Elicitation of prior probability distributions for a proposed Bayesian randomized clinical trial of whole blood for trauma resuscitation

BACKGROUND Whole blood trauma resuscitation is conceptually appealing and increasingly used but lacks evidence. A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the...

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Veröffentlicht in:Transfusion (Philadelphia, Pa.) Pa.), 2020-03, Vol.60 (3), p.498-506
Hauptverfasser: Jansen, Jan O., Wang, Henry, Holcomb, John B., Harvin, John A., Richman, Joshua, Avritscher, Elenir, Stephens, Shannon W., Truong, Van Thi Thanh, Marques, Marisa B., DeSantis, Stacia M., Yamal, Jose‐Miguel, Pedroza, Claudia
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container_end_page 506
container_issue 3
container_start_page 498
container_title Transfusion (Philadelphia, Pa.)
container_volume 60
creator Jansen, Jan O.
Wang, Henry
Holcomb, John B.
Harvin, John A.
Richman, Joshua
Avritscher, Elenir
Stephens, Shannon W.
Truong, Van Thi Thanh
Marques, Marisa B.
DeSantis, Stacia M.
Yamal, Jose‐Miguel
Pedroza, Claudia
description BACKGROUND Whole blood trauma resuscitation is conceptually appealing and increasingly used but lacks evidence. A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the results on an elicitation meeting to create prior probability distributions to help develop such a trial. METHODS In‐person expert elicitation meeting, based on Sheffield Elicitation Framework methodology. We used an interactive graphical tool to elicit the quantities of interest (24‐hour mortality and certainty required). Two rounds were conducted, with an intervening discussion of deidentified responses. Individual responses were aggregated into probability distributions. RESULTS Fifteen experts participated. The pooled belief was that the median 24‐hour mortality of trauma patients with hemorrhagic shock treated with component therapy (the current standard of care) was 19% (95% credible interval [CrI], 6%‐45%), and the median 24‐hour mortality of those treated with whole blood, 16% (95% CrI, 5%‐39%). The pooled prior distribution for the relative risk had a median of 0.84 (95% CrI, 0.26‐3.1), indicating that the expert group had a 64% prior belief that whole blood decreases 24‐hour mortality compared to component therapy. CONCLUSIONS Experts had moderately strong beliefs that whole blood reduces the 24‐hour mortality of trauma patients with hemorrhagic shock. These data will assist with the design and planning of a Bayesian trial of whole blood resuscitation, which will help to answer a key question in contemporary transfusion practice.
doi_str_mv 10.1111/trf.15675
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A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the results on an elicitation meeting to create prior probability distributions to help develop such a trial. METHODS In‐person expert elicitation meeting, based on Sheffield Elicitation Framework methodology. We used an interactive graphical tool to elicit the quantities of interest (24‐hour mortality and certainty required). Two rounds were conducted, with an intervening discussion of deidentified responses. Individual responses were aggregated into probability distributions. RESULTS Fifteen experts participated. The pooled belief was that the median 24‐hour mortality of trauma patients with hemorrhagic shock treated with component therapy (the current standard of care) was 19% (95% credible interval [CrI], 6%‐45%), and the median 24‐hour mortality of those treated with whole blood, 16% (95% CrI, 5%‐39%). The pooled prior distribution for the relative risk had a median of 0.84 (95% CrI, 0.26‐3.1), indicating that the expert group had a 64% prior belief that whole blood decreases 24‐hour mortality compared to component therapy. CONCLUSIONS Experts had moderately strong beliefs that whole blood reduces the 24‐hour mortality of trauma patients with hemorrhagic shock. These data will assist with the design and planning of a Bayesian trial of whole blood resuscitation, which will help to answer a key question in contemporary transfusion practice.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.15675</identifier><identifier>PMID: 31970796</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Bayesian analysis ; Blood ; Conditional probability ; Design ; Hemorrhage ; Hemorrhagic shock ; Mortality ; Resuscitation ; Therapy ; Transfusion ; Transfusion Practice ; Trauma</subject><ispartof>Transfusion (Philadelphia, Pa.), 2020-03, Vol.60 (3), p.498-506</ispartof><rights>2020 The Authors. published by Wiley Periodicals, Inc. on behalf of AABB.</rights><rights>2020 The Authors. 