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Article ; Online: Assessing the validity of using serious game technology to analyze physician decision making.

Mohan, Deepika / Angus, Derek C / Ricketts, Daniel / Farris, Coreen / Fischhoff, Baruch / Rosengart, Matthew R / Yealy, Donald M / Barnato, Amber E

PloS one

2014 Volume 9, Issue 8, Page(s) e105445

Abstract: Background: Physician non-compliance with clinical practice guidelines remains a critical barrier to high quality care. Serious games (using gaming technology for serious purposes) have emerged as a method of studying physician decision making. However, ...

Abstract	Background: Physician non-compliance with clinical practice guidelines remains a critical barrier to high quality care. Serious games (using gaming technology for serious purposes) have emerged as a method of studying physician decision making. However, little is known about their validity. Methods: We created a serious game and evaluated its construct validity. We used the decision context of trauma triage in the Emergency Department of non-trauma centers, given widely accepted guidelines that recommend the transfer of severely injured patients to trauma centers. We designed cases with the premise that the representativeness heuristic influences triage (i.e. physicians make transfer decisions based on archetypes of severely injured patients rather than guidelines). We randomized a convenience sample of emergency medicine physicians to a control or cognitive load arm, and compared performance (disposition decisions, number of orders entered, time spent per case). We hypothesized that cognitive load would increase the use of heuristics, increasing the transfer of representative cases and decreasing the transfer of non-representative cases. Findings: We recruited 209 physicians, of whom 168 (79%) began and 142 (68%) completed the task. Physicians transferred 31% of severely injured patients during the game, consistent with rates of transfer for severely injured patients in practice. They entered the same average number of orders in both arms (control (C): 10.9 [SD 4.8] vs. cognitive load (CL):10.7 [SD 5.6], p = 0.74), despite spending less time per case in the control arm (C: 9.7 [SD 7.1] vs. CL: 11.7 [SD 6.7] minutes, p<0.01). Physicians were equally likely to transfer representative cases in the two arms (C: 45% vs. CL: 34%, p = 0.20), but were more likely to transfer non-representative cases in the control arm (C: 38% vs. CL: 26%, p = 0.03). Conclusions: We found that physicians made decisions consistent with actual practice, that we could manipulate cognitive load, and that load increased the use of heuristics, as predicted by cognitive theory.
MeSH term(s)	Decision Making ; Decision Making, Computer-Assisted ; Emergency Medicine/methods ; Emergency Service, Hospital ; Humans ; Patient Transfer ; Physicians ; Triage/methods ; Video Games
Language	English
Publishing date	2014-08-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Validation Study
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0105445
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Online: Maximizing profit using recommender systems

Das, Aparna / Mathieu, Claire / Ricketts, Daniel

2009

Abstract: Traditional recommendation systems make recommendations based solely on the customer's past purchases, product ratings and demographic data without considering the profitability the items being recommended. In this work we study the question of how a ... ...

Abstract	Traditional recommendation systems make recommendations based solely on the customer's past purchases, product ratings and demographic data without considering the profitability the items being recommended. In this work we study the question of how a vendor can directly incorporate the profitability of items into its recommender so as to maximize its expected profit while still providing accurate recommendations. Our approach uses the output of any traditional recommender system and adjust them according to item profitabilities. Our approach is parameterized so the vendor can control how much the recommendation incorporating profits can deviate from the traditional recommendation. We study our approach under two settings and show that it achieves approximately 22% more profit than traditional recommendations.
Keywords	Computer Science - Computers and Society ; Computer Science - Artificial Intelligence ; Computer Science - Information Retrieval
Publishing date	2009-08-25
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effectiveness of Casirivimab-Imdevimab and Sotrovimab During a SARS-CoV-2 Delta Variant Surge: A Cohort Study and Randomized Comparative Effectiveness Trial.

Huang, David T / McCreary, Erin K / Bariola, J Ryan / Minnier, Tami E / Wadas, Richard J / Shovel, Judith A / Albin, Debbie / Marroquin, Oscar C / Kip, Kevin E / Collins, Kevin / Schmidhofer, Mark / Wisniewski, Mary Kay / Nace, David A / Sullivan, Colleen / Axe, Meredith / Meyers, Russell / Weissman, Alexandra / Garrard, William / Peck-Palmer, Octavia M /

JAMA network open

2022 Volume 5, Issue 7, Page(s) e2220957

Abstract: Importance: The effectiveness of monoclonal antibodies (mAbs), casirivimab-imdevimab and sotrovimab, is unknown in patients with mild to moderate COVID-19 caused by the SARS-CoV-2 Delta variant.: Objective: To evaluate the effectiveness of mAb ... ...

Abstract	Importance: The effectiveness of monoclonal antibodies (mAbs), casirivimab-imdevimab and sotrovimab, is unknown in patients with mild to moderate COVID-19 caused by the SARS-CoV-2 Delta variant. Objective: To evaluate the effectiveness of mAb against the Delta variant compared with no mAb treatment and to ascertain the comparative effectiveness of casirivimab-imdevimab and sotrovimab. Design, setting, and participants: This study comprised 2 parallel studies: (1) a propensity score-matched cohort study of mAb treatment vs no mAb treatment and (2) a randomized comparative effectiveness trial of casirivimab-imdevimab and sotrovimab. The cohort consisted of patients who received mAb treatment at the University of Pittsburgh Medical Center outpatient infusion centers and emergency departments from July 14 to September 29, 2021. Participants were patients with a positive SARS-CoV-2 test result who were eligible to receive mAbs according to emergency use authorization criteria. Exposure: For the trial, patients were randomized to either intravenous casirivimab-imdevimab or sotrovimab according to a system therapeutic interchange policy. Main outcomes and measures: For the cohort study, risk ratio (RR) estimates for the primary outcome of hospitalization or death by 28 days were compared between mAb treatment and no mAb treatment using propensity score-matched models. For the comparative effectiveness trial, the primary outcome was hospital-free days (days alive and free of hospitalization) within 28 days after mAb treatment, where patients who died were assigned -1 day in a bayesian cumulative logistic model adjusted for treatment location, age, sex, and time. Inferiority was defined as a 99% posterior probability of an odds ratio (OR) less than 1. Equivalence was defined as a 95% posterior probability that the OR was within a given bound. Results: A total of 3069 patients (1023 received mAb treatment: mean [SD] age, 53.2 [16.4] years; 569 women [56%]; 2046 had no mAb treatment: mean [SD] age, 52.8 [19.5] years; 1157 women [57%]) were included in the prospective cohort study, and 3558 patients (mean [SD] age, 54 [18] years; 1919 women [54%]) were included in the randomized comparative effectiveness trial. In propensity score-matched models, mAb treatment was associated with reduced risk of hospitalization or death (RR, 0.40; 95% CI, 0.28-0.57) compared with no treatment. Both casirivimab-imdevimab (RR, 0.31; 95% CI, 0.20-0.50) and sotrovimab (RR, 0.60; 95% CI, 0.37-1.00) were associated with reduced hospitalization or death compared with no mAb treatment. In the clinical trial, 2454 patients were randomized to receive casirivimab-imdevimab and 1104 patients were randomized to receive sotrovimab. The median (IQR) hospital-free days were 28 (28-28) for both mAb treatments, the 28-day mortality rate was less than 1% (n = 12) for casirivimab-imdevimab and less than 1% (n = 7) for sotrovimab, and the hospitalization rate by day 28 was 12% (n = 291) for casirivimab-imdevimab and 13% (n = 140) for sotrovimab. Compared with patients who received casirivimab-imdevimab, those who received sotrovimab had a median adjusted OR for hospital-free days of 0.88 (95% credible interval, 0.70-1.11). This OR yielded 86% probability of inferiority for sotrovimab vs casirivimab-imdevimab and 79% probability of equivalence. Conclusions and relevance: In this propensity score-matched cohort study and randomized comparative effectiveness trial, the effectiveness of casirivimab-imdevimab and sotrovimab against the Delta variant was similar, although the prespecified criteria for statistical inferiority or equivalence were not met. Both mAb treatments were associated with a reduced risk of hospitalization or death in nonhospitalized patients with mild to moderate COVID-19 caused by the Delta variant. Trial registration: ClinicalTrials.gov Identifier: NCT04790786.
MeSH term(s)	Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; Bayes Theorem ; Cohort Studies ; Female ; Humans ; Middle Aged ; Prospective Studies ; SARS-CoV-2 ; COVID-19 Drug Treatment
Chemical Substances	Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; sotrovimab (1MTK0BPN8V) ; imdevimab (2Z3DQD2JHM) ; casirivimab (J0FI6WE1QN)
Language	English
Publishing date	2022-07-01
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.20957
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The comparative effectiveness of COVID-19 monoclonal antibodies: A learning health system randomized clinical trial.

