biostudies-literatureUnknown47(4)Shehabi YNational Health and Medical Research Council<h4>Purpose</h4>To quantify potential heterogeneity of treatment effect (HTE), of early sedation with dexmedetomidine (DEX) compared with usual care, and identify patients who have a high probability of lower or higher 90-day mortality according to age, and other identified clusters.<h4>Methods</h4>Bayesian analysis of 3904 critically ill adult patients expected to receive invasive ventilation > 24 h and enrolled in a multinational randomized controlled trial comparing early DEX with usual care sedation.<h4>Results</h4>HTE was assessed according to age and clusters (based on 12 baseline characteristics) using a Bayesian hierarchical models. DEX was associated with lower 90-day mortality compared to usual care in patients > 65 years (odds ratio [OR], 0.83 [95% credible interval [CrI] 0.68-1Intensive care medicine455-466https://www.ebi.ac.uk/biostudies/studies/S-EPMC7939103biostudies-literatureEarly sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial.PMC7939103Paterson RDias ATonks AHassan MAHassan MHMacallum NFerrier JMamo DMcArthur CComadira GLiew SFletcher JWebb SAMacgill SAl-Dawood AAkaltan MYoung PWaddy SYoung HColombo SBailey MBerger SCalder VAndrew GMiller KWhite MFrance DElliot SWaugh VBodenham VTurner EVucago AMMcCulloch CDeeb AGresham RClarey EDuroux MAbudayah AMaher LLandoni GBlakemore AMaher KEastwood GPeck LHasan MSTallott MVoon WLNaseem NSerpa Neto AJudd HTamang KLLesona ETan ITABhatia DMacklin AMcConnochie RSnelson CAsen KWetzig KEwan JArabi YMHyde NBlaser DChen YReynolds CMurray LBall JRahman RANoble HEllis KSamat NMNoble SWehr ACaba RCBarge DArif ALowrey JCampos SWalsham JShehabi YHarkett SSkelly CMacNaughton PNettelbeck KSerban CBlackburn ESharpe SJordan ABabio-Galan MSmyth DPatrick-Heselton JLeggieri CYarad ESulaiman SDukes SAl Saeedi AKadiman SJanin PBennett-Britton JClatworthy BBone APhillips MGregory REdington JZabidi INHarris ALai VHarris CParke RMartin-Loeches IWhitehead CCooper LFourie CWan RGalt PCarrera REdney SCooper GConlon LLatimer-Bell CJong MLBoschert CAl-Harthy AMEmperan ZMcArthur CJRaza AZangrillo AMoizo EAmran RHutchison RAl Samarrai SHogan CRyan CHays LChambler DVenkatesh BRyan DSara TShaw DBass FThomas JCole JO'Kane SGilder ECole LShepherd KFazlija LSebafundi LKanhere MGough MTham LYDennett Jvan Berkel ADumlao LAAl-Soufi SKong JAlbania MLitton EFarnell-Ward SYong CYKazemi ANewby LRyu JHSaidin NWise MClement IHodgson RMazidah NSweet KSach DWise MPHammond NBociek AGlover AO'Donoghue SWojcik GHegazy MLim SKCranshaw JMolloy KMandourah YWebster DWelbourne JAljuaid MDonovan SBaskaran PMineall SWard Gvan Der Graaff MWarhurst TBower RKadir NAReade MCGaur ATan APHacking DWalden AHarrison ANichol ALiew JESLawrence CBulfin LAscough LMcKee HAu KFJShukeri WFWSmith JJong SLLassig-Smith MBasri NNayyar VSymonds FAli SCooper DRashid AIYMFitzJohn FWilliams LMaguire TBernard SWilliams KWilliams EWilliams ANand KMasters KFerguson CDzulkipli NMcAllister RWeisbrodt LPalejs PFahey CCurtin JDickson SSchafer MBrickell KForbes LRatcliffe MCowdrey KCocks EBastick MMashonganyika CBellomo RMarner MWilliams TWilliams PWilliams SCaniba SDriver KReade MBewley JNavarra LElffaki ODbsawy MLei KLeow SBuckley AJones GTreloar SHadinata YKadiman SBAl-Kurdi MHKelly AVisser AStarr TDonnelly AGhosh ABuehner USpruce ELuca CKhoo TMDunlop RGreen DReeves EO'Toole EShirley PArabi YBevan RJawara SPearson DMaseeda YSwann CVij STang CLAli MNHowie LParker KMcCullagh IHunt ALensch MSearles CO'Connor AAshraf HNHill HHill GSjamsuddin NFarrah HLivermore ADawson HMonti GBergin CGrimmer LMeyer JPaisley CArora SBarnes VBercades GLudwig RTakala JMorris ANorddin MFVenz EScott CRobertson YAl Amodi EBassam RAguila JSaid STolan NGatward JBrealey DHart NBadawi MJackson RHowe BDBass FEDinsdale DBlazquez EDespy LFratzia JBrain MMoore JAbidin HZAshcroft PLavrans KMee LThompson LJacques NFirkin CSmellie HHanks FClark MIsmail NIGriffith DMZulkurnain ABassford CShi YMacIsaac CPiah NSMSaylor EButler JRitchie PMerz TButler MCruz RSZacharias DOstermann MMcCarthy LWelters IRazak NASakthi ANConnor HMehrtens JDavies RClark PMcGuinness SIsmail WNWHorton SMcCann KHamdan ADalton JRoth MMcKenzie CSeppelt IRosbergen MElderkin TBurhanuddin HDalton CHenderson SBrailsford JHopkins PPitts SKhadzali FNAMSalerno TBrohi FHurford SCorcoran ESeppelt IMAzzolini MLSPICE III Study InvestigatorsBold CTam KSquire RAzmi NSoar NJoyce CSimpson NValerio JMagdi IWang AHemmings NAlmekhlafi GBahar NIKeating LBarclay LStephens DBerry WMinto EMucci MPark MAl Anizi HHope DBrooks JHo JMellinghoff JBeccaria PElloway EStuart JNaumoff JLim CHHusin NSAbdullah NHRechnitzer TWafer PIsmail AAlonso UBFinney CSabran INLong SStedman WZabidi NSong RIsmail SZBamford AAwang RMorgan CWhitton CCampbell LJarrett POmar SCPalmer NWild LCameron RMorgan MfalseEarly sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial.<h4>Purpose</h4>To quantify potential heterogeneity of treatment effect (HTE), of early sedation with dexmedetomidine (DEX) compared with usual care, and identify patients who have a high probability of lower or higher 90-day mortality according to age, and other identified clusters.<h4>Methods</h4>Bayesian analysis of 3904 critically ill adult patients expected to receive invasive ventilation > 24 h and enrolled in a multinational randomized controlled trial comparing early DEX with usual care sedation.<h4>Results</h4>HTE was assessed according to age and clusters (based on 12 baseline characteristics) using a Bayesian hierarchical models. DEX was associated with lower 90-day mortality compared to usual care in patients > 65 years (odds ratio [OR], 0.83 [95% credible interval [CrI] 0.68-12021-01-01T00:00:00Z2021 Apr2025-05-29T22:18:14.534Z2025-05-29T22:18:14.534ZS-EPMC79391033368648210.1007/s00134-021-06356-8