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Record W4311737828 · doi:10.1056/evidoa2200196

A Bayesian Interpretation of a Pediatric Cardiac Arrest Trial (THAPCA-OH)

2022· article· en· W4311737828 on OpenAlexaff
Michael O. Harhay, Bryan S. Blette, Anders Granholm, Frank W. Moler, Fernando G. Zampieri, Ewan C. Goligher, Monique M. Gardner, Alexis Topjian, Nadir Yehya

Bibliographic record

VenueNEJM Evidence · 2022
Typearticle
Languageen
FieldMedicine
TopicCardiac Arrest and Resuscitation
Canadian institutionsUniversity of TorontoUniversity Health NetworkToronto General HospitalUniversity of Alberta
Fundersnot available
KeywordsBayesian probabilityHypothermiaMedicineLeverage (statistics)Clinical trialIntensive care medicineInternal medicineEmergency medicineComputer scienceMachine learningArtificial intelligence

Abstract

fetched live from OpenAlex

BACKGROUND Pediatric out-of-hospital cardiac arrest results in high morbidity and mortality.Currently, there are no recommended therapies beyond supportive care.The THAPCA-OH (Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital) trial compared hypothermia (33.0 C) with normothermia (36.8 C) in 295 children.Good neurobehavioral outcome and survival at 1 year were higher in the hypothermia group (20 vs. 12% and 38 vs. 29%, respectively).These differences did not meet the planned statistical threshold of P,0.05.To ensure that a potentially efficacious therapy is not prematurely discarded, we reassessed THAPCA-OH using a Bayesian statistical perspective. METHODSWe performed a Bayesian analysis, interpreting the trial in probabilistic terms (i.e., the probability that therapeutic hypothermia had any benefit, and overall absolute improvements greater than 2%, 5%, and 10% for 1-year neurobehavioral outcome and survival).Our primary analyses used noninformative priors, meaning that the analyses were based on the observed trial data without any information added by the priors.In the absence of pediatric trials to derive informative prior distributions, we used:(1) downweighted priors from adult trials; and (2) a previously published set of critical care priors that span benefit, equipoise, and harm. RESULTSIn the primary analyses, the probability of any benefit from hypothermia was 94% for both the neurobehavioral outcome and survival at 1 year.For both outcomes, the probability of benefit was .75% for all informative prior integrations with the THAPCA-OH results, except those with the most pessimistic priors.CONCLUSIONS There is a high probability that hypothermia provides a modest benefit in neurobehavioral outcome and survival at 1 year.(ClinicalTrials.govnumber, NCT00878644.)

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 imitation

Not 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.

metaresearch head score (Codex)0.089
metaresearch head score (Gemma)0.266
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.089
Threshold uncertainty score0.468

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0890.266
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.003
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0020.001
Research integrity0.0030.004
Insufficient payload (model declined to judge)0.0110.001

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.

Opus teacher head0.022
GPT teacher head0.306
Teacher spread0.284 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSimulation or modeling
Domainnot available
GenreEmpirical

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".

Quick stats

Citations22
Published2022
Admission routes1
Has abstractyes

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