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

Michael O. Harhay, Bryan S. Blette, Anders Granholm, Frank W. Moler, Fernando G. Zampieri, Ewan C. Goligher, Monique M. Gardner, Alexis Topjian, Nadir Yehya

2022NEJM Evidence22 citationsDOIOpen Access PDF

Abstract

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 P75% 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.gov number, NCT00878644.)

Topics & Concepts

Bayesian probabilityHypothermiaMedicineLeverage (statistics)Clinical trialIntensive care medicineInternal medicineEmergency medicineComputer scienceMachine learningArtificial intelligenceCardiac Arrest and ResuscitationMechanical Circulatory Support DevicesSepsis Diagnosis and Treatment
A Bayesian Interpretation of a Pediatric Cardiac Arrest Trial (THAPCA-OH) | Litcius