Acute cardiac care & resuscitationSecondary analysis
Intraosseous versus intravenous access in adult out-of-hospital cardiac arrest: a Bayesian secondary analysis of the PARAMEDIC-3 randomised controlled trial
- pre-planned Bayesian secondary analysis of the PARAMEDIC-3 trial
- non-informative priors
- adjusted for key baseline characteristics
Authors' conclusion
Based on non-informative priors, which represent minimal prior knowledge of the treatment effect, an intraosseous-first strategy in adult out-of-hospital cardiac arrest is more likely to be harmful, rather than beneficial. However, the low probability of a moderate or large treatment effect suggests that the overall treatment effect is likely to be modest.
Study context
- Population
- Adults with out-of-hospital cardiac arrest requiring vascular access
- Participants
- 6,082 randomised participants
- Comparison
- an intraosseous-first strategy compared with an intravenous-first strategy
- Primary endpoint
- 30-day survival
- Follow-up
- 30-day
Primary result
As reported in the abstract
posterior probability that intraosseous-first improved 30-day survival (OR > 1.0)
18.4%
probability intraosseous-first inferior, any effect (OR < 1.0)
81.6%
probability intraosseous-first inferior, small effect (OR < 0.9)
55.0%
probability intraosseous-first inferior, moderate effect (OR < 0.75)
13.4%
Further findings
favourable neurological outcome at hospital discharge
- findings were comparable to 30-day survival
return of spontaneous circulation at hospital handover
- posterior probability that intraosseous-first was inferior (OR < 1.0)
- 98.0%
Original publication
Summarised from the published abstract; every number is checked against it