At post-intervention, Headstrong resulted in lower severity (on a 10-point scale) than the control group by child report (5.06 ± 1.50 SD vs. 6.25 ± 1.92 SD, p = 0.03, ES = 0.7).
First, the same changes, although in lower severity, were seen by immunocytochemistry in all other active multiple sclerosis lesions, including the slowly expanding lesions of progressive multiple sclerosis.
In the study of drotrecogin alfa (activated), better outcomes were observed in higher severity subgroups defined by APACHE II scoring and in lower severity subgroups defined by biologic markers of disease severity (i.e. IL-6 level and prothrombin time) [ 24].
Future studies should address whether algorithms need to be adjusted in lower-severity patients, as is the case with antibiotic stewardship algorithms when applied in different clinical settings [ 21].
Another explanation may lie in the lower severity of illness in the Zappitelli cohort, as reflected by a median PRISM II score of 19 (IQR, 12) [ 28] for the renal failure group compared with 48.9 (IQR, 25.5 to 77.1) in our patients with AKI.
If a less expensive reactor can be utilized in these lower severity pretreatments, it may be possible to lower the MESP by an additional $0.11 to $0.14 per gallon of ethanol if a 50% reactor cost reduction is assumed.
Importantly, apart from the differences in effects on outcome, there were other notable differences between the Corticus study [ 11] and Annane and colleagues' study [ 9], including the larger number of postoperative patients, the more common abdominal source of the sepsis, and, in particular, the lower severity of illness in the Corticus study.
For failed studies reporting survival data for subgroups defined by baseline measures of disease severity, four demonstrated lower mortality in the active treatment arm in subgroups with lower severity of illness.
Conversely, higher mortality tends to result from using higher PEEP in patients with lower severity and less recruitability.
However, some of these studies were performed in patients who were just 65 years old or older [ 20- 25], in populations with lower severity scores or lower rates of mechanical ventilation [ 5, 20, 25, 26], in surgical or mixed populations of medical and surgical patients [ 20- 22], or in patients with a previously healthy status [ 23].
On the other hand, intervention with anti-tumor necrosis factor therapy appears to be of benefit primarily in patients without established organ dysfunction [ 8], while the detrimental effects of blood transfusion are most apparent in patients with lower severity of illness [ 9].
