Apr 102017
 

A document that looks like an unsigned, unpublished letter to the Wall Street Journal was posted on Scott Weingart's EMCrit blog. It is signed only "The Department of Emergency Medicine - Henry Ford Hospital" and responds to the 2008 WSJ piece that suggested irregularities or mishandling of the data in the seminal 2001 trial on EGDT for sepsis.

Scott's podcast describes it as a response from Henry Ford Hospital and the lead author of the 2001 EGDT trial. I have not verified its authorship or its authenticity.

I am not reposting it here because of potential privacy or copyright issues, however, you can read it on EMCrit.

https://emcrit.org/wp-content/uploads/Henry-Ford-Hospital-Reply-to-WSJ-10.27.2008.pdf

The internal hospital inquiry into the "missing" 25 patients randomized but excluded from the intention to treat analysis seems to be described on page 4:

Using a chi-square analysis weighted for the differences in illness severity [emphasis added] between control and treatment groups ... This analysis demonstrated a statistically significant retained mortality benefit at all time points for the EGDT treatment group equal to or better than the original reported results of 263 patients.

But it's unclear why one would one weight for the differences in illness severity between control and treatment groups in this situation. Wouldn't the 25 already-randomized patients' data simply be included with the other 263, and the chi-square analysis be repeated?

Original page posting the letter (EMCrit)

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Response re: WSJ Story on EGDT and Sepsis