Journal Article

Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest: a statistical analysis plan

Lange, Theis, Cronberg, Tobias, Joannidis, Michael, Storm, Christian, Taccone, Fabio Silvio, Morgan, Matt P. G., Rylander, Christian, Ullén, Susann, Lilja, Gisela, Young, Paul, Nordberg, Per, Levin, Helena, Saxena, Manoj, Eastwood, Glenn, Hovdenes, Jan, Nielsen, Niklas, Jakobsen, Janus Christian, Bělohlávek, Jan, Dankiewicz, Josef, Pelosi, Paolo, Callaway, Clifton, Kirkegaard, Hans, Wise, Matthew P., Oddo, Mauro, Cariou, Alain, Erlinge, David, Nichol, Alistair, Friberg, Hans

2020

Overview

Background To date, targeted temperature management (TTM) is the only neuroprotective intervention after resuscitation from cardiac arrest that is recommended by guidelines. The evidence on the effects of TTM is unclear. Methods/design The Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) trial is an international, multicentre, parallel group, investigator-initiated, randomised, superiority trial in which TTM with a target temperature of 33 °C after cardiac arrest will be compared with a strategy to maintain normothermia and active treatment of fever (≥ 37.8 °C). Prognosticators, outcome assessors, the steering group, the trial coordinating team, and trial statisticians will be blinded to treatment allocation. The primary outcome will be all-cause mortality at 180 days after randomisation. We estimate a 55% mortality in the targeted normothermia group. To detect an absolute risk reduction of 7.5% with an alpha of 0.05 and 90% power, 1900 participants will be enrolled. The secondary neurological outcome will be poor functional outcome (modified Rankin scale 4–6) at 180 days after cardiac arrest. In this paper, a detailed statistical analysis plan is presented, including a comprehensive description of the statistical analyses, handling of missing data, and assessments of underlying statistical assumptions. Final analyses will be conducted independently by two qualified statisticians following the present plan. Discussion This SAP, which was prepared before completion of enrolment, should increase the validity of the TTM trial by mitigation of analysis-bias.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Anestesi och intensivvård / Anesthesiology and Intensive Care / Biomedicine / Body Temperature / Cardiac arrest / Cardiology and Cardiovascular Disease / Cardiopulmonary Resuscitation / Care and treatment / Clinical significance / Clinical trials / Cooling / Fever / Health Sciences / Humans / Hypothermia / Hypothermia, Induced - adverse effects / Induced hypothermia / Intensive care / Intervention / Kardiologi och kardiovaskulära sjukdomar / Medicine / Medicine & Public Health / Methods / Mortality / Out-of-Hospital Cardiac Arrest - diagnosis / Out-of-Hospital Cardiac Arrest - therapy / Statistical significance / Statistics for Life Sciences / Treatment Outcome / Unconsciousness / Update