Key result
Beta blockers may offer cardioprotection in critically ill tachycardia patients, including those with sepsis.
Why the study?
With advances in acute critical care management, there is a need to re-evaluate the efficacy of beta-blocker therapy across ICU conditions such as cardiac and non-cardiac surgery, acute myocardial infarction, acute heart failure, and sepsis.
Does beta blocker therapy confer cardioprotective effects and improve outcomes in critically ill patients in the intensive care unit?
Does beta blocker therapy confer cardioprotective effects and improve outcomes in critically ill patients in the intensive care unit?
Beta blockers may serve as a cardioprotective strategy to control tachycardia in critically ill ICU patients, including those with sepsis, though personalized application is necessary.
May support individualized beta-blocker use for tachycardia in ICU patients; leaves open definitive efficacy from large RCTs.
ML is playing an increasingly crucial role in estimating causal effects of treatments on outcomes from observational data. Many ML methods ('causal estimators') have been proposed for this task. All of these methods, as with any ML approach, require extensive hyperparameter tuning. For non-causal predictive tasks, there is a consensus on the choice of tuning metrics (e.g. mean squared error), making it simple to compare models. However, for causal inference tasks, such a consensus is yet to be reached, making a any comparison of causal models difficult. On top of that, there is no ideal metric on which to tune causal estimators, so one must rely on proxies. Furthermore, the fact that model selection in causal inference involves multiple components (causal estimator, ML regressor, hyperparameters, metric), complicates the issue even further. In order to evaluate the importance of each component, we perform an extensive empirical study on their combination. Our experimental setup involves many commonly used causal estimators, regressors ('base learners' henceforth) and metrics applied to four well-known causal inference benchmark datasets. Our results show that hyperparameter tuning increased the probability of reaching state-of-the-art performance in average ([Formula: see text]) and individualised ([Formula: see text]) effect estimation with only commonly used estimators. We also show that the performance of standard metrics can be inconsistent across different scenarios. Our findings highlight the need for further research to establish whether metrics uniformly capable of state-of-the-art performance in causal model evaluation can be found.
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Takeshi Suzuki (2019) conducted a review in Tachycardia in critically ill ICU patients. Beta blocker therapy was evaluated. Beta blocker therapy may confer cardioprotective effects in critically ill patients with tachycardia, including those with sepsis, though further large clinical trials are needed to clarify optimal usage.
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