McCreary, Erin K / Bariola, J Ryan / Minnier, Tami E / Wadas, Richard J / Shovel, Judith A / Albin, Debbie / Marroquin, Oscar C / Kip, Kevin E / Collins, Kevin / Schmidhofer, Mark / Wisniewski, Mary Kay / Nace, David A / Sullivan, Colleen / Axe, Meredith / Meyers, Russell / Weissman, Alexandra / Garrard, William / Peck-Palmer, Octavia M / Wells, Alan /

Contemporary clinical trials

2022 Volume 119, Page(s) 106822

Abstract: Background: Monoclonal antibodies (mAb) that neutralize SARS-CoV-2 decrease hospitalization and death compared to placebo in patients with mild to moderate COVID-19; however, comparative effectiveness is unknown. We report the comparative effectiveness ... ...

Abstract	Background: Monoclonal antibodies (mAb) that neutralize SARS-CoV-2 decrease hospitalization and death compared to placebo in patients with mild to moderate COVID-19; however, comparative effectiveness is unknown. We report the comparative effectiveness of bamlanivimab, bamlanivimab-etesevimab, and casirivimab-imdevimab. Methods: A learning health system platform trial in a U.S. health system enrolled patients meeting mAb Emergency Use Authorization criteria. An electronic health record-embedded application linked local mAb inventory to patient encounters and provided random mAb allocation. Primary outcome was hospital-free days to day 28. Primary analysis was a Bayesian model adjusting for treatment location, age, sex, and time. Inferiority was defined as 99% posterior probability of an odds ratio < 1. Equivalence was defined as 95% posterior probability the odds ratio is within a given bound. Findings: Between March 10 and June 25, 2021, 1935 patients received treatment. Median hospital-free days were 28 (IQR 28, 28) for each mAb. Mortality was 0.8% (1/128), 0.8% (7/885), and 0.7% (6/922) for bamlanivimab, bamlanivimab-etesevimab, and casirivimab-imdevimab, respectively. Relative to casirivimab-imdevimab (n = 922), median adjusted odds ratios were 0.58 (95% credible interval [CI] 0.30-1.16) and 0.94 (95% CI 0.72-1.24) for bamlanivimab (n = 128) and bamlanivimab-etesevimab (n = 885), respectively. These odds ratios yielded 91% and 94% probabilities of inferiority of bamlanivimab versus bamlanivimab-etesevimab and casirivimab-imdevimab, and an 86% probability of equivalence between bamlanivimab-etesevimab and casirivimab-imdevimab. Interpretation: Among patients with mild to moderate COVID-19, bamlanivimab-etesevimab or casirivimab-imdevimab treatment resulted in 86% probability of equivalence. No treatment met prespecified criteria for statistical equivalence. Median hospital-free days to day 28 were 28 (IQR 28, 28) for each mAb. Funding and registration: This work received no external funding. The U.S. government provided the reported mAb. This trial is registered at ClinicalTrials.gov, NCT04790786.
MeSH term(s)	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; Bayes Theorem ; COVID-19 ; Humans ; Learning Health System ; SARS-CoV-2
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; imdevimab (2Z3DQD2JHM) ; bamlanivimab (45I6OFJ8QH) ; casirivimab (J0FI6WE1QN) ; etesevimab (N7Q9NLF11I)
Language	English
Publishing date	2022-06-11
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2182176-8
ISSN	1559-2030 ; 1551-7144
ISSN (online)	1559-2030
ISSN	1551-7144
DOI	10.1016/j.cct.2022.106822
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Article ; Online: Effectiveness of casirivimab and imdevimab, and sotrovimab during Delta variant surge: a prospective cohort study and comparative effectiveness randomized trial

Huang, David T. / McCreary, Erin K. / Bariola, J. Ryan / Minnier, Tami E. / Wadas, Richard J. / Shovel, Judith A. / Albin, Debbie / Marroquin, Oscar C. / Kip, Kevin E. / Collins, Kevin / Schmidhofer, Mark / Wisniewski, Mary Kay / Nace, David A. / Sullivan, Colleen / Axe, Meredith / Meyers, Russell / Weissman, Alexandra / Garrard, William / Peck-Palmer, Octavia M. /

medRxiv

Abstract: IMPORTANCE The effectiveness of monoclonal antibodies (mAbs), casirivimab and imdevimab, and sotrovimab, for patients with mild to moderate Covid-19 from the Delta variant is unknown. OBJECTIVE To evaluate the effectiveness of mAbs for the Delta variant ... ...

Abstract	IMPORTANCE The effectiveness of monoclonal antibodies (mAbs), casirivimab and imdevimab, and sotrovimab, for patients with mild to moderate Covid-19 from the Delta variant is unknown. OBJECTIVE To evaluate the effectiveness of mAbs for the Delta variant compared to no treatment, and the comparative effectiveness between mAbs. DESIGN, SETTING, AND PARTICIPANTS Two parallel studies among patients who met Emergency Use Authorization criteria for mAbs from July 14, 2021 to September 29, 2021: i.) prospective observational cohort study comparing mAb treatment to no mAb treatment and, ii.) Bayesian adaptive randomized trial comparing the effectiveness of casirivimab-imdevimab versus sotrovimab. In the observational study, we compared eligible patients who received mAb at an outpatient infusion center at UPMC, to nontreated patients with a positive SARS-CoV-2 test. In the comparative effectiveness trial, we randomly allocated casirivimab-imdevimab or sotrovimab to patients presenting to infusion centers and emergency departments, per system therapeutic interchange policy. EXPOSURE Intravenous mAb per their EUA criteria. MAIN OUTCOMES AND MEASURES For the observational study, risk ratio estimates for hospitalization or death by 28 days were compared between mAb treatment to no mAb treatment using propensity matched models. For the comparative effectiveness trial, the primary outcome was hospital-free days (days alive and free of hospital) within 28 days, where patients who died were assigned -1 day) in a Bayesian cumulative logistic model, adjusted for treatment location, age, sex, and time. Inferiority was defined as a 99% posterior probability of an odds ratio <1. Equivalence was defined as a 95% posterior probability that the odds ratio is within a given bound. RESULTS Among 3,558 patients receiving mAb, the mean age was 54 (SD 18 years), 1,511 (43%) were treated in an infusion center, and 450 (13%) were hospitalized or died by day 28. In propensity matched models, mAb treatment was associated with reduced risk of hospitalization or death compared to no treatment (risk ratio (RR)=0.40, 95% CI: 0.28-0.57). Both casirivimab and imdevimab (RR=0.31, 95% CI: 0.20-0.50), and sotrovimab (RR=0.60, 95% CI: 0.37-1.00) reduced hospitalization or death compared to no mAb treatment. Among patients allocated randomly to casirivimab and imdevimab (n=2,454) or sotrovimab (n=1,104), the median hospital-free days were 28 (IQR 28-28) for both groups, 28-day mortality was 0.5% (n=12) and 0.6% (n=7), and hospitalization by day 28 was 12% (n=291) and 12% (n=140), respectively. Compared to casirivimab and imdevimab, the median adjusted odds ratio for hospital-free days was 0.88 (95% credible interval, 0.70-1.11) for sotrovimab. This odds ratio yielded 86% probability of inferiority of sotrovimab versus casirivimab and imdevimab, and 79% probability of equivalence. CONCLUSIONS AND RELEVANCE In non-hospitalized patients with mild to moderate Covid-19 due to the Delta variant, casirivimab and imdevimab and sotrovimab were both associated with a reduced risk of hospitalization or death. The comparative effectiveness of mAbs appeared similar, though prespecified criteria for statistical inferiority or equivalence were not met. TRIAL REGISTRATION ClinicalTrials.gov: NCT04790786
Keywords	covid19
Language	English
Publishing date	2021-12-27
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.12.23.21268244
Database	COVID19

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Article ; Online: A Learning Health System Randomized Trial of Monoclonal Antibodies for Covid-19

McCreary, Erin K / Bariola, J Ryan / Minnier, Tami / Wadas, Richard J / Shovel, Judith A / Albin, Debbie L / Marroquin, Oscar C / Kip, Kevin E / Collins, Kevin / Schmidhofer, Mark / Wisniewski, Mary K / Nace, David A / Sullivan, Colleen / Axe, Meredith / Meyer, Russell / Weissman, Alexandra / Garrard, William / Peck-Palmer, Octavia M / Wells, Alan /

Bart, Robert D / Yang, Anne / Berry, Lindsay / Berry, Scott / McGlothin, Anna / Crawford, Amy / Khadem, Tina / Linstrum, Kelsey / Montgomery, Stephanie K / Ricketts, Daniel / Kennedy, Jason N / Pidro, Caroline J / Haidar, Ghady / Snyder, Graham M / McVerry, Bryan J / Seymour, Christopher W / Angus, Derek C / Kip, Paula L / Huang, Dave T

medRxiv

Abstract: ABSTRACT Background: Neutralizing monoclonal antibodies (mAb) targeting SARS CoV2 decrease hospitalization and death in patients with mild to moderate Covid 19. Yet, their clinical use is limited, and comparative effectiveness is unknown. Methods: We ... ...

