Fragility index for extended prophylaxis following abdominopelvic surgery: A methodological survey

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-10-19 DOI:10.1016/j.amjsurg.2024.116020

Tyler McKechnie , Ruxandra-Maria Bogdan , Kelly Brennan , Victoria Shi , Shan Grewal , Cagla Eskicioglu , Ameer Farooq , Sunil Patel

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引用次数: 0

Abstract

Background

Fragility Index (FI) is increasingly used to assess robustness of statistically significant p-values reported in randomized controlled trials (RCTs). FI represents the lowest number of non-events changed to events that would make study findings non-significant. This methodological survey was designed to assess the fragility of the evidence for extended VTEp following major abdominopelvic surgery.

Methods

MEDLINE, Embase, and CENTRAL were searched from inception to November 2023. RCTs with parallel, double-armed, superiority design comparing extended VTEp for patients undergoing major abdominopelvic surgery to controls with at least one statistically significant dichotomous outcome were included. Walsh et al.’s method of calculating FI was utilized.

Results

After review of 611 citations, 6 RCTs were identified with 12 statistically significant outcomes between groups. The mean number of patients randomized per RCT was 419 (SD 176). The median FI was 1.5 (range: 1–4). The number of patients lost to follow-up was greater than the FI for 10/12 (83.3 %) outcomes.

Conclusions

Statistically significant differences reported in RCTs evaluating extended VTEp following major abdominopelvic surgery are not robust.

查看原文本刊更多论文

腹盆腔手术后延长预防的脆性指数：方法学调查。

背景：脆性指数（FI）越来越多地被用来评估随机对照试验（RCT）中报告的具有统计学意义的 P 值的稳健性。FI 表示由非事件转变为事件的最低数量，它将使研究结果变得不显著。这项方法学调查旨在评估腹盆腔大手术后延长 VTEp 证据的脆弱性：方法：检索了从开始到 2023 年 11 月的 MEDLINE、Embase 和 CENTRAL。方法：检索了MEDLINE、Embase和CENTRAL，检索时间为2023年11月，采用平行、双臂、优效性设计的RCT，将腹盆腔大手术患者的延长VTEp与对照组进行比较，且至少有一项具有统计学意义的二分法结果。结果：结果：在查阅了 611 篇引文后，确定了 6 项 RCT，其中有 12 项具有统计学意义的组间结果。每项研究的平均随机患者人数为 419 人（标清 176 人）。中位 FI 为 1.5（范围：1-4）。在 10/12 组（83.3%）结果中，失去随访的患者人数多于 FI：结论：对腹盆腔大手术后扩大 VTEp 进行评估的 RCT 所报告的具有统计学意义的差异并不可靠。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.