Utilizing Propensity Score Analyses in Prehospital Blood Product Transfusion Studies: Lessons Learned and Moving Toward Best Practice.

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 intervent...

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Publicado en:Military Medicine Vol. 183; pp. 124 - 134
Autores principales: Greene, Thomas J, DeSantis, Stacia M, Fox, Erin E, Wade, Charles E, Holcomb, John B, Swartz, Michael D
Formato: research systematic review tables/charts Journal Article
Publicado: Oxford University Press / USA 2018 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Utilizing Propensity Score Analyses in Prehospital Blood Product Transfusion Studies: Lessons Learned and Moving Toward Best Practice.
      aug:
        au:
          Greene, Thomas J
          DeSantis, Stacia M
          Fox, Erin E
          Wade, Charles E
          Holcomb, John B
          Swartz, Michael D
        affil: Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX
      sug:
        subj:
          Blood Transfusion Methods
          Probability
          Emergency Medical Services Methods
          Emergency Medical Services Trends
          Blood Transfusion Trends
          Resuscitation Methods
          Resuscitation Equipment and Supplies
          Benchmarking Methods
          Human
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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