A presentation by Anders Perner at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine. All available content from SSAI2017: https://scanfoam.org/ssai2017/ Delivered in collaboration between scanFOAM, SSAI & SFAI.

1. How to conduct high-quality
clinical research?
University of
Copenhagen
Anders Perner

2. COIs
Research funds from Fresenius Kabi,
CSL Behring and Ferring
Pharmaceuticals

3. 6STRIAL
TRISS
TRIAL

4. Low risk of bias
Low risk of bias
Low risk of bias

5. • It is very important
• Guidance
• The research question
• Building collaboration
• Funding
• Just do it!
High-quality clinical research…

6. SSC 2016 - Quality of the evidence
• 93 statements
– 7 high-quality evidence
– 28 moderate
– 58 low/very low/BPS

7. • Initial resuscitation
• Screening
• Diagnosis
• Antibiotics
• Source control
• Fluids
• Vasoactive drugs
• Steroids
• Tx
• IVIG
• Blood purification
• Anti-coagulants
• Mechanical ventilation
• Sedation
• Glucose control
• Bicarbonate
• RRT
• VTE prophylaxis
• Stress ulcer prophylaxis
• Nutrition
• Setting goals of care
93 recommendations and BPS

8. • Initial resuscitation 1/7
• Screening 0/1
• Diagnosis 0/1
• Antibiotics 3/15
• Source control 0/2
• Fluids 2/6
• Vasoactive drugs 3/6
• Steroids 0/1
• Tx 2/4
Moderate or high quality evidence
recommendations

9. • Initial resuscitation 1/7
• Screening 0/1
• Diagnosis 0/1
• Antibiotics 3/15
• Source control 0/2
• Fluids 2/6
• Vasoactive drugs 3/6
• Steroids 0/1
• Tx 2/4
Moderate or high quality evidence
recommendations

10. • Initial resuscitation 1/7
• Screening 0/1
• Diagnosis 0/1
• Antibiotics 3/15
• Source control 0/2
• Fluids 2/6
• Vasoactive drugs 3/6
• Steroids 0/1
• Tx 2/4
Moderate or high quality evidence
recommendations

11. We have harmed pts

12. Interventions that changed mortality in
RCTs in critically ill
• 15 intervention
– 7 reduced mortality

13. • 15 intervention
– 7 reduced mortality
– 8 increased mortality
• TGC, HES, iv salbutamol, glutamine,
supranormal DO2, HFOV, HBOX, GH
Interventions that changed mortality in
RCTs in critically ill

17. Protocol
Reporting

19. Share all trial documents

21. First SSAI course on clinical research
• In CPH
• First week of April 2018
• Tuesday to Wednesday
• Watch www.SSAI.info

25. The research question
• Burden of suffering
–Frequency
–Severity
• If possible, involve patients
• Stuff we do a lot
• Iatrogenesis
• Costly

26. Building collaboration
• Network – people are really nice 
• Method experts – they are really good 
– Trialist
– Statistician
• Research Program
1. Survey
2. Cohort
3. SR-MA
4. RCT

27. Funding
• Write the application yourself – involve the
team
• Seek several sources
• Ask the hospital / university for back-up
cover
• Be persistent

28. Just do it!
• Aim high
• Collaborate – e.g. SCCTG
• Use the tools of others
• Do everything to the highest of
standards
• Be very persistant
• Have fun!

29. University of
Copenhagen
anders.perner@regionh.dk