Abstract 41: Systematic Review Identified Some Early Phase Promising Therapeutics for Subarachnoid Hemorrhage

Introduction: Many randomized clinical trials (RCTs) have been conducted for subarachnoid hemorrhage (SAH), yet no treatment definitively improves outcome. Predictive ability of early phase trials is uncertain because outcome is strongly related to baseline severity factors, yet imbalances are common in these trials. We previously developed a method for ischemic stroke to identify promising treatments at early phase using a pooled model constructed from the control arms of RCTs and comparing trial outcomes at their own baselines. We applied this method to SAH. Methods: SAH predictive models for functional outcome and mortality were developed based on published variables (eg, WFNS, Fisher, age). The outcome model is the best fit 3-d surface bounded on either side by p=±0.1 prediction interval (PI) surfaces. These surfaces incorporate statistical variability to assess whether a treatment differs from expected outcome of a pooled sample. Treatment arms from RCTs and single arm trials for SAH are then visuall...