Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants
Abstract Background Extremely preterm infants have a high mortality and morbidity. Here, we present a statistical analysis plan for secondary Bayesian analyses of the pragmatic, sufficiently powered multinational, trial—SafeBoosC III—evaluating the benefits and harms of cerebral oximetry monitoring...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-023-07720-3 |
| _version_ | 1797556678745391104 |
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| author | Markus Harboe Olsen Mathias Lühr Hansen Theis Lange Christian Gluud Lehana Thabane Gorm Greisen Janus Christian Jakobsen the SafeBoosC-III Trial Group |
| author_facet | Markus Harboe Olsen Mathias Lühr Hansen Theis Lange Christian Gluud Lehana Thabane Gorm Greisen Janus Christian Jakobsen the SafeBoosC-III Trial Group |
| author_sort | Markus Harboe Olsen |
| collection | DOAJ |
| description | Abstract Background Extremely preterm infants have a high mortality and morbidity. Here, we present a statistical analysis plan for secondary Bayesian analyses of the pragmatic, sufficiently powered multinational, trial—SafeBoosC III—evaluating the benefits and harms of cerebral oximetry monitoring plus a treatment guideline versus usual care for such infants. Methods The SafeBoosC-III trial is an investigator-initiated, open-label, randomised, multinational, pragmatic, phase III clinical trial with a parallel-group design. The trial randomised 1601 infants, and the frequentist analyses were published in April 2023. The primary outcome is a dichotomous composite outcome of death or severe brain injury. The exploratory outcomes are major neonatal morbidities associated with neurodevelopmental impairment later in life: (1) bronchopulmonary dysplasia; (2) retinopathy of prematurity; (3) late-onset sepsis; (4) necrotising enterocolitis; and (5) number of major neonatal morbidities (count of bronchopulmonary dysplasia, retinopathy of prematurity, and severe brain injury). The primary Bayesian analyses will use non-informed priors including all plausible effects. The models will use a Hamiltonian Monte Carlo sampler with 1 chain, a sampling of 10,000, and at least 25,000 iterations for the burn-in period. In Bayesian statistics, such analyses are referred to as ‘posteriors’ and will be presented as point estimates with 95% credibility intervals (CrIs), encompassing the most probable results based on the data, model, and priors selected. The results will be presented as probability of any benefit or any harm, Bayes factor, and the probability of clinical important benefit or harm. Two statisticians will analyse the blinded data independently following this protocol. Discussion This statistical analysis plan presents a secondary Bayesian analysis of the SafeBoosC-III trial. The analysis and the final manuscript will be carried out and written after we publicise the primary frequentist trial report. Thus, we can interpret the findings from both the frequentists and Bayesian perspective. This approach should provide a better foundation for interpreting of our findings. Trial registration ClinicalTrials.org, NCT03770741. Registered on 10 December 2018. |
| first_indexed | 2024-03-10T17:06:18Z |
| format | Article |
| id | doaj.art-d02951c978d94f3fa97695556ec2daa1 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-03-10T17:06:18Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-d02951c978d94f3fa97695556ec2daa12023-11-20T10:49:08ZengBMCTrials1745-62152023-11-012411810.1186/s13063-023-07720-3Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infantsMarkus Harboe Olsen0Mathias Lühr Hansen1Theis Lange2Christian Gluud3Lehana Thabane4Gorm Greisen5Janus Christian Jakobsen6the SafeBoosC-III Trial GroupCentre for Clinical Intervention Research, Copenhagen Trial Unit, The Capital Region, Copenhagen University Hospital ─ RigshospitaletCentre for Clinical Intervention Research, Copenhagen Trial Unit, The Capital Region, Copenhagen University Hospital ─ RigshospitaletSection of Biostatistics, Department of Publich Health, Copenhagen UniversityCentre for Clinical Intervention Research, Copenhagen Trial Unit, The Capital Region, Copenhagen University Hospital ─ RigshospitaletHealth Research Methods, Evidence, and Impact, McMaster UniversityDepartment of Neonatology, Juliane Marie Centre, Copenhagen University Hospital ─ RigshospitaletCentre for Clinical Intervention Research, Copenhagen Trial Unit, The Capital Region, Copenhagen University Hospital ─ RigshospitaletAbstract Background Extremely preterm infants have a high mortality and morbidity. Here, we present a statistical analysis plan for secondary Bayesian analyses of the pragmatic, sufficiently powered multinational, trial—SafeBoosC III—evaluating the benefits and harms of cerebral oximetry monitoring plus a treatment guideline versus usual care for such infants. Methods The SafeBoosC-III trial is an investigator-initiated, open-label, randomised, multinational, pragmatic, phase III clinical trial with a parallel-group design. The trial randomised 1601 infants, and the frequentist analyses were published in April 2023. The primary outcome is a dichotomous composite outcome of death or severe brain injury. The exploratory outcomes are major neonatal morbidities associated with neurodevelopmental impairment later in life: (1) bronchopulmonary dysplasia; (2) retinopathy of prematurity; (3) late-onset sepsis; (4) necrotising enterocolitis; and (5) number of major neonatal morbidities (count of bronchopulmonary dysplasia, retinopathy of prematurity, and severe brain injury). The primary Bayesian analyses will use non-informed priors including all plausible effects. The models will use a Hamiltonian Monte Carlo sampler with 1 chain, a sampling of 10,000, and at least 25,000 iterations for the burn-in period. In Bayesian statistics, such analyses are referred to as ‘posteriors’ and will be presented as point estimates with 95% credibility intervals (CrIs), encompassing the most probable results based on the data, model, and priors selected. The results will be presented as probability of any benefit or any harm, Bayes factor, and the probability of clinical important benefit or harm. Two statisticians will analyse the blinded data independently following this protocol. Discussion This statistical analysis plan presents a secondary Bayesian analysis of the SafeBoosC-III trial. The analysis and the final manuscript will be carried out and written after we publicise the primary frequentist trial report. Thus, we can interpret the findings from both the frequentists and Bayesian perspective. This approach should provide a better foundation for interpreting of our findings. Trial registration ClinicalTrials.org, NCT03770741. Registered on 10 December 2018.https://doi.org/10.1186/s13063-023-07720-3Randomised clinical trialExtremely pretermCerebral oximetryNear-infrared spectroscopyStatistical analysis planBayesian statistics |
| spellingShingle | Markus Harboe Olsen Mathias Lühr Hansen Theis Lange Christian Gluud Lehana Thabane Gorm Greisen Janus Christian Jakobsen the SafeBoosC-III Trial Group Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants Trials Randomised clinical trial Extremely preterm Cerebral oximetry Near-infrared spectroscopy Statistical analysis plan Bayesian statistics |
| title | Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| title_full | Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| title_fullStr | Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| title_full_unstemmed | Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| title_short | Detailed statistical analysis plan for a secondary Bayesian analysis of the SafeBoosC-III trial: a multinational, randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| title_sort | detailed statistical analysis plan for a secondary bayesian analysis of the safeboosc iii trial a multinational randomised clinical trial assessing treatment guided by cerebral oximetry monitoring versus usual care in extremely preterm infants |
| topic | Randomised clinical trial Extremely preterm Cerebral oximetry Near-infrared spectroscopy Statistical analysis plan Bayesian statistics |
| url | https://doi.org/10.1186/s13063-023-07720-3 |
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