Abstract:
:Recently, observational studies analyzing prehospital blood product transfusions (PHT) for trauma have become more widespread in both military and civilian communities. Due to these studies' non-random treatment assignment, propensity score (PS) methodologies are often used to determine an intervention's effectiveness. However, there are no guidelines on how to appropriately conduct PS analyses in prehospital studies. Such analyses are complicated when treatments are given in emergent settings as the ability to administer treatment early, often before hospital admission, can interfere with assumptions of PS modeling. This study conducts a systematic review of literature from military and civilian populations to assess current practice of PS methodology in PHT analyses. The decision-making process from the multicenter Prehospital Resuscitation on Helicopter Study (PROHS) is discussed and used as a motivating example. Results show that researchers often omit or incorrectly assess variable balance between treatment groups and include inappropriate variables in the propensity model. When used correctly, PS methodology is an effective statistical technique to show that aggressive en route resuscitation strategies, including PHT, can reduce mortality in individuals with severe trauma. This review provides guidelines for best practices in study design and analyses that will advance trauma care.
journal_name
Mil Medjournal_title
Military medicineauthors
Greene TJ,DeSantis SM,Fox EE,Wade CE,Holcomb JB,Swartz MDdoi
10.1093/milmed/usx137subject
Has Abstractpub_date
2018-03-01 00:00:00pages
124-133issue
suppl_1eissn
0026-4075issn
1930-613Xpii
4959924journal_volume
183pub_type
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journal_title:Military medicine
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doi:
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journal_title:Military medicine
pub_type: 历史文章,杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2006-05-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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