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GlideScope® Video Laryngoscope clinical trial in 200 patients- reply
- Deidre A Sun, C. Brian Warriner (27 September 2006)
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Glidescope Videolaryngoscope
- NORMAN KUFAKWARO (11 July 2006)
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Deidre A Sun , C. Brian Warriner
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We thank Dr Kufakwaro for his interest in our study. Establishing the usefulness of new instruments is important in an environment that is continually being introduced to new technologies. Intubation studies are difficult to perform, as measurement of scores can be subjective. There may have been confusion with interpretation of our explanation of results and tests applied. Our first objective was to see if the GlideScope® does provide an improved laryngoscopic view. We did a direct laryngoscopy(DL) examination with a Macintosh Blade followed by a GlideScope® examination on the same patient, in those who were randomized for a GlideScope® intubation. These patients were matched pairs as presented in table 2. This was categorical data analyzed using McNemar χ2 –test for matched pairs to examine GlideScope® group Cormack and Lehane(C&L) grades. The Bland-Altmann approach(1), compares two instruments by plotting the difference between two scores (from each patient) against the mean of the scores and is used when determining agreement between two methods of clinical measurement eg new blood pressure measuring technique compared with an established blood pressure measuring technique. This approach would not be appropriate in this instance. Our second objective was to compare the GlideScope® with direct laryngoscopy using the standard Macintosh laryngoscope measured as time to intubate(TTI). We chose TTI as it was an objective measure. These were indeed randomized, not paired groups with t-test and ANOVA tests used to analyze this data. Spearman rank, Pearson correlation and linear regression were used to look for associations and correlations between airway parameters, C&L grades and TTI scores as presented in Table 1. We believe that the statistical methods used to analyse our results were appropriate for the purpose of our study. Again thank you for your interest in our study. 1. Bland JM, Altman DG. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, i, 307-310. Conflict of Interest:None declared |
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NORMAN KUFAKWARO
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I read with interest the randomised control trial done by D.A Sun and colleagues comparing the laryngoscope views for elective patients between the glidescope video laryngoscope and a macIntosh laryngoscope.I just wanted to find out why they did not consider using Bland and Altman plots in analysing their results.Could it be that they did and realised that macIntosh blade was better than the glidesscope videolaryngoscope?. I strongly believe that this method would have been the best statistical way to compare the two laryngoscopes.The statistical methods used to analyse the results were not appropriate. The data was not matched pairs in the true sense. Conflict of Interest:None declared |
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