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Published in: Intensive Care Medicine 1/2021

01-01-2021 | Central Nervous System Trauma | Editorial

Clinical validation of precision medicine protocols: the last mile is the longest

Authors: Michael P. Casaer, Audrey De Jong, Anders Perner

Published in: Intensive Care Medicine | Issue 1/2021

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Excerpt

Advanced understanding of the complex pathophysiology of critical illness drives the development and optimization of sophisticated therapeutic protocols with the ambition to improve short- and long-term outcomes for every patient [1]. During the last decade, individualized, titrated, precision and/or target-driven approaches have proliferated [2]. Such strategies aim to replace or supplement more generic one-size-fits-all therapies or more simple clinical titration, through detailed measurements of markers of pathophysiological derangement followed by protocolized corrective or reactive interventions. …
Literature
1.
go back to reference Hawryluk GWJ, Aguilera S, Buki A et al (2019) A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med 45:1783–1794CrossRef Hawryluk GWJ, Aguilera S, Buki A et al (2019) A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med 45:1783–1794CrossRef
2.
go back to reference May F, Fourati S, Mekontso Dessap A, de Prost N (2020) Antiviral treatment strategy should be individualized in critically ill patients with severe influenza. Intensive Care Med 46:1292–1293CrossRef May F, Fourati S, Mekontso Dessap A, de Prost N (2020) Antiviral treatment strategy should be individualized in critically ill patients with severe influenza. Intensive Care Med 46:1292–1293CrossRef
3.
go back to reference Helms J, Bion J, De Jong A (2019) Observational vs randomized: David vs Goliath for thromboprophylaxis in critically ill patients? Intensive Care Med 45:272–274CrossRef Helms J, Bion J, De Jong A (2019) Observational vs randomized: David vs Goliath for thromboprophylaxis in critically ill patients? Intensive Care Med 45:272–274CrossRef
4.
go back to reference Moseby-Knappe M, Westhall E, Backman S et al (2020) Performance of a guideline-recommended algorithm for prognostication of poor neurological outcome after cardiac arrest. Intensive Care Med 46:1852–1862CrossRef Moseby-Knappe M, Westhall E, Backman S et al (2020) Performance of a guideline-recommended algorithm for prognostication of poor neurological outcome after cardiac arrest. Intensive Care Med 46:1852–1862CrossRef
5.
go back to reference Brohi K, Gruen RL, Holcomb JB (2019) Why are bleeding trauma patients still dying? Intensive Care Med 45:709–711CrossRef Brohi K, Gruen RL, Holcomb JB (2019) Why are bleeding trauma patients still dying? Intensive Care Med 45:709–711CrossRef
6.
go back to reference Allingstrup MJ, Kondrup J, Wiis J et al (2017) Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial. Intensive Care Med 43(11):1637–1647CrossRef Allingstrup MJ, Kondrup J, Wiis J et al (2017) Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial. Intensive Care Med 43(11):1637–1647CrossRef
7.
go back to reference Holm C, Mayr M, Tegeler J et al (2004) A clinical randomized study on the effects of invasive monitoring on burn shock resuscitation. Burns 30:798–807CrossRef Holm C, Mayr M, Tegeler J et al (2004) A clinical randomized study on the effects of invasive monitoring on burn shock resuscitation. Burns 30:798–807CrossRef
8.
go back to reference Rossaint R, Bouillon B, Cerny V et al (2016) The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care 20:100CrossRef Rossaint R, Bouillon B, Cerny V et al (2016) The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care 20:100CrossRef
10.
go back to reference Harhay MO, Casey JD, Clement M et al (2020) Contemporary strategies to improve clinical trial design for critical care research: insights from the First Critical Care Clinical Trialists Workshop. Intensive Care Med 46:930–942CrossRef Harhay MO, Casey JD, Clement M et al (2020) Contemporary strategies to improve clinical trial design for critical care research: insights from the First Critical Care Clinical Trialists Workshop. Intensive Care Med 46:930–942CrossRef
11.
go back to reference Karanicolas PJ, Farrokhyar F, Bhandari M (2010) Practical tips for surgical research: blinding: who, what, when, why, how? Can J Surg J Canadien de Chirurgie 53:345–348 Karanicolas PJ, Farrokhyar F, Bhandari M (2010) Practical tips for surgical research: blinding: who, what, when, why, how? Can J Surg J Canadien de Chirurgie 53:345–348
12.
go back to reference Brookes ST, Whitley E, Peters TJ, Mulheran PA, Egger M, Davey SG (2001) Subgroup analyses in randomised controlled trials: quantifying the risks of false-positives and false-negatives. Health Technol Assess (Winchester, England) 5:1–56 Brookes ST, Whitley E, Peters TJ, Mulheran PA, Egger M, Davey SG (2001) Subgroup analyses in randomised controlled trials: quantifying the risks of false-positives and false-negatives. Health Technol Assess (Winchester, England) 5:1–56
13.
go back to reference Leontiadis GI (2016) How to interpret a negative study. Am J Gastroenterol 111:1506–1507CrossRef Leontiadis GI (2016) How to interpret a negative study. Am J Gastroenterol 111:1506–1507CrossRef
14.
go back to reference Young PJ, Nickson CP, Perner A (2020) When should clinicians act on non-statistically significant results from clinical trials? JAMA 323:2256–2257CrossRef Young PJ, Nickson CP, Perner A (2020) When should clinicians act on non-statistically significant results from clinical trials? JAMA 323:2256–2257CrossRef
15.
go back to reference Khan S, Davenport R, Raza I et al (2015) Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med 41:239–247CrossRef Khan S, Davenport R, Raza I et al (2015) Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med 41:239–247CrossRef
16.
17.
go back to reference Thimbleby H (2013) Technology and the future of healthcare. J Public Health Res 2:e28CrossRef Thimbleby H (2013) Technology and the future of healthcare. J Public Health Res 2:e28CrossRef
Metadata
Title
Clinical validation of precision medicine protocols: the last mile is the longest
Authors
Michael P. Casaer
Audrey De Jong
Anders Perner
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 1/2021
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-06301-1

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