TY - CHAP M1 - Book, Section TI - How to Use a Subgroup Analysis A1 - Sun, Xin A1 - Ioannidis, John P. A. A1 - Agoritsas, Thomas A1 - Alba, Ana C. A1 - Guyatt, Gordon A2 - Guyatt, Gordon A2 - Rennie, Drummond A2 - Meade, Maureen O. A2 - Cook, Deborah J. PY - 2015 T2 - Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed AB - CLINICAL SCENARIOYou are a physician working at a regional trauma center. Your unit's committee, which is responsible for standardization of care, is considering using tranexamic acid to treat trauma patients who arrive 3 hours after injury. Almost all of the information on this topic is derived from a single blinded trial that randomized trauma patients to tranexamic acid or placebo.1The original publication reported that 99% of the enrolled patients were followed up and there was a reduction in all-cause mortality (relative risk [RR], 0.91; 95% confidence interval [CI], 0.85-0.97) with no apparent subgroup effect.1 A subsequent publication2 focused on an additional analysis that addressed death from bleeding and reported a powerful subgroup effect with a large benefit for patients treated within 3 hours of injury and possible harm if treated 3 or more hours after injury. The committee's mandate is to decide whether tranexamic acid should not be given to patients 3 hours or more after injury. The credibility you place on the subgroup analysis will determine your decision. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - jamaevidence.mhmedical.com/content.aspx?aid=1183878067 ER -