Safety and Efficacy of Midline and Peripherally Inserted Central Catheter for Intravenous Therapy: A Randomized Controlled Trial
Bibliographic record
Abstract
Introduction: The aim of this study was to test the hypothesis that midlines are noninferior to peripherally inserted central catheter (PICC) for intravenous therapy that does not require a central catheter. Materials and Methods: Prospective randomized open-label clinical trial, in which midlines are compared with PICCs in adults who required peripheral intravenous therapy of 1 to 4 weeks. With a noninferiority margin of 10%, 510 patients need to be enrolled in this study. Patients eligible for midline according to recommendations of the Infusion Nurses Society (2016) were included. Vesicant intravenous therapy was excluded. Patients were followed until 1 week after venous access removal. The primary efficacy outcome was the percentage of patients who completed their treatment without limitation due to catheter dysfunction. Result: This interim analysis includes the first 72 patients enrolled (45 men, 27 women; average age: 52.6 years) since August 2018, 35 randomized to the midline group and 37 to the PICC group. One catheter was removed prematurely in both groups ( p = 0.78). Catheter dysfunction, mostly incapacity to draw blood, was observed in 6/35 (21%) patients in the midline group versus 1/36 (2.8%) patients in the PICCs group ( p = 0.01). There were 3/35 (8.5%) device-related adverse events in midline group and no adverse event in PICCs ( p = 0.46), There was one unrelated death in the PICC group and no major device-related event in both groups. Conclusions: Comparison of primary efficacy outcomes with available data is not yet conclusive. However, given the greater catheter dysfunction rate with midlines, these catheters should not replace PICC in patients with difficult venipuncture and who require blood samplings. Publication History Article published online: 17 August 2022 © 2022. The Pan Arab Interventional Radiology Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".