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Gastric tubes (G-tubes) are commonly offered to amyotrophic lateral sclerosis (ALS) patients with dysphagia, although studies regarding efficacy are inconclusive. Here, investigators used advanced statistical methods to carry out a post hoc analysis of G-tube placement in 481 patients who participated in a recent trial of ceftriaxone in ALS. The authors used causal inference techniques to estimate the effect of G-tube placement on ventilation-free survival and quality of life, adjusting for potential confounding by indication.
The strongest predictors of G-tube placement were forced vital capacity and scores on the revised ALS Functional Rating Scale. Using a structural nested analysis to correct for these factors, G-tube placement decreased…