The stepped wedge design came up in the #CCRDownUnder meeting last week so it seemed a good time to revisit the pros and cons of this design 1/6
#MethodologyMonday #128
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Hashtag
#CCRDownUnder
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Had a great time sitting on the panels for #RSI and #CLIPII at #CCRDownunder and it was great to see my Monash statto pals on stage @jesskasza.bsky.social @criticalcarereviews.com
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Hat die schon jemand vollständig gelesen oder ist sogar bei #ccrdownunder und was machen wir daraus? 🤔 #Notfallmedizin #Medibubble #RSI
www.nejm.org/doi/full/10....
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Co-Chief Investigators Carol Hodgson and Lisa Higgins share an overview of the #ECMORehab trial and the key takeaways for clinicians after presenting the results at #CCRdownunder
@jama.com
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Chief Investigator Angelique de Man and Senior Investigator Sander Rozemeijer share the results from the #VITaCCA trial and what it means for clinicians after presenting at #CCRdownunder
Livestream -> www.criticalcarereviews.com
@jama.com
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Co-Chief Investigators Jonathan Casey and Matthew Semler share their insights from the #RSI trial after presenting at #CCRdownunder
Livestream -> www.criticalcarereviews.com
@jama.com
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Chief Investigator Arthur Kwizera shares an overview of the #ARISEAFRICA trial after presenting at #CCRdownunder and highlights what clinicians can take away from the results.
Livestream -> www.criticalcarereviews.com
@jama.com
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Ascorbate is its ionised (deprotonated) form, which predominates in the body at physiological pH. Ascorbate is the focus of new Vitamin C research #ccrdownunder
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The preparation is important- Mark Plummer nicely outlining the importance of understanding what is studied in Vit C trials
Ascorbic acid is the acidic, protonated form of Vit C (used in many trials and may explain the harm 1/2 #ccrdownunder #VITACCtrial
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Many thanks for facilitating the publication of the RSI trial with #CCRdownunder
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Next up VITaCC results session (Early high-dose vitamin C in post-cardiac arrest syndrome) up next at #CCRdownunder #VITACCtrial
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Congratulations to the RSI trial team #CCRdownunder
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RSI trial now starting
➡️ Etomidate vs Ketamine for RSI
➡️ Jonathan Casey & Matthew Semler presenting
➡️ Chris Nickson editorialising
➡️ Join the livestream - criticalcarereviews.com
#ccrdownunder
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Next up RSI results session (Etomidate vs Ketamine for intubation) up next at #CCRdownunder #RSItrial
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#ARISEAFRICAtrial is a stepped wedge cluster- this design is useful for interventions delivered at the ICU/hospital level and individual randomisation is difficult. Clusters transition from control to intervention at different times www.bmj.com/content/350/... #ccrdownunder @criticalcarereviews.com
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And here is the protocol publication for #ARISEAFRICAtrial: pmc.ncbi.nlm.nih.gov/articles/PMC... #ccrdownunder
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First up on Day 2 of #CCRdownunder is #ARISEAFRICAtrial. Post your questions using the hash tags and follow the live stream here: criticalcarereviews.com
@criticalcarereviews.com
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Chief Investigator Ary Serpa Neto shares an overview of the #ACTiVE trial after presenting the results at #CCRdownunder
@jama.com
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Chief Investigator Michael Reade provides an overview of the #CLIP-II trial at #CCRdownunder and what it means for clinicians.
@jama.com
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Co-Chief Investigators Brenda O'Neill and Danny McAuley share the results of the #iRehab trial after presenting at #CCRdownunder
Livestream -> www.criticalcarereviews.com
@jama.com
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Chief Investigator, Evangelos Giamarellos-Bourboulis shares the findings from the #ImmunoSep trial and what it means for clinicians at #CCRdownunder
Livestream -> www.criticalcarereviews.com
@jama.com
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An editorial from JAMA, published December 8, 2025, titled "Automated Modes to Improve Mechanical Ventilation Outcomes—The Ghost in the Machine" by Michael C. Sklar, MD, MSc; Niall D. Ferguson, MD, MSc.
Editorial: Sinnige et al demonstrate that closed-loop ventilation did not improve ventilator-free days compared to conventional care.
Questions remain regarding how best to integrate adaptive ventilation systems into real-world practice. #CCRdownunder ja.ma/4pXyYJb
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JAMA Research Summary: Effect of Automated Closed-Loop Ventilation vs Protocolized Conventional Ventilation on Ventilator-Free Days in Critically Ill Adults. Closed-loop ventilation: 16.7 days. Conventional ventilation: 16.3 days.
Research Summary: Early use of automated closed-loop ventilation did not increase ventilator-free days at day 28 compared with protocolized conventional ventilation. #CCRdownunder ja.ma/48AgJCj
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JAMA study graph: Cumulative distribution of ventilator-free days for critically ill adults. Compares closed-loop (blue) vs. conventional ventilation (red). X-axis: Ventilator-free days. Y-axis: Cumulative patients, %.
RCT: Among critically ill adults receiving invasive mechanical ventilation, early use of an automated closed-loop ventilation system did not increase ventilator-free days at day 28 compared with protocolized conventional ventilation. #CCRdownunder ja.ma/4oHW9Gj
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Last session of the day- ACTiVE Trial #ACTIVEtrial #ccrdownunder
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A page from JAMA, featuring an editorial titled "An Oasis in the Platelet Desert?" by Matthew D. Neal, Philip C. Spinella, and Lucy Z. Kornblith, discusses challenges in platelet transfusion access and supply limitations.
Editorial: In the CLIP-II trial, cryopreserved platelets did not match liquid platelets for bleeding control after cardiac surgery, raising safety and efficacy concerns. #CCRdownunder ja.ma/49TXfeh
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JAMA Research Summary: Cryopreserved vs Liquid-Stored Platelets. Investigated if cryopreserved platelets are less effective than liquid-stored for bleeding during/after cardiac surgery. Trial details, outcomes, and limitations are presented.
📊 Research Summary: Cryopreserved platelets did not meet the criteria for noninferiority in controlling surgical bleeding compared with liquid-stored platelets. #CCRdownunder ja.ma/3Kus1QI
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JAMA article titled 'Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding'. Key points: cryopreserved platelets may be less effective/safe than liquid-stored for cardiac surgery bleeding; didn't meet noninferiority criterion.
Among adults undergoing cardiac surgery at high risk of bleeding and platelet transfusion, cryopreserved platelets did not meet noninferiority for controlling postoperative bleeding and were less effective than liquid-stored platelets. #CCRdownunder ja.ma/4rEC06z
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Scatter plot showing incremental cost in Australian dollars (A$) versus incremental effectiveness (bleeding avoided in mL) within 24 hours of ICU admission. Data points are scattered across the graph.
Cryopreserved platelets can be stored for up to 2 yrs, compared to 7 days for liquid-stored platelets. This cost-effectiveness analysis found that cryopreserved platelets were costlier & less effective for managing bleeding in cardiac surgery. #CCRdownunder ja.ma/49ZZpsT
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Next up #ccrdownunder - #CLIPIItrial
Post your questions at #ccrdownunder and #CLIPIItrial or at the livestream: criticalcarereviews.com @criticalcarereviews.com
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