Prophylactic platelet transfusions versus no prophylaxis in hospitalized patients with thrombocytopenia: A systematic review with meta‐analysis
Notice bibliographique
Résumé
PROSPERO; CRD42021236014) and conducted in accordance with a published protocol.19 We followed the recommendations by the Cochrane Collaboration, 20 the Grading of Recommendations Assessment, Development and Evaluation (GRADE) 21 approach and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement (checklist available in Supplement S1).22 | Study selectionAll RCTs and cluster RCTs comparing prophylactic platelet transfusion in any dose versus no prophylaxis or placebo in non-bleeding hospitalized patients with thrombocytopenia (as defined in the trials) were eligible for inclusion without restriction regarding age, diagnoses, or settings.Cohort studies, case-control studies, reviews, quasi-randomized trials, and crossover trials were excluded.We did not allow concomitant use of other interventions unless they were used in both allocation groups. | Outcomes | Primary outcome1. All-cause mortality at longest follow-up. | Secondary outcomes1.The proportion of participants with at least one episode of clinically important bleeding.2. Days with clinically important bleeding.3. The proportion of participants with at least one nosocomial infection.4. The proportion of participants with at least one venous or arterial thromboembolic event.5.The proportion of participants with at least one transfusion-related adverse event.6. Days alive without life support.7. Length of hospital stay.8. Health-related quality of life.Clinically important bleeding, nosocomial infection, venous or arterial thrombo-embolic, and transfusionrelated adverse events were defined in the included trials.The unit of analysis was randomized patients, and all outcomes were assessed at the longest follow-up.19 Additional details are available in the protocol 19 and Supplement S3. | Process variablesWe collected data on the number of units of platelets, red blood cells (RBC) and fresh frozen plasma (FFP) transfused per participant. | Search strategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, and Epistemonikos and searched for ongoing trials in the U.S. National Library of Medicine (ClinicalTrials.gov),EU Clinical Trials Register, and the World Health Organization (WHO) International Clinical Trials Registry.The searches were conducted without restrictions on language or publication status on March 29, 2021 and updated in PubMed on February 3, 2022 (Supplement S4). | Data collection and analysis | Study selectionAll records were independently screened for eligibility by two authors (CTA, AG, PS, and NZ).Potential eligible articles were assessed in full text by two authors (CTA, AG, PS, and NZ).We resolved disagreements by discussion and consulted a third author (MHM and LR) if needed.We used Covidence (https://www.covidence.org;Veritas Health Innovation, Melbourne, Australia) to facilitate the study selection. | Data extraction and managementTwo authors independently (CA and AG) extracted data from the included studies.We extracted data on trial characteristics, population characteristics, interventions, co-interventions, outcomes, and process variables as specified above (Supplement S5).We contacted the corresponding authors at least twice for clarifications and unpublished or missing outcome data, if applicable.We resolved disagreements by discussion and involved a third author (MHM and LR) if needed. | Risk of bias in included trialsTwo authors independently (CA and PS) assessed the risk of bias using the Risk of Bias 2.0 tool.23 We assessed the risk of bias on the outcome level within all five domains: "bias arising from the randomization process," "bias due 2118
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,025 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,018 | 0,034 |
| Bibliométrie | 0,005 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».