Emergency Medicine

How can the same treatment benefit sound dramatic or modest depending on how it is described? This 2014 podcast explores relative and absolute risk reduction, numbers needed to treat and harm, and the use of natural frequencies to explain benefits and harms to patients.

What happens when later research overturns an established medical practice? This 2014 journal club examines a decade of medical reversals reported in one major journal, considering publication bias, the limits of that sample and the need to question both new treatments and familiar clinical beliefs.

Louise Cullen introduces her SMACC Gold talk on how research is produced, analysed and reported. Reflecting on changes in her own approach to new evidence, she discusses the traps in interpreting published findings and the importance of critical appraisal before changing clinical practice.

How do our beliefs and interpretations of evidence shape what we do for patients? Simon Carley introduces his SMACC Gold talk on deciding when to change practice, exploring the place of innovators and sceptics and linking to the debate that followed with Scott Weingart.

How does disease prevalence change the meaning of a diagnostic test result? In this 2014 podcast, Iain Beardsell and Simon Carley discuss residual risk, the consequences of missed diagnoses and over-investigation, and how shared decisions and clear return advice can help patients navigate uncertainty.

Could analysis of the ventricular fibrillation waveform help decide when to defibrillate? This 2014 appraisal examines a randomised trial in out-of-hospital cardiac arrest that found no improvement in survival, considering the study’s limitations and the gap between a plausible technology and demonstrated patient benefit.