RT Book, Section
A1 Park, Jay J. H.
A1 Detry, Michelle A.
A1 Murthy, Srinivas
A1 Guyatt, Gordon
A1 Mills, Edward J.
A2 Guyatt, Gordon
A2 Rennie, Drummond
A2 Meade, Maureen O.
A2 Cook, Deborah J.
SR Print(0)
ID 1193374442
T1 How to Use and Interpret the Results of a Platform Trial
T2 Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179071-0
LK jamaevidence.mhmedical.com/content.aspx?aid=1193374442
RD 2024/10/12
AB CLINICAL  SCENARIOA  hospitalist  physician  is  evaluating  a  60-year-old  patient  with  severe  COVID-19  who  was  admitted  to  the  intensive  care  unit  (ICU)  and  is  receiving  high-flow  oxygen  via  nasal  cannula.  A  resident  physician  on  the  ICU  team  is  considering  administration  of  intravenous  hydrocortisone  to  the  patient.  The  hospitalist  physician  is  requested  to  assess  the  evidence  regarding  that  decision.  The  physician  is  aware  of  a  platform  trial,  the  Randomized,  Embedded,  Multifactorial  Adaptive  Platform  Trial  for  Community-Acquired  Pneumonia  (REMAP-CAP),  that  investigated  hydrocortisone  vs  no  hydrocortisone  for  patients  with  severe  COVID-19.1  REMAP-CAP  is  an  ongoing,  international,  multicenter  platform  trial  that  aims  to  determine  best  treatment  strategies  for  patients  with  severe  pneumonia  in  pandemic  and  nonpandemic  settings.2  This  trial  is  investigating  multiple  interventions  including  corticosteroids.The  article  reporting  the  corticosteroid  findings  of  the  REMAP-CAP  trial  presented  results  on  organ  support–free  days,  in-hospital  mortality,  and  other  clinical  outcomes  of  2  hydrocortisone  regimens  vs  no  hydrocortisone.1  To  assess  this  article,  and  in  particular  to  determine  what  inferences  can  be  drawn  from  platform  trials  compared  with  conventional  randomized  clinical  trials  (RCTs),  the  physician  uses  the  framework  in  the  Users’  Guide  to  Platform  Trials  (Box  7.2-1).