Prophylactic platelet transfusions versus no prophylaxis in hospitalized patients with thrombocytopenia: A systematic review with meta‐analysis
Bibliographic record
Abstract
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
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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 | 0.009 | 0.025 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.034 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".