Abstract	ABSTRACT Background: Neutralizing monoclonal antibodies (mAb) targeting SARS CoV2 decrease hospitalization and death in patients with mild to moderate Covid 19. Yet, their clinical use is limited, and comparative effectiveness is unknown. Methods: We present the first results of an ongoing, learning health system adaptive platform trial to expand mAb treatment to all eligible patients and evaluate the comparative effectiveness of available mAbs. The trial launched March 10, 2021. Results are reported as of June 25, 2021 due to the U.S. federal decision to pause distribution of bamlanivimab etesevimab; patient follow-up concluded on July 23, 2021. Patients referred for mAb who met Emergency Use Authorization criteria were provided a random mAb allocation of bamlanivimab, bamlanivimab etesevimab, or casirivimab imdevimab with a therapeutic interchange policy. The primary outcome was hospital-free days (days alive and free of hospital) within 28 days, where patients who died were assigned -1 day. The primary analysis was a Bayesian cumulative logistic model of all patients treated at an infusion center or emergency department, adjusting for treatment location, age, sex, and time. Inferiority was defined as a 99% posterior probability of an odds ratio < 1. Equivalence was defined as a 95% posterior probability that the odds ratio is within a given bound. Results: Prior to trial launch, 3.1% (502) of 16,345 patients who were potentially eligible by an automated electronic health record (EHR) screen received mAb. During the trial period, 23.2% (1,201) of 5,173 EHR-screen eligible patients were treated, a 7.5-fold increase. After including additional referred patients from outside the health system, a total of 1,935 study patients received mAb therapy (128 bamlanivimab, 885 bamlanivimab etesevimab, 922 casirivimab imdevimab). Mean age ranged from 55 to 57 years, half were female (range, 53% to 54%), and 17% were Black (range, 12% to 19%). Median hospital free days were 28 (IQR, 28 to 28) for each mAb group. Hospitalization varied between groups (bamlanivimab, 12.5%; bamlanivimab etesevimab, 14.7%, casirivimab imdevimab, 14.3%). Relative to casirivimab-imdevimab, the median adjusted odds ratios were 0.58 (95% credible interval (CI), 0.30 to 1.16) and 0.94 (95% CI, 0.72 to 1.24) for the bamlanivimab and bamlanivimab-etesevimab groups, respectively. These odds ratios yielded 91% and 94% probabilities of inferiority of bamlanivimab versus bamlanivimab etesevimab and casirivimab imdevimab respectively, and an 86% probability of equivalence between bamlanivimab etesevimab and casirivimab imdevimab, at the prespecified odds ratio bound of 0.25. Twenty one infusion related adverse events occurred in 0% (0/128), 1.4% (12/885), and 1.0% (9/922) of patients treated with bamlanivimab, bamlanivimab etesevimab, and casirivimab imdevimab, respectively. Conclusion: In non-hospitalized patients with mild to moderate Covid-19, bamlanivimab, compared to bamlanivimab etesevimab and casirivimab imdevimab, resulted in 91% and 94% probabilities of inferiority with regards to odds of improvement in hospital free days within 28 days. There was an 86% probability of equivalence between bamlanivimab etesevimab and casirivimab imdevimab at an odds ratio bound of 0.25. However, the trial was unblinded early due to federal distribution decisions, and no mAb met prespecified criteria for statistical inferiority or equivalence. (ClinicalTrials.gov, NCT04790786).
Keywords	covid19
Language	English
Publishing date	2021-09-09
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.09.03.21262551
Database	COVID19

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Article ; Online: Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Angus, Derek C / Derde, Lennie / Al-Beidh, Farah / Annane, Djillali / Arabi, Yaseen / Beane, Abigail / van Bentum-Puijk, Wilma / Berry, Lindsay / Bhimani, Zahra / Bonten, Marc / Bradbury, Charlotte / Brunkhorst, Frank / Buxton, Meredith / Buzgau, Adrian / Cheng, Allen C / de Jong, Menno / Detry, Michelle / Estcourt, Lise / Fitzgerald, Mark /

