• Acta Anaesthesiol Scand · Aug 2023

    Review Meta Analysis

    Non-response for health-related quality of life outcomes in ICU patients: A systematic review of the reporting in randomised trials.

    • Maj-Brit Nørregaard Kjaer, Martin Bruun Madsen, Nick Meier, Anders Granholm, MøllerMorten HylanderMH0000-0002-6378-9673Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Ingrid Egerod, and Anders Perner.
    • Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
    • Acta Anaesthesiol Scand. 2023 Aug 1; 67 (7): 842852842-852.

    BackgroundHealth-related quality of life (HRQoL) is frequently assessed in randomised clinical trials (RCTs) in the intensive care unit (ICU), but data are limited regarding the proportions of patients without responses or not surviving to HRQoL follow-up and the handling of this. We aimed to describe the extent and pattern of missing HRQoL data in intensive care trials and describe how these data and deaths were handled statistically.MethodsWe conducted a systematic review and meta-analysis following a published protocol. We searched PubMed, EMBASE, CINAHL and Cochrane Library for RCTs involving adult ICU patients reporting HRQoL as an outcome and excluded RCTs unobtainable in full text. We performed risk of bias assessment independently and in duplicate.ResultsWe included 196 outcomes from 88 RCTs published in the years 2002-2022; the numbers of patients alive and eligible to respond HRQoL were reported in 76% of trials. At follow-up, median 27% (interquartile range 14%-39%) of patients had died, and median 20% (9%-38%) of survivors did not respond across outcomes. Analyses of 80% of outcomes were restricted to complete cases only. The handling of non-survivors in analyses were reported for 46% of outcomes, with 26% of all outcomes reported as including non-survivors (using the value zero or the worst possible score).ConclusionFor HRQoL outcomes in ICU trials, we found that mortality at time of follow-up was high and non-response among survivors frequent. The reporting and statistical handling of these issues were insufficient, which may have biased results.© 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

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