Anticoagulation, immortality, and observations of COVID‐19

[...]controversy erupted over whether RCTs were ethical given the urgent circumstances. 5 Ultimately, only 1 RCT was conducted, and no evidence‐supported therapies were available at the time of the next outbreak of EVD in 2019. [...]even if the authors had provided characteristics of the groups and...

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Published in:Research and practice in thrombosis and haemostasis 2020-07, Vol.4 (5), p.674-676
Main Authors: Maley, Jason H., Petri, Camille R., Brenner, Laura N., Chivukula, Raghu R., Calhoun, Tiara F., Vinarsky, Vladimir, Hardin, Charles Corey
Format: Article
Language:English
Subjects:
Bias
Biomarkers
Commentaries
COVID-19
Mortality
Pandemics
Patients
Researchers
Thrombosis
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Summary:[...]controversy erupted over whether RCTs were ethical given the urgent circumstances. 5 Ultimately, only 1 RCT was conducted, and no evidence‐supported therapies were available at the time of the next outbreak of EVD in 2019. [...]even if the authors had provided characteristics of the groups and incorporated these into the analysis, additional unmeasured confounders likely preclude correct effect estimates. [...]most importantly, immortal time bias certainly contributes to the observed treatment effect and may be the fatal flaw of this study. 17 Immortal time refers to the time period in observational studies between patients entering into a cohort and ultimately receiving an exposure of interest (Figure 1).
ISSN:2475-0379
2475-0379
DOI:10.1002/rth2.12398