Catalogue of bias: attrition bias

This article is part of a series of articles featuring the Catalogue of Bias introduced in this volume of BMJ Evidence-Based Medicine that describes attrition bias and outlines its potential impact on research studies and the preventive steps to minimise its risk. Attrition bias is a type of selection bias due to systematic differences between study groups in the number and the way participants are lost from a study. Differences between people who leave a study and those who continue, particularly between study groups, can be the reason for any observed effect and not the intervention itself. Associations for mortality in trials of tranexamic acid and upper gastrointestinal bleeding were no longer apparent after studies with high or unclear risk of attrition bias were removed. Over-recruitment can help prevent important attrition bias. Sampling weights and tailored replenishment samples can help to compensate for the effects of attrition bias when present.

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Management of upper gastrointestinal bleeding emergencies: evidence-based medicine and practical consideration

World Journal of Emergency Medicine ◽

10.5847/wjem.j.1920-8642.2011.01.001 ◽

2011 ◽

Vol 2 (1) ◽

pp. 5 ◽

Cited By ~ 8

Author(s):

Zongyu John Chen

Keyword(s):

Gastrointestinal Bleeding ◽

Evidence Based Medicine ◽

Upper Gastrointestinal Bleeding ◽

Evidence Based ◽

Practical Consideration ◽

Based Medicine ◽

Upper Gastrointestinal

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Vasoconstrictors in combination with proton pump inhibitors as an initial treatment of acute upper gastrointestinal bleeding in liver cirrhosis: is it evidence based?

Annals of Translational Medicine ◽

10.21037/atm.2018.08.07 ◽

2018 ◽

Vol 6 (16) ◽

pp. 327-327

Author(s):

Fan Gao ◽

Nahum Méndez-Sánchez ◽

Xingshun Qi

Keyword(s):

Liver Cirrhosis ◽

Gastrointestinal Bleeding ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Initial Treatment ◽

Upper Gastrointestinal Bleeding ◽

Evidence Based ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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Upper Gastrointestinal Bleeding: An Evidence-Based Approach

A Clinical Approach to Medicine ◽

10.1142/9789810248178_0019 ◽

2001 ◽

pp. 372-394

Author(s):

WIDJAJA LUMAN

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Evidence Based ◽

Upper Gastrointestinal

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British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding

Frontline Gastroenterology ◽

10.1136/flgastro-2019-101395 ◽

2020 ◽

Vol 11 (4) ◽

pp. 311-323 ◽

Cited By ~ 2

Author(s):

Keith Siau ◽

Sarah Hearnshaw ◽

Adrian J Stanley ◽

Lise Estcourt ◽

Ashraf Rasheed ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Patient Outcomes ◽

Upper Gastrointestinal Bleeding ◽

British Society ◽

Standards Of Care ◽

Care Bundle ◽

Evidence Based ◽

Early Management ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

Medical care bundles improve standards of care and patient outcomes. Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency which has been consistently associated with suboptimal care. We aimed to develop a multisociety care bundle centred on the early management of AUGIB.Commissioned by the British Society of Gastroenterology (BSG), a UK multisociety task force was assembled to produce an evidence-based and consensus-based care bundle detailing key interventions to be performed within 24 hours of presentation with AUGIB. A modified Delphi process was conducted with stakeholder representation from BSG, Association of Upper Gastrointestinal Surgeons, Society for Acute Medicine and the National Blood Transfusion Service of the UK. A formal literature search was conducted and international AUGIB guidelines reviewed. Evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation tool and statements were formulated and subjected to anonymous electronic voting to achieve consensus. Accepted statements were eligible for incorporation into the final bundle after a separate round of voting. The final version of the care bundle was reviewed by the BSG Clinical Services and Standards Committee and approved by all stakeholder groups.Consensus was reached on 19 statements; these culminated in 14 corresponding care bundle items, contained within 6 management domains: Recognition, Resuscitation, Risk assessment, Rx (Treatment), Refer and Review.A multisociety care bundle for AUGIB has been developed to facilitate timely delivery of evidence-based interventions and drive quality improvement and patient outcomes in AUGIB.

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