In Reply The generation of scientific knowledge is an iterative process. It is common for rigorous trials to modify or contradict previous evidence, especially when initial studies yield strongly positive results.1 The findings of the ENGAGES trial2 differ from the conclusion of a meta-analysis of trials that examined the effectiveness of intraoperative EEG guidance of anesthesia at preventing postoperative delirium.3 As such, the meta-analysis should be updated and the guidelines of the European Society of Anesthesiology and American Geriatric Society should be revised if necessary.
Wildes TS, Mickle AM, Avidan MS. Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium—Reply. JAMA. 2019;321(24):2471–2472. doi:10.1001/jama.2019.5161
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