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A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the results on an elicitation meeting to create prior probability distributions to help develop such a trial. METHODS In‐person expert elicitation meeting, based on Sheffield Elicitation Framework methodology. We used an interactive graphical tool to elicit the quantities of interest (24‐hour mortality and certainty required). Two rounds were conducted, with an intervening discussion of deidentified responses. Individual responses were aggregated into probability distributions. RESULTS Fifteen experts participated. The pooled belief was that the median 24‐hour mortality of trauma patients with hemorrhagic shock treated with component therapy (the current standard of care) was 19% (95% credible interval [CrI], 6%‐45%), and the median 24‐hour mortality of those treated with whole blood, 16% (95% CrI, 5%‐39%). The pooled prior distribution for the relative risk had a median of 0.84 (95% CrI, 0.26‐3.1), indicating that the expert group had a 64% prior belief that whole blood decreases 24‐hour mortality compared to component therapy. CONCLUSIONS Experts had moderately strong beliefs that whole blood reduces the 24‐hour mortality of trauma patients with hemorrhagic shock. These data will assist with the design and planning of a Bayesian trial of whole blood resuscitation, which will help to answer a key question in contemporary transfusion practice.</description><subject>Bayesian analysis</subject><subject>Blood</subject><subject>Conditional probability</subject><subject>Design</subject><subject>Hemorrhage</subject><subject>Hemorrhagic shock</subject><subject>Mortality</subject><subject>Resuscitation</subject><subject>Therapy</subject><subject>Transfusion</subject><subject>Transfusion Practice</subject><subject>Trauma</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kU1rFTEUhoMo9lpd-Ack4EYX0-ZMkvnYCLW0KhQEqetwJh82JTO5JjOW6y_wZ5vpbYsKZpFAzpMnJ3kJeQnsCMo4npM7Atm08hHZgORtVfe9fEw2jAmoAHh9QJ7lfM0Yq3sGT8kBh75lbd9syK-z4LWfcfZxotHRbfIxlTkOOPjg5x01Ps_JD8tKZOpKFdf6NmZr6Hvc2exxogknE0f_s-zp4CevMdByrMxFenMVg6VDiNHcCuaEy4g02bzk-8ufkycOQ7Yv7tZD8vX87PL0Y3Xx-cOn05OLSgvBZSVqwK4B13Wy7wehZSdrgdIIzTqttUDgumuY5qaxyOsWwTW86czQmsEJJ_ghebf3bpdhtEbbqXQTVHn3iGmnInr1d2XyV-pb_KHWDwNgRfDmTpDi98XmWY0-axsCTjYuWdVciJozLqGgr_9Br-OSpvK8QrUlDMG6Vfh2T-kUc07WPTQDTK35qpKvus23sK_-7P6BvA-0AMd74MYHu_u_SV1-Od8rfwPgLLNA</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Jansen, Jan O.</creator><creator>Wang, Henry</creator><creator>Holcomb, John B.</creator><creator>Harvin, John A.</creator><creator>Richman, Joshua</creator><creator>Avritscher, Elenir</creator><creator>Stephens, Shannon W.</creator><creator>Truong, Van Thi Thanh</creator><creator>Marques, Marisa B.</creator><creator>DeSantis, Stacia M.</creator><creator>Yamal, Jose‐Miguel</creator><creator>Pedroza, Claudia</creator><general>John Wiley &amp; 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Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jansen, Jan O.</au><au>Wang, Henry</au><au>Holcomb, John B.</au><au>Harvin, John A.</au><au>Richman, Joshua</au><au>Avritscher, Elenir</au><au>Stephens, Shannon W.</au><au>Truong, Van Thi Thanh</au><au>Marques, Marisa B.</au><au>DeSantis, Stacia M.</au><au>Yamal, Jose‐Miguel</au><au>Pedroza, Claudia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elicitation of prior probability distributions for a proposed Bayesian randomized clinical trial of whole blood for trauma resuscitation</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2020-03</date><risdate>2020</risdate><volume>60</volume><issue>3</issue><spage>498</spage><epage>506</epage><pages>498-506</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><abstract>BACKGROUND Whole blood trauma resuscitation is conceptually appealing and increasingly used but lacks evidence. A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the results on an elicitation meeting to create prior probability distributions to help develop such a trial. METHODS In‐person expert elicitation meeting, based on Sheffield Elicitation Framework methodology. We used an interactive graphical tool to elicit the quantities of interest (24‐hour mortality and certainty required). Two rounds were conducted, with an intervening discussion of deidentified responses. Individual responses were aggregated into probability distributions. RESULTS Fifteen experts participated. The pooled belief was that the median 24‐hour mortality of trauma patients with hemorrhagic shock treated with component therapy (the current standard of care) was 19% (95% credible interval [CrI], 6%‐45%), and the median 24‐hour mortality of those treated with whole blood, 16% (95% CrI, 5%‐39%). The pooled prior distribution for the relative risk had a median of 0.84 (95% CrI, 0.26‐3.1), indicating that the expert group had a 64% prior belief that whole blood decreases 24‐hour mortality compared to component therapy. CONCLUSIONS Experts had moderately strong beliefs that whole blood reduces the 24‐hour mortality of trauma patients with hemorrhagic shock. These data will assist with the design and planning of a Bayesian trial of whole blood resuscitation, which will help to answer a key question in contemporary transfusion practice.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>31970796</pmid><doi>10.1111/trf.15675</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8863-4398</orcidid><orcidid>https://orcid.org/0000-0002-4738-0093</orcidid><oa>free_for_read</oa></addata></record>
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subjects Bayesian analysis
Blood
Conditional probability
Design
Hemorrhage
Hemorrhagic shock
Mortality
Resuscitation
Therapy
Transfusion
Transfusion Practice
Trauma
title Elicitation of prior probability distributions for a proposed Bayesian randomized clinical trial of whole blood for trauma resuscitation
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