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December 4, 2018

Time for Clinicians to Embrace Their Inner Bayesian?Reanalysis of Results of a Clinical Trial of Extracorporeal Membrane Oxygenation

Author Affiliations
  • 1Department of Emergency Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance, California
  • 2Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles
  • 3Berry Consultants, Austin, Texas
  • 4Department of Critical Care Medicine, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 5Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
  • 6Associate Editor, JAMA
JAMA. 2018;320(21):2208-2210. doi:10.1001/jama.2018.16916

This issue of JAMA includes a Special Communication by Goligher et al1 reporting a Bayesian reanalysis of the results from the recent Extracorporeal Membrane Oxygenation (ECMO) to Rescue Lung Injury in Severe Acute Respiratory Distress Syndrome (ARDS) (EOLIA) trial. This trial, which tested whether routine early ECMO reduced mortality for patients with severe ARDS, was stopped early for futility, and concluded that ECMO was not shown to reduce mortality.2 In contrast, Goligher et al found it highly probable that ECMO lowers mortality, incorporating various assumptions, although it is unclear whether the benefit is as large as that assumed when the EOLIA trial was designed. How can the conclusions drawn from these 2 analyses of the same trial be so different?

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