4 research outputs found

    Influence diagnostics for the proportional hazards model

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    Influence diagnostics based on Cook's curvature diagnostic (1986) are developed for the proportional hazards model. Three perturbation schemes are considered: perturbation of the likelihood, perturbation of the censoring information and perturbation of covariate values.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28377/1/0000142.pd

    A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators

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    Purpose: To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock. Methods: Using a search strategy of PubMed, EmBase and CENTRAL, we selected all relevant randomised clinical trials published from January 2000 to January 2015. We translated non-English papers and contacted authors as necessary. Our primary analysis generated a pooled odds ratio (OR) from a fixed-effect model. Sensitivity analyses explored the effect of including non-ED studies, adjusting for study quality, and conducting a random-effects model. Secondary outcomes included organ support and hospital and ICU length of stay. Results: From 2395 initially eligible abstracts, five randomised clinical trials (n\ua0=\ua04735 patients) met all criteria and generally scored high for quality except for lack of blinding. There was no effect on the primary mortality outcome (EGDT: 23.2\ua0% [495/2134] versus control: 22.4\ua0% [582/2601]; pooled OR 1.01 [95\ua0% CI 0.88–1.16], P\ua0=\ua00.9, with heterogeneity [I\ua0=\ua057\ua0%; P\ua0=\ua00.055]). The pooled estimate of 90-day mortality from the three recent multicentre studies (n\ua0=\ua04063) also showed no difference [pooled OR 0.99 (95\ua0% CI 0.86–1.15), P\ua0=\ua00.93] with no heterogeneity (I\ua0=\ua00.0\ua0%; P\ua0=\ua00.97). EGDT increased vasopressor use (OR 1.25 [95\ua0% CI 1.10–1.41]; P\ua
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