Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest

Suverein, Martje M.; Delnoij, Thijs; Lorusso, Roberto; Bruinsma, George J. Brandon Bravo; Otterspoor, Luuk C.; Kraemer, Carlos V. Elzo; Vlaar, Alexander P.J.; Heijden, Joris J. van der; Scholten, Erik; Uil, Corstiaan A. den; Jansen, T.; Bogaard, Bas van den; Kuijpers, Marijn; Lam, Ka Yan; Cabezas, José M. Montero; Driessen, Antoine H.G.; Rittersma, Saskia Z.H.; Heijnen, Bram G.; Miranda, Dinís Dos Reis; Bleeker, Gabe B.; Metz, Jesse de; Hermanides, Renicus S; Matta, Jorge López; Eberl, Susanne; Donker, Dirk W.; Thiel, Robert J. van; Akın, Şakir; Meer, Oene van; Henriques, José P.S.; Bokhoven, Karen C.; Mandigers, Loes; Bunge, Jeroen J H; Bol, Martine E.; Winkens, Björn; Essers, Brigitte; Weerwind, Patrick W.; Maessen, Jos G.; Poll, Marcel C. G. van de

doi:10.1056/nejmoa2204511

Cited by 169 publications

(132 citation statements)

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“…For the literature search, ChatGPT and AI research assistants (such as “elicit.org”) can aid researchers in the review process by finding academic papers, summarizing their conclusions, and highlighting areas of uncertainty (i.e., summarizing the recent randomized clinical trial on the use of extracorporeal membrane oxygenation for refractory cardiac arrest [ 3 ], Fig. 1 ).…”

Section: Chatgpt In Scientific Writingmentioning

confidence: 99%

Can artificial intelligence help for scientific writing?

2023

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This paper discusses the use of Artificial Intelligence Chatbot in scientific writing. ChatGPT is a type of chatbot, developed by OpenAI, that uses the Generative Pre-trained Transformer (GPT) language model to understand and respond to natural language inputs. AI chatbot and ChatGPT in particular appear to be useful tools in scientific writing, assisting researchers and scientists in organizing material, generating an initial draft and/or in proofreading. There is no publication in the field of critical care medicine prepared using this approach; however, this will be a possibility in the next future. ChatGPT work should not be used as a replacement for human judgment and the output should always be reviewed by experts before being used in any critical decision-making or application. Moreover, several ethical issues arise about using these tools, such as the risk of plagiarism and inaccuracies, as well as a potential imbalance in its accessibility between high- and low-income countries, if the software becomes paying. For this reason, a consensus on how to regulate the use of chatbots in scientific writing will soon be required.

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Section: Chatgpt In Scientific Writingmentioning

confidence: 99%

Can artificial intelligence help for scientific writing?

2023

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Section: Resultsmentioning

confidence: 99%

“…ITT data from the INCEPTION trial 1 and two other pertinent trials 5,6 that also randomized out of hospital cardiac arrest patients to cCPR to eCPR are shown in Table 1. Performing a Bayesian analysis on the INCEPTION 1 trial, using a default vague prior, produces an odds ratio (OR) 1.32 with 95% CrI 0.54 - 3.22. The closeness of this result to the original analysis (OR, 1.4; 95% CI 0.5 - 3.5) confirms the minimal impact of the default vague prior and reveals a Bayesian analysis completely dominated by the observed INCEPTION 1 data.…”

Section: Resultsmentioning

confidence: 99%

“…INCEPTION 1 did not report a per-protocol analysis. Such an analysis may be helpful in assessing treatment efficacy, unfortunately at the risk of an increased risk of bias by not respecting the ITT principle.…”

Section: Resultsmentioning

confidence: 99%

“…These probability statements arise from the posterior distribution according to the Bayes Thereom, expressed as follows: Therefore, in addition to the current data summarized by the probability of the data (likelihood function), prior probability distributions are required. Because our main focus is the analysis and interpretation of the INCEPTION trial 1 alone, our primary analysis used a default vague parameter prior ( log ( θ ) ∼Normal [0, 2.50], thereby assuring that the posterior distribution is dominated by the observed INCEPTION 1 data.…”

Section: Methodsmentioning

confidence: 99%

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A Bayesian Perspective Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest

Brophy

2023

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A recent randomized clinical trial, INCEPTION, reported in patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR (eCPR) and conventional CPR (cCPR) had similar effects on survival with a favorable neurologic outcome. The current study examines if a Bayesian perspective provides additional quantative insights. Depending on the prior selected, the Bayesian approach for the INCEPTION intentionto treat (ITT) analysis shows an equivalence probability between 13.4 - 16.8% (defined as 1 / 1.1 < odds ratio (OR) < 1.1). The probability of clinical superiority with eCPR ranges from 65.7 - 77.0 % (defined as OR > 1.1). A similar analyses using INCEPTION per protocol (PP) data shows an equivalence probability between 4.7 - 20.2% with reduced probabilities of clinical superiority not exceeding 25%. It is concluded that a Bayesian perspective allows considerable additional quantative insights into the trial analysis and interpretation. The non-negligible probabilities of increased survival, or even harm, with their considerable residual uncertainties, suggests that additional studies are required before concluding that eCPR and cCPR have similar average survival effects.

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