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• W2018423265 endingPage "1922" @default.
• W2018423265 startingPage "1915" @default.
• W2018423265 abstract "Background Intensivists commonly encounter patients who may be inadvertently harmed by critical care interventions. This article is designed to guide clinicians in the evaluations of an individual article assessing a question of harm, as well as the sum of multiple pieces of evidence. Objectives To assess the vaidity of a group of articles about the relationship between high tidal volumes and ventilating pressures on ventilator-induced lung injury; to interpret the results of these studies; and to consider whether they apply in practice. Data Sources Issues of harm are sometimes measured in randomized trials, but are evaluated more often in myriad observational studies. Data Extraction We use critical appralsal guides for experimental studies (e.g., randomized trials) and observational studies (e.g., cohort studies, case-control studies and case series) that evaluate the potentially harmful exposure of high tidal volumes and ventilating pressures. This involves assessing the validity of the research, then determining the strength of association between the putative harmful exposure and adverse outcomes. These study designs and their interpretation using relative risks and odds ratios are reviewed. Finally, the relevance of this information (or lack thereof) to clinical practice needs to be determined. Data Synthesis Examining these studies individually and in totality, there appears to be a relationship between high tidal volumes and ventilating pressures, although the strength of inference from this research is limited by design issues and sample sizes. Conclusions Critically appraising a body of literature is more challenging than evaluating a single study, but often gives a broader view of the available evidence. Future large, rigorous, randomized trials of different approaches to mechanical ventilation will help to advance our understanding and to better inform our practice. (Crit Care Med 1997; 25:1915-1922)" @default.
• W2018423265 created "2016-06-24" @default.
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• W2018423265 date "1997-11-01" @default.
• W2018423265 modified "2023-10-13" @default.
• W2018423265 title "How to use articles about harm" @default.
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• W2018423265 doi "https://doi.org/10.1097/00003246-199711000-00034" @default.
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