TY - JOUR
AU - Swets, Maaike C.
AU - Kerr, Steven
AU - Scott-Brown, James
AU - Brown, Adam
AU - Gupta, Rishi K.
AU - Millar, Jonathan E.
AU - Spata, Enti
AU - McCurrach, Fiona
AU - Bretherick, Andrew D.
AU - Docherty, Annemarie B.
AU - Harrison, David James
AU - Rowan, Kathy
AU - Young, Neil
AU - Groeneveld, Geert H.
AU - Dunning, Jake
AU - Nguyen-Van-Tam, Jonathan S.
AU - Openshaw, Peter J. M.
AU - Horby, Peter W.
AU - Harrison, Ewen M.
AU - Staplin, Natalie
AU - Semple, Malcolm G
AU - Lone, Nazir I.
AU - Baillie, J. Kenneth
PY - 2023
DA - November
TI - Evaluation of pragmatic oxygenation measurement as a proxy for Covid-19 severity
JO - Nature Communications
VL - 14
DO - https://doi.org/10.1038/s41467-023-42205-6
AB - Choosing optimal outcome measures maximizes statistical power, accelerates discovery and improves reliability in early-phase trials. We devised and evaluated a modification to a pragmatic measure of oxygenation function, the 𝑆/𝐹 ratio. Because of the ceiling effect in oxyhaemoglobin saturation, 𝑆/𝐹 ratio ceases to reflect pulmonary oxygenation function at high 𝑆𝑝𝑂2 values. We found that the correlation of 𝑆/𝐹 with the reference standard (𝑃𝑎𝑂2/𝐹𝐼𝑂2 ratio) improves substantially when excluding 𝑆𝑝𝑂2 &gt; 0.94 and refer to this measure as 𝑆/𝐹94. Using observational data from 39,765 hospitalised COVID-19 patients, we demonstrate that 𝑆/𝐹94 isn predictive of mortality, and compare the sample sizes required for trials using four different outcome measures. We show that a significant difference in outcome could be detected with the smallest sample size using 𝑆/𝐹94. We demonstrate that 𝑆/𝐹94 is an effective intermediate outcome measure in COVID-19. It is a noninvasive measurement, representative of disease severity and provides greater statistical power.
PB - Springer Nature
UR - https://www.research.ed.ac.uk/en/publications/50b2980f-f4b0-48c9-a39e-d3b3f9d12cab
KW - Coronavirus (COVID-19)
ER