{"title":"Searching for defining adequate protein intake in ICU patients: is intention to treat analysis the best?","authors":"Eric Fontaine","doi":"10.1097/MCO.0000000000001145","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Many clinical trials have failed to demonstrate the superiority of one nutritional protocol over another. This raises questions about the assessment tools used. In particular, intention-to-treat data analysis can mask individual truths, especially in cases of protocol noncompliance. If patients do not always achieve their nutritional goals, an intention-to-treat analysis tends to conclude that the two protocols studied are no different.</p><p><strong>Recent findings: </strong>This is particularly the case in two recent articles published in The Lancet, where patients failed to achieve the predefined protein target in intensive care patients due to protocol deviation.</p><p><strong>Summary: </strong>I argue here for further analysis, including per-protocol analysis, to avoid the false conclusion that failure to show a difference means there is no difference.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"433-435"},"PeriodicalIF":3.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Clinical Nutrition and Metabolic Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCO.0000000000001145","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Many clinical trials have failed to demonstrate the superiority of one nutritional protocol over another. This raises questions about the assessment tools used. In particular, intention-to-treat data analysis can mask individual truths, especially in cases of protocol noncompliance. If patients do not always achieve their nutritional goals, an intention-to-treat analysis tends to conclude that the two protocols studied are no different.
Recent findings: This is particularly the case in two recent articles published in The Lancet, where patients failed to achieve the predefined protein target in intensive care patients due to protocol deviation.
Summary: I argue here for further analysis, including per-protocol analysis, to avoid the false conclusion that failure to show a difference means there is no difference.
期刊介绍：
A high impact review journal which boasts an international readership, Current Opinion in Clinical Nutrition and Metabolic Care offers a broad-based perspective on the most recent and exciting developments within the field of clinical nutrition and metabolic care. Published bimonthly, each issue features insightful editorials and high quality invited reviews covering two or three key disciplines which include protein, amino acid metabolism and therapy, lipid metabolism and therapy, nutrition and the intensive care unit and carbohydrates. Each discipline introduces world renowned guest editors to ensure the journal is at the forefront of knowledge development and delivers balanced, expert assessments of advances from the previous year.
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