Goossens, Herman / Green, Cameron / Haniffa, Rashan / Higgins, Alisa M / Horvat, Christopher / Hullegie, Sebastiaan J / Kruger, Peter / Lamontagne, Francois / Lawler, Patrick R / Linstrum, Kelsey / Litton, Edward / Lorenzi, Elizabeth / Marshall, John / McAuley, Daniel / McGlothin, Anna / McGuinness, Shay / McVerry, Bryan / Montgomery, Stephanie / Mouncey, Paul / Murthy, Srinivas / Nichol, Alistair / Parke, Rachael / Parker, Jane / Rowan, Kathryn / Sanil, Ashish / Santos, Marlene / Saunders, Christina / Seymour, Christopher / Turner, Anne / van de Veerdonk, Frank / Venkatesh, Balasubramanian / Zarychanski, Ryan / Berry, Scott / Lewis, Roger J / McArthur, Colin / Webb, Steven A / Gordon, Anthony C / Angus, Derek / Cheng, Allen / De Jong, Menno / Gordon, Anthony / Lawler, Patrick / Webb, Steve / Campbell, Lewis / Forbes, Andrew / Gattas, David / Heritier, Stephane / Higgins, Lisa / Peake, Sandra / Presneill, Jeffrey / Seppelt, Ian / Trapani, Tony / Young, Paul / Bagshaw, Sean / Daneman, Nick / Ferguson, Niall / Misak, Cheryl / Hullegie, Sebastiaan / Pletz, Mathias / Rohde, Gernot / Rowan, Kathy / Alexander, Brian / Basile, Kim / Girard, Timothy / Huang, David / Vates, Jennifer / Beasley, Richard / Fowler, Robert / McGloughlin, Steve / Morpeth, Susan / Paterson, David / Venkatesh, Bala / Uyeki, Tim / Baillie, Kenneth / Duffy, Eamon / Fowler, Rob / Hills, Thomas / Orr, Katrina / Patanwala, Asad / Tong, Steve / Netea, Mihai / Bihari, Shilesh / Carrier, Marc / Fergusson, Dean / Goligher, Ewan / Haidar, Ghady / Hunt, Beverley / Kumar, Anand / Laffan, Mike / Lawless, Patrick / Lother, Sylvain / McCallum, Peter / Middeldopr, Saskia / McQuilten, Zoe / Neal, Matthew / Pasi, John / Schutgens, Roger / Stanworth, Simon / Turgeon, Alexis / Weissman, Alexandra / Adhikari, Neill / Anstey, Matthew / Brant, Emily / de Man, Angelique / Lamonagne, Francois / Masse, Marie-Helene / Udy, Andrew / Arnold, Donald / Begin, Phillipe / Charlewood, Richard / Chasse, Michael / Coyne, Mark / Cooper, Jamie / Daly, James / Gosbell, Iain / Harvala-Simmonds, Heli / Hills, Tom / MacLennan, Sheila / Menon, David / McDyer, John / Pridee, Nicole / Roberts, David / Shankar-Hari, Manu / Thomas, Helen / Tinmouth, Alan / Triulzi, Darrell / Walsh, Tim / Wood, Erica / Calfee, Carolyn / O’Kane, Cecilia / Shyamsundar, Murali / Sinha, Pratik / Thompson, Taylor / Young, Ian / Bihari, Shailesh / Hodgson, Carol / Laffey, John / McAuley, Danny / Orford, Neil / Neto, Ary / Lewis, Roger / McGlothlin, Anna / Miller, Eliza / Singh, Vanessa / Zammit, Claire / van Bentum Puijk, Wilma / Bouwman, Wietske / Mangindaan, Yara / Parker, Lorraine / Peters, Svenja / Rietveld, Ilse / Raymakers, Kik / Ganpat, Radhika / Brillinger, Nicole / Markgraf, Rene / Ainscough, Kate / Brickell, Kathy / Anjum, Aisha / Lane, Janis-Best / Richards-Belle, Alvin / Saull, Michelle / Wiley, Daisy / Bion, Julian / Connor, Jason / Gates, Simon / Manax, Victoria / van der Poll, Tom / Reynolds, John / van Beurden, Marloes / Effelaar, Evelien / Schotsman, Joost / Boyd, Craig / Harland, Cain / Shearer, Audrey / Wren, Jess / Clermont, Giles / Garrard, William / Kalchthaler, Kyle / King, Andrew / Ricketts, Daniel / Malakoutis, Salim / Marroquin, Oscar / Music, Edvin / Quinn, Kevin / Cate, Heidi / Pearson, Karen / Collins, Joanne / Hanson, Jane / Williams, Penny / Jackson, Shane / Asghar, Adeeba / Dyas, Sarah / Sutu, Mihaela / Murphy, Sheenagh / Williamson, Dawn / Mguni, Nhlanhla / Potter, Alison / Porter, David / Goodwin, Jayne / Rook, Clare / Harrison, Susie / Williams, Hannah / Campbell, Hilary / Lomme, Kaatje / Williamson, James / Sheffield, Jonathan / van’t Hoff, Willian / McCracken, Phobe / Young, Meredith / Board, Jasmin / Mart, Emma / Knott, Cameron / Smith, Julie / Boschert, Catherine / Affleck, Julia / Ramanan, Mahesh / D’Souza, Ramsy / Pateman, Kelsey / Shakih, Arif / Cheung, Winston / Kol, Mark / Wong, Helen / Shah, Asim / Wagh, Atul / Simpson, Joanne / Duke, Graeme / Chan, Peter / Cartner, Brittney / Hunter, Stephanie / Laver, Russell / Shrestha, Tapaswi / Regli, Adrian / Pellicano, Annamaria / McCullough, James / Tallott, Mandy / Kumar, Nikhil / Panwar, Rakshit / Brinkerhoff, Gail / Koppen, Cassandra / Cazzola, Federica / Brain, Matthew / Mineall, Sarah / Fischer, Roy / Biradar, Vishwanath / Soar, Natalie / White, Hayden / Estensen, Kristen / Morrison, Lynette / Smith, Joanne / Cooper, Melanie / Health, Monash / Shehabi, Yahya / Al-Bassam, Wisam / Hulley, Amanda / Whitehead, Christina / Lowrey, Julie / Gresha, Rebecca / Walsham, James / Meyer, Jason / Harward, Meg / Venz, Ellen / Williams, Patricia / Kurenda, Catherine / Smith, Kirsy / Smith, Margaret / Garcia, Rebecca / Barge, Deborah / Byrne, Deborah / Byrne, Kathleen / Driscoll, Alana / Fortune, Louise / Janin, Pierre / Yarad, Elizabeth / Hammond, Naomi / Bass, Frances / Ashelford, Angela / Waterson, Sharon / Wedd, Steve / McNamara, Robert / Buhr, Heidi / Coles, Jennifer / Schweikert, Sacha / Wibrow, Bradley / Rauniyar, Rashmi / Myers, Erina / Fysh, Ed / Dawda, Ashlish / Mevavala, Bhaumik / Litton, Ed / Ferrier, Janet / Nair, Priya / Buscher, Hergen / Reynolds, Claire / Santamaria, John / Barbazza, Leanne / Homes, Jennifer / Smith, Roger / Murray, Lauren / Brailsford, Jane / Forbes, Loretta / Maguire, Teena / Mariappa, Vasanth / Smith, Judith / Simpson, Scott / Maiden, Matthew / Bone, Allsion / Horton, Michelle / Salerno, Tania / Sterba, Martin / Geng, Wenli / Depuydt, Pieter / De Waele, Jan / De Bus, Liesbet / Fierens, Jan / Bracke, Stephanie / Reeve, Brenda / Dechert, William / Chassé, Michaël / Carrier, François Martin / Boumahni, Dounia / Benettaib, Fatna / Ghamraoui, Ali / Bellemare, David / Cloutier, Ève / Francoeur, Charles / Lamontagne, François / D’Aragon, Frédérick / Carbonneau, Elaine / Leblond, Julie / Vazquez-Grande, Gloria / Marten, Nicole / Wilson, Maggie / Albert, Martin / Serri, Karim / Cavayas, Alexandros / Duplaix, Mathilde / Williams, Virginie / Rochwerg, Bram / Karachi, Tim / Oczkowski, Simon / Centofanti, John / Millen, Tina / Duan, Erick / Tsang, Jennifer / Patterson, Lisa / English, Shane / Watpool, Irene / Porteous, Rebecca / Miezitis, Sydney / McIntyre, Lauralyn / Brochard, Laurent / Burns, Karen / Sandhu, Gyan / Khalid, Imrana / Binnie, Alexandra / Powell, Elizabeth / McMillan, Alexandra / Luk, Tracy / Aref, Noah / Andric, Zdravko / Cviljevic, Sabina / Đimoti, Renata / Zapalac, Marija / Mirković, Gordan / Baršić, Bruno / Kutleša, Marko / Kotarski, Viktor / Vujaklija Brajković, Ana / Babel, Jakša / Sever, Helena / Dragija, Lidija / Kušan, Ira / Vaara, Suvi / Pettilä, Leena / Heinonen, Jonna / Kuitunen, Anne / Karlsson, Sari / Vahtera, Annukka / Kiiski, Heikki / Ristimäki, Sanna / Azaiz, Amine / Charron, Cyril / Godement, Mathieu / Geri, Guillaume / Vieillard-Baron, Antoine / Pourcine, Franck / Monchi, Mehran / Luis, David / Mercier, Romain / Sagnier, Anne / Verrier, Nathalie / Caplin, Cecile / Siami, Shidasp / Aparicio, Christelle / Vautier, Sarah / Jeblaoui, Asma / Fartoukh, Muriel / Courtin, Laura / Labbe, Vincent / Leparco, Cécile / Muller, Grégoire / Nay, Mai-Anh / Kamel, Toufik / Benzekri, Dalila / Jacquier, Sophie / Mercier, Emmanuelle / Chartier, Delphine / Salmon, Charlotte / Dequin, PierreFrançois / Schneider, Francis / Morel, Guillaume / L’Hotellier, Sylvie / Badie, Julio / Berdaguer, Fernando Daniel / Malfroy, Sylvain / Mezher, Chaouki / Bourgoin, Charlotte / Megarbane, Bruno / Voicu, Sebastian / Deye, Nicolas / Malissin, Isabelle / Sutterlin, Laetitia / Guitton, Christophe / Darreau, Cédric / Landais, Mickaël / Chudeau, Nicolas / Robert, Alain / Moine, Pierre / Heming, Nicholas / Maxime, Virginie / Bossard, Isabelle / Nicholier, Tiphaine Barbarin / Colin, Gwenhael / Zinzoni, Vanessa / Maquigneau, Natacham / Finn, André / Kreß, Gabriele / Hoff, Uwe / Friedrich Hinrichs, Carl / Nee, Jens / Hagel, Stefan / Ankert, Juliane / Kolanos, Steffi / Bloos, Frank / Petros, Sirak / Pasieka, Bastian / Kunz, Kevin / Appelt, Peter / Schütze, Bianka / Kluge, Stefan / Nierhaus, Axel / Jarczak, Dominik / Roedl, Kevin / Weismann, Dirk / Frey, Anna / Klinikum Neukölln, Vivantes / Reill, Lorenz / Distler, Michael / Maselli, Astrid / Bélteczki, János / Magyar, István / Fazekas, Ágnes / Kovács, Sándor / Szőke, Viktória / Szigligeti, Gábor / Leszkoven, János / Collins, Daniel / Breen, Patrick / Frohlich, Stephen / Whelan, Ruth / McNicholas, Bairbre / Scully, Michael / Casey, Siobhan / Kernan, Maeve / Doran, Peter / O’Dywer, Michael / Smyth, Michelle / Hayes, Leanne / Hoiting, Oscar / Peters, Marco / Rengers, Els / Evers, Mirjam / Prinssen, Anton / Bosch Ziekenhuis, Jeroen / Simons, Koen / Rozendaal, Wim / Polderman, F / de Jager, P / Moviat, M / Paling, A / Salet, A / Rademaker, Emma / Peters, Anna Linda / de Jonge, E / Wigbers, J / Guilder, E / Butler, M / Cowdrey, Keri-Anne / Newby, Lynette / Chen, Yan / Simmonds, Catherine / McConnochie, Rachael / Ritzema Carter, Jay / Henderson, Seton / Van Der Heyden, Kym / Mehrtens, Jan / Williams, Tony / Kazemi, Alex / Song, Rima / Lai, Vivian / Girijadevi, Dinu / Everitt, Robert / Russell, Robert / Hacking, Danielle / Buehner, Ulrike / Williams, Erin / Browne, Troy / Grimwade, Kate / Goodson, Jennifer / Keet, Owen / Callender, Owen / Martynoga, Robert / Trask, Kara / Butler, Amelia / Schischka, Livia / Young, Chelsea / Lesona, Eden / Olatunji, Shaanti / Robertson, Yvonne / José, Nuno / Amaro dos Santos Catorze, Teodoro / de Lima Pereira, Tiago Nuno Alfaro / Neves Pessoa, Lucilia Maria / Castro Ferreira, Ricardo Manuel / Pereira Sousa Bastos, Joana Margarida / Aysel Florescu, Simin / Stanciu, Delia / Zaharia, Miahela Florentina / Kosa, Alma Gabriela / Codreanu, Daniel / Marabi, Yaseen / Al Qasim, Eman / Moneer Hagazy, Mohamned / Al Swaidan, Lolowa / Arishi, Hatim / Muñoz-Bermúdez, Rosana / Marin-Corral, Judith / Salazar Degracia, Anna / Parrilla Gómez, Francisco / Mateo López, Maria Isabel / Rodriguez Fernandez, Jorge / Cárcel Fernández, Sheila / Carmona Flores, Rosario / León López, Rafael / de la Fuente Martos, Carmen / Allan, Angela / Polgarova, Petra / Farahi, Neda / McWilliam, Stephen / Hawcutt, Daniel / Rad, Laura / O’Malley, Laura / Whitbread, Jennifer / Kelsall, Olivia / Wild, Laura / Thrush, Jessica / Wood, Hannah / Austin, Karen / Donnelly, Adrian / Kelly, Martin / O’Kane, Sinéad / McClintock, Declan / Warnock, Majella / Johnston, Paul / Gallagher, Linda Jude / Mc Goldrick, Clare / Mc Master, Moyra / Strzelecka, Anna / Jha, Rajeev / Kalogirou, Michael / Ellis, Christine / Krishnamurthy, Vinodh / Deelchand, Vashish / Silversides, Jon / McGuigan, Peter / Ward, Kathryn / O’Neill, Aisling / Finn, Stephanie / Phillips, Barbara / Mullan, Dee / Oritz-Ruiz de Gordoa, Laura / Thomas, Matthew / Sweet, Katie / Grimmer, Lisa / Johnson, Rebekah / Pinnell, Jez / Robinson, Matt / Gledhill, Lisa / Wood, Tracy / Morgan, Matt / Cole, Jade / Hill, Helen / Davies, Michelle / Antcliffe, David / Templeton, Maie / Rojo, Roceld / Coghlan, 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/ Craner, Michelle / Watters, Malcolm / Prout, Rachel / Davies, Louisa / Pegler, Suzannah / Kyeremeh, Lynsey / Arbane, Gill / Wilson, Karen / Gomm, Linda / Francia, Federica / Brett, Stephen / Sousa Arias, Sonia / Elin Hall, Rebecca / Budd, Joanna / Small, Charlotte / Birch, Janine / Collins, Emma / Henning, Jeremy / Bonner, Stephen / Hugill, Keith / Cirstea, Emanuel / Wilkinson, Dean / Karlikowski, Michal / Sutherland, Helen / Wilhelmsen, Elva / Woods, Jane / North, Julie / Sundaran, Dhinesh / Hollos, Laszlo / Coburn, Susan / Walsh, Joanne / Turns, Margaret / Hopkins, Phil / Smith, John / Noble, Harriet / Depante, Maria Theresa / Clarey, Emma / Laha, Shondipon / Verlander, Mark / Williams, Alexandra / Huckle, Abby / Hall, Andrew / Cooke, Jill / Gardiner-Hill, Caroline / Maloney, Carolyn / Qureshi, Hafiz / Flint, Neil / Nicholson, Sarah / Southin, Sara / Nicholson, Andrew / Borgatta, Barbara / Turner-Bone, Ian / Reddy, Amie / Wilding, Laura / Chamara Warnapura, Loku / Agno 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Elhassan, Munzir / Bakthavatsalam, Dhanalakshmi / Rowland, Matthew / Hutton, Paula / Bashyal, Archana / Davidson, Neil / Hird, Clare / Chhablani, Manish / Phalod, Gunjan / Kirkby, Amy / Archer, Simon / Netherton, Kimberley / Reschreiter, Henrik / Camsooksai, Julie / Patch, Sarah / Jenkins, Sarah / Pogson, David / Rose, Steve / Daly, Zoe / Brimfield, Lutece / Claridge, Helen / Parekh, Dhruv / Bergin, Colin / Bates, Michelle / Dasgin, Joanne / McGhee, Christopher / Sim, Malcolm / Hay, Sophie Kennedy / Henderson, Steven / Phull, Mandeep-Kaur / Zaidi, Abbas / Pogreban, Tatiana / Rosaroso, Lace Paulyn / Harvey, Daniel / Lowe, Benjamin / Meredith, Megan / Ryan, Lucy / Hormis, Anil / Walker, Rachel / Collier, Dawn / Kimpton, Sarah / Oakley, Susan / Rooney, Kevin / Rodden, Natalie / Hughes, Emma / Thomson, Nicola / McGlynn, Deborah / Walden, Andrew / Jacques, Nicola / Coles, Holly / Tilney, Emma / Vowell, Emma / Schuster-Bruce, Martin / Pitts, Sally / Miln, Rebecca / Purandare, Laura / 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Alistair / Rostron, Anthony / Woods, Lindsey / Cornell, Sarah / Pillai, Suresh / Harford, Rachel / Rees, Tabitha / Ivatt, Helen / Sundara Raman, Ajay / Davey, Miriam / Lee, Kelvin / Barber, Russell / Chablani, Manish / Brohi, Farooq / Jagannathan, Vijay / Clark, Michele / Purvis, Sarah / Wetherill, Bill / Dushianthan, Ahilanandan / Cusack, Rebecca / de Courcy-Golder, Kim / Smith, Simon / Jackson, Susan / Attwood, Ben / Parsons, Penny / Page, Valerie / Zhao, Xiao Bei / Oza, Deepali / Rhodes, Jonathan / Anderson, Tom / Morris, Sheila / Xia Le Tai, Charlotte / Thomas, Amy / Keen, Alexandra / Digby, Stephen / Cowley, Nicholas / Southern, David / Reddy, Harsha / Campbell, Andy / Watkins, Claire / Smuts, Sara / Touma, Omar / Barnes, Nicky / Alexander, Peter / Felton, Tim / Ferguson, Susan / Sellers, Katharine / Bradley-Potts, Joanne / Yates, David / Birkinshaw, Isobel / Kell, Kay / Marshall, Nicola / Carr-Knott, Lisa / Summers, Charlotte

