651
Bibliographic record
Abstract
Introduction: The purpose of this review was to systematically identify and characterize randomized controlled trials (RCTs) in pediatric critical care. Hypothesis: We hypothesize that RCTs in critically ill children are limited in number, size and methodologic quality. Methods: We searched MEDLINE, EMBASE, LILACS and CENTRAL (from inception to July 1, 2012). We included published RCTs and quasi-randomized trials that administered any intervention to children in a pediatric critical care unit. We excluded trials enrolling exclusively newborns, cross-over trials and those only published as abstracts. We used no language restrictions. Pairs of reviewers independently screened studies for eligibility and abstracted data. Discrepancies were resolved by consensus. Results: We included 226 RCTs out of 7280 unique citations screened: 39 (17.3%) were multicentered and 10 (4.4%) were multinational. The most frequently studied populations were mixed critically ill (43.4%), post-operative cardiac surgery (16.4%) and bronchiolitis (7.1%). The most frequently evaluated interventions were medications (59.7%), devices (10.6%), nutrition (9.3%) and mechanical ventilation (8.0%). Almost half, 105 (46.5%), reported blinding. Of the 93 (41.2%) trials that reported an a priori sample size, 32 (34.4%) were stopped early and 20 (21.5%) were stopped for futility, funding or recruitment problems. The median number of children randomized per trial was 47.5 and varied from 6 to 1199. Of the 133 (58.9%) trials reporting the mean age children enrolled, the mean was 4.3 years and varied from 1 month to 14.3 years. Of the 135 (59.7%) trials reporting mortality outcomes, the median mortality rate was 6.4%, varying from 0% to 88.2%. The frequency of RCT publication increased at a mean rate of 1.2 RCT/year (p<0.001) from 1988 to 2011, but the median sample size did not change significantly (p=0.31). Conclusions: The majority of RCTs in pediatric critical care focused on medications, were single-centered and of variable methodological quality. The number of published pediatric critical care trials is increasing but the sample size is not. Significant challenges still exist in completing these studies.Funding: The Canadian Institutes of Health Research.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.323 | 0.127 |
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".