Evidence-Based Medicine

A contemporary review of NICE’s January 2014 head-injury guideline, CG176. The post explores what changed for emergency clinicians, including CT decisions in adults and children, anticoagulation, cervical spine imaging and discharge information, while discussing the evidence and uncertainties behind the recommendations.

Does giving prasugrel before angiography help patients with non-ST-elevation acute coronary syndromes? This 2014 appraisal of ACCOAST examines the balance between ischaemic outcomes and major bleeding, alongside patient selection, the composite endpoint and the limits of applying the findings more widely.

An introduction to the evidence-based medicine workshop at SMACC Gold 2014, led by St Emlyn’s and Critical Care Reviews. It sets out an approach to asking useful questions, finding relevant research and translating evidence into care, with a self-assessment quiz on everyday EBM habits.

A collection of BestBets critical appraisal checklists for clinicians preparing for journal club or examinations. The post links to tools for different study designs, including randomised trials, diagnostic studies, reviews, decision rules and qualitative research, and encourages sharing completed appraisals.

Does the precordial thump deliver the dramatic benefit its image suggests? This 2013 journal club examines Australian cardiac-arrest registry data, considering rhythm deterioration, the small number of treated patients and the limitations of using observational records to judge an intervention.

Can symptoms or clinical scores predict which adults with sore throat will develop complications? This 2013 journal club examines a large primary-care cohort, using rare outcomes to explain positive predictive value and to question assumptions behind antibiotic prescribing.