Evidence-Based Medicine

A 2013 journal club reviews Louise Cullen and colleagues’ validation of a two-hour strategy using high-sensitivity troponin to assess chest pain. It explores diagnostic performance, the proportion potentially suitable for early discharge and how patient selection and subsequent interventions complicate interpretation.

How often are peripheral intravenous cannulas placed in the emergency department actually used? This 2013 journal club reviews a Melbourne study, considers use after admission as well as in the ED, and asks how teams might reconsider routine cannulation and audit local practice.

Do changes in vital signs predict trauma outcomes better than a single set of observations? This 2013 journal club examines retrospective TARN data, considering shock index and changes in blood pressure, respiratory rate and heart rate, alongside study exclusions and the small number of deaths.

This 2013 journal club examines the Cochrane review of colloids versus crystalloids, with a particular interest in sepsis. Simon Carley explores mortality findings, numbers needed to harm and why differences between trial populations matter when interpreting a meta-analysis.

Could propofol have a role in refractory migraine? This 2013 journal club critiques an eight-patient case series, examining unclear recruitment, pain measurement during sedation and why larger, better-designed studies would be needed before drawing conclusions for practice.

How should clopidogrel use influence assessment after a head injury? This 2012 journal club examines a prospective cohort study of intracranial bleeding, questioning comparisons with warfarin, patient selection and whether CT findings adequately capture the outcomes that matter to patients.