Thanks Dr Peter Ritchie for forwarding this article about an interesting case. Key points: Rarer diagnoses are often encountered in daily ED practice hidden amongst common symptoms attention to details that do not fit usual patterns (eg. in this case abnormal renal function that was not accountable by dehydration,… Read more
Euthanasia and physician assisted suicide is a recurring topic of public discourse. The Australian Medical Association (AMA) has released their position statement which highlights: prioritisation of good quality end of life care ensuring that co-morbid conditions that may impact on a patient’s desire for euthanasia have been adequately and optimally… Read more
Key points: well powered, international multi-centre randomised control, non-blinded trial primary hypothesis was that intensive blood pressure control with haemorrhagic stroke (SBP <140mmHg) would improve outcomes with regards to death and disability compared to standard BP targets (SBP <180mmHg) trial ended early due to futility (no statistical difference found) possible… Read more
Thanks to Dr Szechi Freidanck for her presentation. Take home points: The quality of a systematic review is determined by the relative quality of the included and excluded studies. The AMSTAR tool is a way to assess the methodological rigor of the systematic review A Likelihood ratio of… Read more
Key points: single centre, retrospective cohort study 503 patients with sepsis – (263 without new onset AF; 240 with new onset AF) sinus rhythm restored in 165 of 240; mix of amiodarone / beta-blockers / calcium channel blocker / digoxin / DCR mortality of new onset AF group highest… Read more
Thanks to Prof Anne-Maree Kelly – we reviewed these articles this week: Take home points: critically unwell patients in whom desaturation was particularly critical were not included not statistically powered to detected clinically significant desaturations apnoeic oxygenation has minimal harm – and its introduction likely has had intangible effects on… Read more
Thanks Elliott Adamson for this presentation about the PEAPETT study. Key points: Suggests that thrombolysis with tPA in PEA arrest with confirmed PE has benefit Logically contrasts with other studies of thrombolysis in PEA arrest (all causes) which does not appear to show particular benefit Despite minimal proven benefit… Read more
Searching the literature
Use the PICO model (population, intervention, comparison, outcome) to frame and crystallise your search question, or, consider whether the paper you are reading has established a clear and specific clinical question.
The British Medical Journal published an excellent collection of articles called ‘How to read a paper.’ Of particular note:
The following worksheets were developed by the Centre for Evidence Based Medicine to assist with the appraisal of research studies.
The University of South Australia’s International Centre for Allied Health Excellence also has a comprehensive collection of critical appraisal tools.