scholarly journals 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)

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalia Elis Giordani ◽  
Caroline Cabral Robinson ◽  
Glauco Adrieno Westphal ◽  
Regis Goulart Rosa ◽  
Daniel Sganzerla ◽  
...  
BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028570 ◽  
Author(s):  
Glauco Adrieno Westphal ◽  
Caroline Cabral Robinson ◽  
Alexandre Biasi ◽  
Flávia Ribeiro Machado ◽  
Regis Goulart Rosa ◽  
...  

IntroductionThere is an increasing demand for multi-organ donors for organ transplantation programmes. This study protocol describes the Donation Network to Optimise Organ Recovery Study, a planned cluster randomised controlled trial that aims to evaluate the effectiveness of the implementation of an evidence-based, goal-directed checklist for brain-dead potential organ donor management in intensive care units (ICUs) in reducing the loss of potential donors due to cardiac arrest.Methods and analysisThe study will include ICUs of at least 60 Brazilian sites with an average of ≥10 annual notifications of valid potential organ donors. Hospitals will be randomly assigned (with a 1:1 allocation ratio) to the intervention group, which will involve the implementation of an evidence-based, goal-directed checklist for potential organ donor maintenance, or the control group, which will maintain the usual care practices of the ICU. Team members from all participating ICUs will receive training on how to conduct family interviews for organ donation. The primary outcome will be loss of potential donors due to cardiac arrest. Secondary outcomes will include the number of actual organ donors and the number of organs recovered per actual donor.Ethics and disseminationThe institutional review board (IRB) of the coordinating centre and of each participating site individually approved the study. We requested a waiver of informed consent for the IRB of each site. Study results will be disseminated to the general medical community through publications in peer-reviewed medical journals.Trial registration numberNCT03179020; Pre-results.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e041799
Author(s):  
Mickael Landais ◽  
Mai-Anh Nay ◽  
Johann Auchabie ◽  
Noemie Hubert ◽  
Anne Rebion ◽  
...  

IntroductionFasting is frequently imposed to patients before extubation in the intensive care unit based on scheduled surgery guidelines. This practice has never been evaluated among critically ill patients and may delay extubation, increase nursing workload and reduce caloric intake. We are hypothesising that continuous enteral nutrition until extubation represents a safe alternative compared with fasting prior to extubation in the intensive care unit.Methods and analysisAdult patients ventilated more than 48 hours and receiving pre-pyloric enteral nutrition for more than 24 hours are included in this open-label cluster randomised parallel group non-inferiority trial. The participating centres are randomised allocated to continued enteral nutrition until extubation or 6-hour fasting (with concomitant gastric suctioning when feasible) prior to extubation. The primary outcome is extubation failure (ie, reintubation within 7 days following extubation).Ethics and disseminationThis study has been approved by the national ethics review board (comité de protection, des personnes Sud Mediterranée III No 2017.10.02 bis) and patients are included after informed consent. Results will be submitted for publication in peer-reviewed journals.Trial registration numberClinicalTrials.gov Registry (NCT03335345).


BMJ ◽  
2004 ◽  
Vol 329 (7473) ◽  
pp. 1004 ◽  
Author(s):  
Jeffrey D Horbar ◽  
Joseph H Carpenter ◽  
Jeffrey Buzas ◽  
Roger F Soll ◽  
Gautham Suresh ◽  
...  

2021 ◽  
Author(s):  
Laurent Billot ◽  
Denise O'Connor ◽  
Brigit Maguire ◽  
Dina Schram ◽  
Robert Ma ◽  
...  

The primary objective of the MSK DI AF trial is to estimate the effectiveness of audit and feedback for reducing diagnostic imaging requests for 11 musculoskeletal imaging services in high requesting GPs in Australia compared with control. It is a 5-arm partial 2 x 2 factorial cluster randomised trial testing variations in the design and delivery of audit and feedback for reducing musculoskeletal diagnostic imaging requests in Australian general practice. This statistical analysis plan pre-specifies all analyses and was prepared while blinded to the randomised allocation.


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