Evidence-Based Medicine

A 2021 review of pulse oximetry accuracy in patients assessed for ECMO. It examines differences in unrecognised hypoxaemia between reported racial groups, the limitations of retrospective data and why skin pigmentation needs more precise investigation than broad racial classifications allow.

Could a 14F pigtail catheter replace a larger chest drain for traumatic haemothorax? This 2021 appraisal examines a multicentre randomised trial, weighing drainage failure, patient discomfort and statistical uncertainty, with particular attention to the exclusion of patients needing immediate emergency drainage.

How reliably do symptoms and examination findings identify cauda equina compression? This 2021 appraisal reviews a retrospective MRI cohort, questioning the diagnostic value of digital rectal examination while explaining why individual findings and a single-centre study cannot safely settle the diagnosis.

Does extracorporeal carbon dioxide removal make lower-volume ventilation safer or more effective? This 2021 review of the REST trial examines 90-day mortality, adverse events and the uncertainty left by early stopping in patients with acute hypoxaemic respiratory failure.

A 2021 appraisal of early CT coronary angiography for patients with suspected acute coronary syndrome. It examines a UK randomised trial's patient outcomes, use of invasive angiography and limitations, asking whether routine CTCA is justified in this selected population.

Simon Carley's selection of ten trauma papers for the 2021 Trauma Care UK conference spans haemorrhage control, airway intervention and traumatic brain injury. The review considers what the findings add to practice and where trial design or uncertainty limits their interpretation.