{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:49:01Z","timestamp":1779886141122,"version":"3.53.1"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>MyTEMP was a cluster-randomized trial to assess the effect of using a personalized cooler dialysate compared to standard temperature dialysate for potential cardiovascular benefits in patients receiving maintenance hemodialysis in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To conduct Bayesian analyses of the MyTEMP trial, which sought to determine whether adopting a center-wide policy of personalized cooler dialysate is superior to a standard dialysate temperature of 36.5\u00b0C in reducing the risk of a composite outcome of cardiovascular-related deaths or hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Secondary analysis of a parallel-group cluster-randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>In total, 84 dialysis centers in Ontario, Canada, were randomly allocated to the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Adult outpatients receiving in-center maintenance hemodialysis from dialysis centers participating in the trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>The primary composite outcome was cardiovascular-related death or hospital admission with myocardial infarction, ischemic stroke, or congestive heart failure during the 4-year trial period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>MyTEMP trial data were analyzed using Bayesian cause-specific parametric Weibull methods to model the survival time with 6 pre-defined reference priors of normal distributions on the log hazard ratio for the treatment effect (strongly enthusiastic, moderately enthusiastic, non-informative, moderately skeptical, skeptical, strongly skeptical). For each analysis, we reported the posterior mean, 2nd, 50th, and 98th percentiles of the treatment effects (hazard ratios) and 96% credible interval (CrI). We also reported the estimated posterior probabilities for different magnitudes of treatment effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Regardless of priors, Bayesian analysis yielded consistent posterior means and a 96% CrI. The posterior distribution of the hazard ratio was concentrated between 0.95 and 1.05, indicating there was probably no substantial difference between the 2 trial arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>The interpretation of Bayesian methods highly depends on the prior distributions. In our study, the prior distributions were determined by 2 experts without a formal elicitation method. A formal elicitation is encouraged in future trials to better quantify experts\u2019 uncertainty about the treatment effect. In addition, we used cause-specific parametric Weibull methods to model survival time, as semi-parametric methods were not available in the standard Bayesian statistical software package at the time of analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our Bayesian analysis indicated that implementing personalized cooler dialysate as a center-wide policy is unlikely to yield meaningful benefits in reducing the composite outcome of cardiovascular-related deaths and hospitalizations, regardless of prior expectations, whether optimistic or skeptical, about the intervention\u2019s effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581251341710","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T05:45:17Z","timestamp":1751089517000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Bayesian Analysis of Time-To-Event Data in a Cluster-Randomized Trial: Major Outcomes With Personalized Dialysate TEMPerature (MyTEMP) Trial"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-2991","authenticated-orcid":false,"given":"Yongdong","family":"Ouyang","sequence":"first","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, ON, Canada"},{"name":"Methodological and Implementation Research, Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0608-9793","authenticated-orcid":false,"given":"Bin","family":"Luo","sequence":"additional","affiliation":[{"name":"ICES, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-6574","authenticated-orcid":false,"given":"Stephanie N.","family":"Dixon","sequence":"additional","affiliation":[{"name":"ICES, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"},{"name":"Schulich School of Medicine and Dentistry, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0376-2214","authenticated-orcid":false,"given":"Ahmed A.","family":"Al-Jaishi","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.J.","family":"Devereaux","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Health Research Methods, Evidence &amp; 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