JAMA

2020 Volume 324, Issue 13, Page(s) 1317–1329

Abstract: Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.: Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19.: Design, setting, and participants: An ...

Abstract	Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, setting, and participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main outcomes and measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial registration: ClinicalTrials.gov Identifier: NCT02735707.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Adult ; Anti-Inflammatory Agents/administration & dosage ; Anti-Inflammatory Agents/adverse effects ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Early Termination of Clinical Trials ; Female ; Humans ; Hydrocortisone/administration & dosage ; Hydrocortisone/adverse effects ; Intensive Care Units ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2 ; Shock/drug therapy ; Shock/etiology ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Adrenal Cortex Hormones ; Anti-Inflammatory Agents ; Hydrocortisone (WI4X0X7BPJ)
Keywords	covid19
Language	English
Publishing date	2020-12-08
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2020.17022
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19

Goossens, Herman / Green, Cameron / Haniffa, Rashan / Higgins, Alisa M / Horvat, Christopher / Hullegie, Sebastiaan J / Kruger, Peter / Lamontagne, Francois / Lawler, Patrick R / Linstrum, Kelsey / Litton, Edward / Lorenzi, Elizabeth / Marshall, John / McAuley, Daniel / McGlothin, Anna / McGuinness, Shay / McVerry, Bryan / Montgomery, Stephanie / Mouncey, Paul / Murthy, Srinivas / Nichol, Alistair / Parke, Rachael / Parker, Jane / Rowan, Kathryn / Sanil, Ashish / Santos, Marlene / Saunders, Christina / Seymour, Christopher / Turner, Anne / van de Veerdonk, Frank / Venkatesh, Balasubramanian / Zarychanski, Ryan / Berry, Scott / Lewis, Roger J / McArthur, Colin / Webb, Steven A / Gordon, Anthony C / Writing Committee for the REMAP-CAP Investigators, / Angus, Derek / Cheng, Allen / De Jong, Menno / Gordon, Anthony / Lawler, Patrick / Webb, Steve / Campbell, Lewis / Forbes, Andrew / Gattas, David / Heritier, Stephane / Higgins, Lisa / Peake, Sandra / Presneill, Jeffrey / Seppelt, Ian / Trapani, Tony / Young, Paul / Bagshaw, Sean / Daneman, Nick / Ferguson, Niall / Misak, Cheryl / Hullegie, Sebastiaan / Pletz, Mathias / Rohde, Gernot / Rowan, Kathy / Alexander, Brian / Basile, Kim / Girard, Timothy / Huang, David / Vates, Jennifer / Beasley, Richard / Fowler, Robert / McGloughlin, Steve / Morpeth, Susan / Paterson, David / Venkatesh, Bala / Uyeki, Tim / Baillie, Kenneth / Duffy, Eamon / Fowler, Rob / Hills, Thomas / Orr, Katrina / Patanwala, Asad / Tong, Steve / Netea, Mihai / Bihari, Shilesh / Carrier, Marc / Fergusson, Dean / Goligher, Ewan / Haidar, Ghady / Hunt, Beverley / Kumar, Anand / Laffan, Mike / Lawless, Patrick / Lother, Sylvain / McCallum, Peter / Middeldopr, Saskia / McQuilten, Zoe / Neal, Matthew / Pasi, John / Schutgens, Roger / Stanworth, Simon / Turgeon, Alexis / Weissman, Alexandra / Adhikari, Neill / Anstey, Matthew / Brant, Emily / de Man, Angelique / Lamonagne, Francois / Masse, Marie-Helene / Udy, Andrew / Arnold, Donald / Begin, Phillipe / Charlewood, Richard / Chasse, Michael / Coyne, Mark / Cooper, Jamie / Daly, James / Gosbell, Iain / Harvala-Simmonds, Heli / Hills, Tom / MacLennan, Sheila / Menon, David / McDyer, John / Pridee, Nicole / Roberts, David / Shankar-Hari, Manu / Thomas, Helen / Tinmouth, Alan / Triulzi, Darrell / Walsh, Tim / Wood, Erica / Calfee, Carolyn / O’Kane, Cecilia / Shyamsundar, Murali / Sinha, Pratik / Thompson, Taylor / Young, Ian / Bihari, Shailesh / Hodgson, Carol / Laffey, John / McAuley, Danny / Orford, Neil / Neto, Ary / Lewis, Roger / McGlothlin, Anna / Miller, Eliza / Singh, Vanessa / Zammit, Claire / van Bentum Puijk, Wilma / Bouwman, Wietske / Mangindaan, Yara / Parker, Lorraine / Peters, Svenja / Rietveld, Ilse / Raymakers, Kik / Ganpat, Radhika / Brillinger, Nicole / Markgraf, Rene / Ainscough, Kate / Brickell, Kathy / Anjum, Aisha / Lane, Janis-Best / Richards-Belle, Alvin / Saull, Michelle / Wiley, Daisy / Bion, Julian / Connor, Jason / Gates, Simon / Manax, Victoria / van der Poll, Tom / Reynolds, John / van Beurden, Marloes / Effelaar, Evelien / Schotsman, Joost / Boyd, Craig / Harland, Cain / Shearer, Audrey / Wren, Jess / Clermont, Giles / Garrard, William / Kalchthaler, Kyle / King, Andrew / Ricketts, Daniel / Malakoutis, Salim / Marroquin, Oscar / Music, Edvin / Quinn, Kevin / Cate, Heidi / Pearson, Karen / Collins, Joanne / Hanson, Jane / Williams, Penny / Jackson, Shane / Asghar, Adeeba / Dyas, Sarah / Sutu, Mihaela / Murphy, Sheenagh / Williamson, Dawn / Mguni, Nhlanhla / Potter, Alison / Porter, David / Goodwin, Jayne / Rook, Clare / Harrison, Susie / Williams, Hannah / Campbell, Hilary / Lomme, Kaatje / Williamson, James / Sheffield, Jonathan / van’t Hoff, Willian / McCracken, Phobe / Young, Meredith / Board, Jasmin / Mart, Emma / Knott, Cameron / Smith, Julie / Boschert, Catherine / Affleck, Julia / Ramanan, Mahesh / D’Souza, Ramsy / Pateman, Kelsey / Shakih, Arif / Cheung, Winston / Kol, Mark / Wong, Helen / Shah, Asim / Wagh, Atul / Simpson, Joanne / Duke, Graeme / Chan, Peter / Cartner, Brittney / Hunter, Stephanie / Laver, Russell / Shrestha, Tapaswi / Regli, Adrian / Pellicano, Annamaria / McCullough, James / Tallott, Mandy / Kumar, Nikhil / Panwar, Rakshit / Brinkerhoff, Gail / Koppen, Cassandra / Cazzola, Federica / Brain, Matthew / Mineall, Sarah / Fischer, Roy / Biradar, Vishwanath / Soar, Natalie / White, Hayden / Estensen, Kristen / Morrison, Lynette / Smith, Joanne / Cooper, Melanie / Health, Monash / Shehabi, Yahya / Al-Bassam, Wisam / Hulley, Amanda / Whitehead, Christina / Lowrey, Julie / Gresha, Rebecca / Walsham, James / Meyer, Jason / Harward, Meg / Venz, Ellen / Williams, Patricia / Kurenda, Catherine / Smith, Kirsy / Smith, Margaret / Garcia, Rebecca / Barge, Deborah / Byrne, Deborah / Byrne, Kathleen / Driscoll, Alana / Fortune, Louise / Janin, Pierre / Yarad, Elizabeth / Hammond, Naomi / Bass, Frances / Ashelford, Angela / Waterson, Sharon / Wedd, Steve / McNamara, Robert / Buhr, Heidi / Coles, Jennifer / Schweikert, Sacha / Wibrow, Bradley / Rauniyar, Rashmi / Myers, Erina / Fysh, Ed / Dawda, Ashlish / Mevavala, Bhaumik / Litton, Ed / Ferrier, Janet / Nair, Priya / Buscher, Hergen / Reynolds, Claire / Santamaria, John / Barbazza, Leanne / Homes, Jennifer / Smith, Roger / Murray, Lauren / Brailsford, Jane / Forbes, Loretta / Maguire, Teena / Mariappa, Vasanth / Smith, Judith / Simpson, Scott / Maiden, Matthew / Bone, Allsion / Horton, Michelle / Salerno, Tania / Sterba, Martin / Geng, Wenli / Depuydt, Pieter / De Waele, Jan / De Bus, Liesbet / Fierens, Jan / Bracke, Stephanie / Reeve, Brenda / Dechert, William / Chassé, Michaël / Carrier, François Martin / Boumahni, Dounia / Benettaib, Fatna / Ghamraoui, Ali / Bellemare, David / Cloutier, Ève / Francoeur, Charles / Lamontagne, François / D’Aragon, Frédérick / Carbonneau, Elaine / Leblond, Julie / Vazquez-Grande, Gloria / Marten, Nicole / Wilson, Maggie / Albert, Martin / Serri, Karim / Cavayas, Alexandros / Duplaix, Mathilde / Williams, Virginie / Rochwerg, Bram / Karachi, Tim / Oczkowski, Simon / Centofanti, John / Millen, Tina / Duan, Erick / Tsang, Jennifer / Patterson, Lisa / English, Shane / Watpool, Irene / Porteous, Rebecca / Miezitis, Sydney / McIntyre, Lauralyn / Brochard, Laurent / Burns, Karen / Sandhu, Gyan / Khalid, Imrana / Binnie, Alexandra / Powell, Elizabeth / McMillan, Alexandra / Luk, Tracy / Aref, Noah / Andric, Zdravko / Cviljevic, Sabina / Đimoti, Renata / Zapalac, Marija / Mirković, Gordan / Baršić, Bruno / Kutleša, Marko / Kotarski, Viktor / Vujaklija Brajković, Ana / Babel, Jakša / Sever, Helena / Dragija, Lidija / Kušan, Ira / Vaara, Suvi / Pettilä, Leena / Heinonen, Jonna / Kuitunen, Anne / Karlsson, Sari / Vahtera, Annukka / Kiiski, Heikki / Ristimäki, Sanna / Azaiz, Amine / Charron, Cyril / Godement, Mathieu / Geri, Guillaume / Vieillard-Baron, Antoine / Pourcine, Franck / Monchi, Mehran / Luis, David / Mercier, Romain / Sagnier, Anne / Verrier, Nathalie / Caplin, Cecile / Siami, Shidasp / Aparicio, Christelle / Vautier, Sarah / Jeblaoui, Asma / Fartoukh, Muriel / Courtin, Laura / Labbe, Vincent / Leparco, Cécile / Muller, Grégoire / Nay, Mai-Anh / Kamel, Toufik / Benzekri, Dalila / Jacquier, Sophie / Mercier, Emmanuelle / Chartier, Delphine / Salmon, Charlotte / Dequin, PierreFrançois / Schneider, Francis / Morel, Guillaume / L’Hotellier, Sylvie / Badie, Julio / Berdaguer, Fernando Daniel / Malfroy, Sylvain / Mezher, Chaouki / Bourgoin, Charlotte / Megarbane, Bruno / Voicu, Sebastian / Deye, Nicolas / Malissin, Isabelle / Sutterlin, Laetitia / Guitton, Christophe / Darreau, Cédric / Landais, Mickaël / Chudeau, Nicolas / Robert, Alain / Moine, Pierre / Heming, Nicholas / Maxime, Virginie / Bossard, Isabelle / Nicholier, Tiphaine Barbarin / Colin, Gwenhael / Zinzoni, Vanessa / Maquigneau, Natacham / Finn, André / Kreß, Gabriele / Hoff, Uwe / Friedrich Hinrichs, Carl / Nee, Jens / Hagel, Stefan / Ankert, Juliane / Kolanos, Steffi / Bloos, Frank / Petros, Sirak / Pasieka, Bastian / Kunz, Kevin / Appelt, Peter / Schütze, Bianka / Kluge, Stefan / Nierhaus, Axel / Jarczak, Dominik / Roedl, Kevin / Weismann, Dirk / Frey, Anna / Klinikum Neukölln, Vivantes / Reill, Lorenz / Distler, Michael / Maselli, Astrid / Bélteczki, János / Magyar, István / Fazekas, Ágnes / Kovács, Sándor / Szőke, Viktória / Szigligeti, Gábor / Leszkoven, János / Collins, Daniel / Breen, Patrick / Frohlich, Stephen / Whelan, Ruth / McNicholas, Bairbre / Scully, Michael / Casey, Siobhan / Kernan, Maeve / Doran, Peter / O’Dywer, Michael / Smyth, Michelle / Hayes, Leanne / Hoiting, Oscar / Peters, Marco / Rengers, Els / Evers, Mirjam / Prinssen, Anton / Bosch Ziekenhuis, Jeroen / Simons, Koen / Rozendaal, Wim / Polderman, F / de Jager, P / Moviat, M / Paling, A / Salet, A / Rademaker, Emma / Peters, Anna Linda / de Jonge, E / Wigbers, J / Guilder, E / Butler, M / Cowdrey, Keri-Anne / Newby, Lynette / Chen, Yan / Simmonds, Catherine / McConnochie, Rachael / Ritzema Carter, Jay / Henderson, Seton / Van Der Heyden, Kym / Mehrtens, Jan / Williams, Tony / Kazemi, Alex / Song, Rima / Lai, Vivian / Girijadevi, Dinu / Everitt, Robert / Russell, Robert / Hacking, Danielle / Buehner, Ulrike / Williams, Erin / Browne, Troy / Grimwade, Kate / Goodson, Jennifer / Keet, Owen / Callender, Owen / Martynoga, Robert / Trask, Kara / Butler, Amelia / Schischka, Livia / Young, Chelsea / Lesona, Eden / Olatunji, Shaanti / Robertson, Yvonne / José, Nuno / Amaro dos Santos Catorze, Teodoro / de Lima Pereira, Tiago Nuno Alfaro / Neves Pessoa, Lucilia Maria / Castro Ferreira, Ricardo Manuel / Pereira Sousa Bastos, Joana Margarida / Aysel Florescu, Simin / Stanciu, Delia / Zaharia, Miahela Florentina / Kosa, Alma Gabriela / Codreanu, Daniel / Marabi, Yaseen / Al Qasim, Eman / Moneer Hagazy, Mohamned / Al Swaidan, Lolowa / Arishi, Hatim / Muñoz-Bermúdez, Rosana / Marin-Corral, Judith / Salazar Degracia, Anna / Parrilla Gómez, Francisco / Mateo López, Maria Isabel / Rodriguez Fernandez, Jorge / Cárcel Fernández, Sheila / Carmona Flores, Rosario / León López, Rafael / de la Fuente Martos, Carmen / Allan, Angela / Polgarova, Petra / Farahi, Neda / McWilliam, Stephen / Hawcutt, Daniel / Rad, Laura / O’Malley, Laura / Whitbread, Jennifer / Kelsall, Olivia / Wild, Laura / Thrush, Jessica / Wood, Hannah / Austin, Karen / Donnelly, Adrian / Kelly, Martin / O’Kane, Sinéad / McClintock, Declan / Warnock, Majella / Johnston, Paul / Gallagher, Linda Jude / Mc Goldrick, Clare / Mc Master, Moyra / Strzelecka, Anna / Jha, Rajeev / Kalogirou, Michael / Ellis, Christine / Krishnamurthy, Vinodh / Deelchand, Vashish / Silversides, Jon / McGuigan, Peter / Ward, Kathryn / O’Neill, Aisling / Finn, Stephanie / Phillips, Barbara / Mullan, Dee / Oritz-Ruiz de Gordoa, Laura / Thomas, Matthew / Sweet, Katie / Grimmer, Lisa / Johnson, Rebekah / Pinnell, Jez / Robinson, Matt / Gledhill, Lisa / Wood, Tracy / Morgan, Matt / Cole, Jade / Hill, Helen / Davies, Michelle / Antcliffe, David / Templeton, Maie / Rojo, Roceld / Coghlan, Phoebe / Smee, Joanna / Mackay, Euan / Cort, Jon / Whileman, Amanda / Spencer, Thomas / Spittle, Nick / Kasipandian, Vidya / Patel, Amit / Allibone, Suzanne / Genetu, Roman Mary / Ramali, Mohamed / Ghosh, Alison / Bamford, Peter / London, Emily / Cawley, Kathryn / Faulkner, Maria / Jeffrey, Helen / Smith, Tim / Brewer, Chris / Gregory, Jane / Limb, James / Cowton, Amanda / O’Brien, Julie / Nikitas, Nikitas / Wells, Colin / Lankester, Liana / Pulletz, Mark / Birch, Jenny / Wiseman, Sophie / Horton, Sarah / Alegria, Ana / Turki, Salah / Elsefi, Tarek / Crisp, Nikki / Allen, Louise / McCullagh, Iain / Robinson, Philip / Hays, Carole / Babio-Galan, Maite / Stevenson, Hannah / Khare, Divya / Pinder, Meredith / Selvamoni, Selvin / Gopinath, Amitha / Pugh, Richard / Menzies, Daniel / Mackay, Callum / Allan, Elizabeth / Davies, Gwyneth / Puxty, Kathryn / McCue, Claire / Cathcart, Susanne / Hickey, Naomi / Ireland, Jane / Yusuff, Hakeem / Isgro, Graziella / Brightling, Chris / Bourne, Michelle / Craner, Michelle / Watters, Malcolm / Prout, Rachel / Davies, Louisa / Pegler, Suzannah / Kyeremeh, Lynsey / Arbane, Gill / Wilson, Karen / Gomm, Linda / Francia, Federica / Brett, Stephen / Sousa Arias, Sonia / Elin Hall, Rebecca / Budd, Joanna / Small, Charlotte / Birch, Janine / Collins, Emma / Henning, Jeremy / Bonner, Stephen / Hugill, Keith / Cirstea, Emanuel / Wilkinson, Dean / Karlikowski, Michal / Sutherland, Helen / Wilhelmsen, Elva / Woods, Jane / North, Julie / Sundaran, Dhinesh / Hollos, Laszlo / Coburn, Susan / Walsh, Joanne / Turns, Margaret / Hopkins, Phil / Smith, John / Noble, Harriet / Depante, Maria Theresa / Clarey, Emma / Laha, Shondipon / Verlander, Mark / Williams, Alexandra / Huckle, Abby / Hall, Andrew / Cooke, Jill / Gardiner-Hill, Caroline / Maloney, Carolyn / Qureshi, Hafiz / Flint, Neil / Nicholson, Sarah / Southin, Sara / Nicholson, Andrew / Borgatta, Barbara / Turner-Bone, Ian / Reddy, Amie / Wilding, Laura / Chamara Warnapura, Loku / Agno Sathianathan, Ronan / Golden, David / Hart, Ciaran / Jones, Jo / Bannard-Smith, Jonathan / Henry, Joanne / Birchall, Katie / Pomeroy, Fiona / Quayle, Rachael / Makowski, Arystarch / Misztal, Beata / Ahmed, Iram / KyereDiabour, Thyra / Naiker, Kevin / Stewart, Richard / Mwaura, Esther / Mew, Louise / Wren, Lynn / Willams, Felicity / Innes, Richard / Doble, Patricia / Hutter, Joanne / Shovelton, Charmaine / Plumb, Benjamin / Szakmany, Tamas / Hamlyn, Vincent / Hawkins, Nancy / Lewis, Sarah / Dell, Amanda / Gopal, Shameer / Ganguly, Saibal / Smallwood, Andrew / Harris, Nichola / Metherell, Stella / Lazaro, Juan Martin / Newman, Tabitha / Fletcher, Simon / Nortje, Jurgens / Fottrell-Gould, Deirdre / Randell, Georgina / Zaman, Mohsin / Elmahi, Einas / Jones, Andrea / Hall, Kathryn / Mills, Gary / Ryalls, Kim / Bowler, Helen / Sall, Jas / Bourne, Richard / Borrill, Zoe / Duncan, Tracey / Lamb, Thomas / Shaw, Joanne / Fox, Claire / Moreno Cuesta, Jeronimo / Xavier, Kugan / Purohit, Dharam / Elhassan, Munzir / Bakthavatsalam, Dhanalakshmi / Rowland, Matthew / Hutton, Paula / Bashyal, Archana / Davidson, Neil / Hird, Clare / Chhablani, Manish / Phalod, Gunjan / Kirkby, Amy / Archer, Simon / Netherton, Kimberley / Reschreiter, Henrik / Camsooksai, Julie / Patch, Sarah / Jenkins, Sarah / Pogson, David / Rose, Steve / Daly, Zoe / Brimfield, Lutece / Claridge, Helen / Parekh, Dhruv / Bergin, Colin / Bates, Michelle / Dasgin, Joanne / McGhee, Christopher / Sim, Malcolm / Hay, Sophie Kennedy / Henderson, Steven / Phull, Mandeep-Kaur / Zaidi, Abbas / Pogreban, Tatiana / Rosaroso, Lace Paulyn / Harvey, Daniel / Lowe, Benjamin / Meredith, Megan / Ryan, Lucy / Hormis, Anil / Walker, Rachel / Collier, Dawn / Kimpton, Sarah / Oakley, Susan / Rooney, Kevin / Rodden, Natalie / Hughes, Emma / Thomson, Nicola / McGlynn, Deborah / Walden, Andrew / Jacques, Nicola / Coles, Holly / Tilney, Emma / Vowell, Emma / Schuster-Bruce, Martin / Pitts, Sally / Miln, Rebecca / Purandare, Laura / Vamplew, Luke / Spivey, Michael / Bean, Sarah / Burt, Karen / Moore, Lorraine / Day, Christopher / Gibson, Charly / Gordon, Elizabeth / Zitter, Letizia / Keenan, Samantha / Baker, Evelyn / Cherian, Shiney / Cutler, Sean / Roynon-Reed, Anna / Harrington, Kate / Raithatha, Ajay / Bauchmuller, Kris / Ahmad, Norfaizan / Grecu, Irina / Trodd, Dawn / Martin, Jane / Wrey Brown, Caroline / Arias, Ana-Marie / Craven, Thomas / Hope, David / Singleton, Jo / Clark, Sarah / Rae, Nicola / Welters, Ingeborg / Hamilton, David Oliver / Williams, Karen / Waugh, Victoria / Shaw, David / Puthucheary, Zudin / Martin, Timothy / Santos, Filipa / Uddin, Ruzena / Somerville, Alastair / Tatham, Kate Colette / Jhanji, Shaman / Black, Ethel / Dela Rosa, Arnold / Howle, Ryan / Tully, Redmond / Drummond, Andrew / Dearden, Joy / Philbin, Jennifer / Munt, Sheila / Vuylsteke, Alain / Chan, Charles / Victor, Saji / Matsa, Ramprasad / Gellamucho, Minerva / Creagh-Brown, Ben / Tooley, Joe / Montague, Laura / De Beaux, Fiona / Bullman, Laetitia / Kersiake, Ian / Demetriou, Carrie / Mitchard, Sarah / Ramos, Lidia / White, Katie / Donnison, Phil / Johns, Maggie / Casey, Ruth / Mattocks, Lehentha / Salisbury, Sarah / Dark, Paul / Claxton, Andrew / McLachlan, Danielle / Slevin, Kathryn / Lee, Stephanie / Hulme, Jonathan / Joseph, Sibet / Kinney, Fiona / Senya, Ho Jan / Oborska, Aneta / Kayani, Abdul / Hadebe, Bernard / Orath Prabakaran, Rajalakshmi / Nichols, Lesley / Thomas, Matt / Worner, Ruth / Faulkner, Beverley / Gendall, Emma / Hayes, Kati / Hamilton-Davies, Colin / Chan, Carmen / Mfuko, Celina / Abbass, Hakam / Mandadapu, Vineela / Leaver, Susannah / Forton, Daniel / Patel, Kamal / Paramasivam, Elankumaran / Powell, Matthew / Gould, Richard / Wilby, Elizabeth / Howcroft, Clare / Banach, Dorota / Fernández de Pinedo Artaraz, Ziortza / Cabreros, Leilani / White, Ian / Croft, Maria / Holland, Nicky / Pereira, Rita / Zaki, Ahmed / Johnson, David / Jackson, Matthew / Garrard, Hywel / Juhaz, Vera / Roy, Alistair / Rostron, Anthony / Woods, Lindsey / Cornell, Sarah / Pillai, Suresh / Harford, Rachel / Rees, Tabitha / Ivatt, Helen / Sundara Raman, Ajay / Davey, Miriam / Lee, Kelvin / Barber, Russell / Chablani, Manish / Brohi, Farooq / Jagannathan, Vijay / Clark, Michele / Purvis, Sarah / Wetherill, Bill / Dushianthan, Ahilanandan / Cusack, Rebecca / de Courcy-Golder, Kim / Smith, Simon / Jackson, Susan / Attwood, Ben / Parsons, Penny / Page, Valerie / Zhao, Xiao Bei / Oza, Deepali / Rhodes, Jonathan / Anderson, Tom / Morris, Sheila / Xia Le Tai, Charlotte / Thomas, Amy / Keen, Alexandra / Digby, Stephen / Cowley, Nicholas / Southern, David / Reddy, Harsha / Campbell, Andy / Watkins, Claire / Smuts, Sara / Touma, Omar / Barnes, Nicky / Alexander, Peter / Felton, Tim / Ferguson, Susan / Sellers, Katharine / Bradley-Potts, Joanne / Yates, David / Birkinshaw, Isobel / Kell, Kay / Marshall, Nicola / Carr-Knott, Lisa

The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

2020

Keywords	Writing Committee for the REMAP-CAP Investigators ; Humans ; Pneumonia ; Viral ; Coronavirus Infections ; Shock ; Hydrocortisone ; Adrenal Cortex Hormones ; Anti-Inflammatory Agents ; Treatment Outcome ; Respiration ; Artificial ; Adult ; Middle Aged ; Intensive Care Units ; Female ; Male ; Early Termination of Clinical Trials ; Pandemics ; Betacoronavirus ; covid19
Language	English
Publisher	JAMA
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

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Article ; Online: Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19

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