A randomized controlled trial comparing the outcome of critically ill adults who received fresher vs. older red cells units
Bibliographic record
Abstract
Background and Objectives Red blood cell ( RBC ) units are stored up to 42 days postcollection. The standard policy is to deliver the oldest units in order to limit blood wastage. The hypothesis of the ‘Age of Blood Evaluation’ ( ABLE ) study was that the outcomes of adults transfused in intensive care units ( ICU ) with RBC units stored ≤7 days will be better than controls who received the oldest RBC units. Materials and Methods The ABLE study is a double‐blind randomized controlled trial. The primary outcome measure was all‐cause 90‐day mortality postrandomization. Secondary outcomes included 28‐day, ICU and hospital mortality, acquired infections, length of ICU and hospital stay, and length of treatments. Statistical analyses were performed using an intention‐to‐treat approach. Results From 2009 to 2014, 1211 patients were allocated to the fresh arm, 1219 to the control arm (length of storage: 6·1 ± 4·9 and 22·0 ± 8·4 days, P < 0·001). There were 448 deaths (37·0%) in the fresh arm 90‐day postrandomization, and 430 (35·3%) in the control arm (absolute risk difference: 1·7%; 95% CI : −2·1% to 5·5%). A survival analysis revealed that the hazard ratio of deaths 90 days postrandomization was 1·1% in the fresh‐blood group (95% CI : 0·9% and 1·2%). The same trend against the fresh arm intervention was observed with all but one secondary outcome measure. Conclusion The transfusion of RBC units stored ≤7 days does not improve the outcome of critically ill adults compared to the transfusion of units stored about 3 weeks ( ISRCTN 44878718).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".