Rua Ramiro Barcelos, 910, Porto Alegre, RS, 90035-001, Brazil.

Postgraduate Programme in Epidemiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

出版信息

Trials. 2020 Jun 17;21(1):540. doi: 10.1186/s13063-020-04457-1.

DOI:10.1186/s13063-020-04457-1
PMID:32552839
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7298918/
Abstract

BACKGROUND

The quality of clinical care of brain-dead potential organ donors may help reduce donor losses caused by irreversible or unreversed cardiac arrest and increase the number of organs donated. We sought to determine whether an evidence-based, goal-directed checklist for donor management in intensive care units (ICUs) can reduce donor losses to cardiac arrest.

METHODS/DESIGN: The DONORS study is a multicentre, cluster-randomised controlled trial with a 1:1 allocation ratio designed to compare an intervention group (goal-directed checklist for brain-dead potential organ donor management) with a control group (standard ICU care). The primary outcome is loss of potential donors due to cardiac arrest. Secondary outcomes are the number of actual organ donors and the number of solid organs recovered per actual donor. Exploratory outcomes include the achievement of relevant clinical goals during the management of brain-dead potential organ donors. The present statistical analysis plan (SAP) describes all primary statistical procedures that will be used to evaluate the results and perform exploratory and sensitivity analyses of the trial.

DISCUSSION

The SAP of the DONORS study aims to describe its analytic procedures, enhancing the transparency of the study. At the moment of SAP subsmission, 63 institutions have been randomised and were enrolling study participants. Thus, the analyses reported herein have been defined before the end of the study recruitment and database locking.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03179020. Registered on 7 June 2017.

摘要

背景

脑死亡潜在供体的临床护理质量有助于减少因不可逆或未逆转的心脏骤停而导致的供体损失,并增加捐献器官的数量。我们旨在确定 ICU 中基于证据的脑死亡潜在供体管理目标导向检查表是否可以减少因心脏骤停导致的供体损失。

方法/设计:DONORS 研究是一项多中心、集群随机对照试验,采用 1:1 分配比设计,旨在比较干预组(脑死亡潜在供体管理目标导向检查表)与对照组(标准 ICU 护理)。主要结局是因心脏骤停而失去潜在供体。次要结局是实际供体的数量和每个实际供体恢复的实体器官数量。探索性结局包括在管理脑死亡潜在供体期间实现相关临床目标的情况。本统计分析计划(SAP)描述了所有将用于评估试验结果和进行探索性及敏感性分析的主要统计程序。

讨论

DONORS 研究的 SAP 旨在描述其分析程序,提高研究的透明度。在 SAP 提交时,已经对 63 家机构进行了随机分组并正在招募研究参与者。因此,本文报告的分析是在研究招募结束和数据库锁定之前定义的。

试验注册

ClinicalTrials.gov,NCT03179020。于 2017 年 6 月 7 日注册。

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本文引用的文献

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DONORS (Donation Network to Optimise Organ Recovery Study): Study protocol to evaluate the implementation of an evidence-based checklist for brain-dead potential organ donor management in intensive care units, a cluster randomised trial.供者(优化器官获取网络研究):一项评价在 ICU 中对脑死亡潜在器官捐献者管理实施基于证据的检查表的方案,一项整群随机试验。
BMJ Open. 2019 Jun 25;9(6):e028570. doi: 10.1136/bmjopen-2018-028570.
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Estimating relative risks in multicenter studies with a small number of centers - which methods to use? A simulation study.在中心数量较少的多中心研究中估计相对风险——应使用哪些方法?一项模拟研究。
Trials. 2017 Nov 2;18(1):512. doi: 10.1186/s13063-017-2248-1.
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Int J Epidemiol. 2018 Feb 1;47(1):321-331. doi: 10.1093/ije/dyx169.
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Positive impact of a clinical goal-directed protocol on reducing cardiac arrests during potential brain-dead donor maintenance.临床目标导向方案对减少潜在脑死亡供体维持期间心脏骤停的积极影响。
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Performance of models for estimating absolute risk difference in multicenter trials with binary outcome.多中心二分类结局试验中绝对风险差异估计模型的性能
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