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STATISTICAL ANALYSIS PLAN FOR A CLUSTER-RANDOMIZED CROSSOVER TRIAL COMPARING THE EFFECTIVENESS AND SAFETY OF A FLEXIBLE FAMILY VISITATION MODEL FOR DELIRIUM PREVENTION IN ADULT INTENSIVE CARE UNITS (THE ICU VISITS STUDY)
Delirium
Cross infection
Family
Personal satisfaction
Anxiety
Depression
Health personnel
Burnout
Author
Sganzerla, Daniel
Teixeira, Cassiano
Robinson, Caroline Cabral
Kochhann, Renata
Santos, Mariana Martins Siqueira
Moura, Rafaela Moraes de
Barbosa, Mirceli Goulart
Silva, Daiana Barbosa da
Ribeiro, Tarissa
Eugênio, Cláudia
Schneider, Daniel
Mariani, Débora
Jeffman, Rodrigo Wiltgen
Bozza, Fernando A.
Cavalcanti, Alexandre Biasi
Azevedo, Luciano Cesar Pontes
Machado, Flávia Ribeiro
Salluh, Jorge Ibrain
Pellegrini, José Augusto Santos
Moraes, Rafael Barberena
Damiani, Lucas Petri
Silva, Nilton Brandão da
Falavigna, Maicon
Rosa, Regis Goulart
Teixeira, Cassiano
Robinson, Caroline Cabral
Kochhann, Renata
Santos, Mariana Martins Siqueira
Moura, Rafaela Moraes de
Barbosa, Mirceli Goulart
Silva, Daiana Barbosa da
Ribeiro, Tarissa
Eugênio, Cláudia
Schneider, Daniel
Mariani, Débora
Jeffman, Rodrigo Wiltgen
Bozza, Fernando A.
Cavalcanti, Alexandre Biasi
Azevedo, Luciano Cesar Pontes
Machado, Flávia Ribeiro
Salluh, Jorge Ibrain
Pellegrini, José Augusto Santos
Moraes, Rafael Barberena
Damiani, Lucas Petri
Silva, Nilton Brandão da
Falavigna, Maicon
Rosa, Regis Goulart
Affilliation
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Instituto D’Or de Pesquisa e Ensino. Department of Critical Care. Rio de Janeiro, RJ, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Hospital Sírio-Libanês. Intensive Care Unit. São Paulo, SP, Brazil.
Universidade Federal de São Paulo. Department of Anesthesiology, Pain and Intensive Care. São Paulo, SP, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Hospital de Clínicas de Porto Alegre. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Institute for Education and Research. Porto Alegre, RS, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre. Department of Internal Medicine, School of Medicine. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Institute for Education and Research. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Research Projects Office. Porto Alegre, RS, Brazil.
Instituto D’Or de Pesquisa e Ensino. Department of Critical Care. Rio de Janeiro, RJ, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Hospital Sírio-Libanês. Intensive Care Unit. São Paulo, SP, Brazil.
Universidade Federal de São Paulo. Department of Anesthesiology, Pain and Intensive Care. São Paulo, SP, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Hospital de Clínicas de Porto Alegre. Intensive Care Unit. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Institute for Education and Research. Porto Alegre, RS, Brazil.
HCor Research Institute. São Paulo, SP, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre. Department of Internal Medicine, School of Medicine. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Institute for Education and Research. Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento. Intensive Care Unit. Porto Alegre, RS, Brazil.
Abstract
Background: Most adult intensive care units (ICUs) worldwide adopt restrictive family visitation models (RFVMs). However, evidence, mostly from non-randomized studies, suggests that flexible adult ICU visiting hours are safe policies that can result in benefits such as prevention of delirium and increase in satisfaction with care. Accordingly, the ICU Visits Study was designed to compare the effectiveness and safety of a flexible family visitation model (FFVM) vs. an RFVM on delirium prevention among ICU patients, and also to analyze its potential effects on family members and ICU professionals. Methods/design: The ICU Visits Study is a cluster-randomized crossover trial which compares an FFVM (12 consecutive ICU visiting hours per day) with an RFVM (< 4.5 ICU visiting hours per day) in 40 Brazilian adult ICUs. Participant ICUs are randomly assigned to either an FFVM or RFVM in a 1:1 ratio. After enrollment and follow-up of 25 patients, each ICU is crossed over to the other visitation model, until 25 more patients per site are enrolled and followed. The primary outcome is the cumulative incidence of delirium measured by the Confusion Assessment Method for the ICU. Secondary and tertiary outcomes include relevant measures of effectiveness and safety of ICU visiting policies among patients, family members, and ICU professionals. Herein, we describe all primary statistical procedures that will be used to evaluate the results and perform exploratory and sensitivity analyses of this study. This pre-specified statistical analysis plan was written and submitted without knowledge of the study data. Discussion: This a priori statistical analysis plan aims to enhance the transparency of our study, facilitating unbiased analyses of ICU visit study data, and provide guidance for statistical analysis for groups conducting studies in the same field.
Keywords
Critical careDelirium
Cross infection
Family
Personal satisfaction
Anxiety
Depression
Health personnel
Burnout
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