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Methodological Concerns in Whole Blood Meta-Analysis—Reply

Дата публикации: 01-09-2026 00:00:00

In Reply We thank Gurney and colleagues for their thoughtful engagement with our analysis. Their 2022 cohort study is a methodologically rigorous contribution to this literature and was included for that reason. Our article characterized the military subgroup as low-certainty evidence per Grading of Recommendations Assessment, Development, and Evaluation (GRADE), with a 95% prediction interval of 0.41 to 2.39 spanning substantial benefit to potential harm, and our limitations section explicitly cautioned against applying the average pooled effect across specific settings. The phrasing “No benefit was observed in military settings” describes the pooled, unadjusted estimate; it is not a clinical claim that whole blood is ineffective nor an attempt to reinterpret or reverse the contribution of any individual study. Differences between crude and adjusted estimates reflect confounding adjustment in nonrandomized evidence, not bias in either approach.

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