Recommendations for improving the design, conduct, and analysis of clinical trials in hospital-acquired pneumonia and ventilator-associated pneumonia

Overall decisions on the clinical use of new antimicrobials depend on the validity and reliability of the evidence from appropriately designed, conducted, and analyzed clinical trials. Because pneumonia is the sixth leading cause of death in the United States and the leading cause of infectious disease-related death, appropriate design of trials in hospital-acquired pneumonia and ventilator-associated pneumonia are an important public health issue. Several issues with the current design of trials in hospital-acquired pneumonia and/or ventilator-associated pneumonia potentially bias their results and raise questions about their validity. These issues are magnified in the context of noninferiority trials, in which bias can make interventions appear more similar, giving false-positive results of safety and effectiveness. The goal of this article is to provide a scientific basis for improving the validity, reliability, and efficiency of clinical trials in hospital-acquired pneumonia and/or ventilator-associated pneumonia to provide better information for decision making for patients, clinicians, regulators, and other stakeholders.

Contributors

Powers, John H.

Publication

Journal: Clinical Infectious Diseases
Volume: 51 Suppl 1
Issue:
Pages: S18 - 28
Year: 2010
DOI: 10.1086/653036

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): National Cancer Institute, National Institutes of Health (contract HHSN261200800001E) and the National Institute of Allergy and Infectious Disease.


Health Area

Disease Category: Infectious disease

Disease Name: Pneumonia (hospital-acquired), Pneumonia (ventilator-associated)

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Drug

Stakeholders Involved

- Clinical experts
- Other (unknown)

Study Type

- COS for clinical trials or clinical research

Method(s)

- Semi structured discussion

Semi structured discussion: workshop