Stolz 2009.
| Methods | STUDY DESIGN: RCT Risk of Bias: MEDIUM |
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| Participants | PROVIDERS: all staff in adult ICUs PARTICIPANTS: 101 patients with VAP (51 intervention, 50 control) CLINICAL PROBLEM: receiving antibiotics for VAP SETTING: 3 university hospitals in Switzerland and the USA | |
| Interventions | FORMAT: Interventions: reminders (circumstantial, decision support algorithm with each PCT test); structural, introduction of PCT testing
Intervention Functions: enablement, environmental restructuring
DELIVERER: respiratory physicians
COMPARISON: usual care
DESIRED CHANGE: decrease excessive POWER CALCULATION; yes, 84 participants total. Details in Appendix 3 |
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| Outcomes | PRESCRIBING: Exposure: duration of antibiotic treatment CLINICAL: Balancing: mortality, hospital length of stay |
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| Notes | FINANCIAL SUPPORT: Funding: Swiss National Foundation, Margarete und Walter Liechtenstein Foundation, Freiwillige Akademische Gesellschaft Basel, Will Rogers Foundation, and participating hospitals. B.R.A.H.M.S AG funded assay material and logistics. Competing Interests: not clear. The published paper says that a statement of interest for the study itself is available but the web address provided online and in print does not work. ADDITIONAL DATA: email response from authors with additional information about intervention |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Block size 20 envelopes |
| Allocation concealment (selection bias) | Low risk | Sealed, opaque envelopes |
| Blinding (performance bias and detection bias) All outcomes | High risk | Primary outcome measure required collection of data from case noes by investigators. |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Text shows that primary outcome was reported for all 101 randomised patients. |
| Selective reporting (reporting bias) | Low risk | Text shows that primary outcome was reported for all 101 randomised patients. |
| Other bias | Low risk | Multivariate analysis to adjust primary outcome for age, microbiology and centre effect |
| Baseline Outcomes similar? | Unclear risk | No data about baseline outcomes |
| Free of contamination? | Low risk | Procalcitonin only measured for intervention patients. |
| Baseline characteristics similar? | Low risk | Table 1 |