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Colloid Use for Fluid Resuscitation: Evidence and Spin

Deborah Cook, MD; and Gordon Guyatt, MD
[+] Article, Author, and Disclosure Information

Drs. Cook and Guyatt: McMaster University; Hamilton, Ontario L8N 4A6, Canada

Disclosures: Drs. Cook and Guyatt have received no personal funding from pharmaceutical agencies producing either colloids or crystalloids. Dr. Cook coauthored a previous meta-analysis of colloids versus crystalloids. Bayer, Inc., paid Dr. Guyatt's expenses to attend a conference and provided an honorarium that he contributed to a McMaster University research fund.

Requests for Single Reprints: Deborah J. Cook, MD, Department of Medicine, St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.

Current Author Addresses: Dr. Cook: Department of Medicine, St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.

Dr. Guyatt: Department of Clinical Epidemiology and Biostatistics, St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.

Ann Intern Med. 2001;135(3):205-208. doi:10.7326/0003-4819-135-3-200108070-00013
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In this issue, Wilkes and Navickis (1) present a meta-analysis of albumin versus crystalloids in seriously ill patients. Their study has many strengths. The comprehensive search strategy minimized the chance of publication bias and English-language bias. Explicit selection criteria were used, including studies with randomized allocation; comparison of albumin administration with crystalloid, no albumin, or lower-dose albumin; and an end point of mortality. The investigators selected trials and abstracted data in duplicate. Other criteria for quality assessment of the trials included treatment allocation, crossovers, and blinding. Blinding of whom (clinicians, researchers, outcome assessors, analysts, or patients) and for what purpose (minimization of co-interventions and outcome ascertainment) is a useful technique for reporting meta-analyses that acknowledges the inherent problems associated with conventional blinding labels (2). The analysis is clear and replicable, and the authors used the QUORUM (Quality of Reporting of Meta-Analyses) format to aid in transparent reporting (3).

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