#FOAMed

Could selected patients with uncomplicated appendicitis receive antibiotics without a hospital admission? This 2016 appraisal examines a small pilot trial, questioning its mixed treatment comparison, restrictive eligibility and what feasibility findings can establish before a larger, more definitive study.

Does low-molecular-weight heparin prevent symptomatic clots after lower-limb casting? This 2016 review of POT-CAST examines a trial that found no statistically significant reduction, while discussing patient selection, low event numbers and the unresolved question of benefit in higher-risk groups.

Can a rude comment disrupt clinical teamwork? This 2016 appraisal examines a randomised neonatal simulation study in which rudeness impaired performance and information sharing, then considers the limits of transferring those findings to real care and the implications for everyday professional behaviour.

How convincing were the early results for andexanet alfa in major bleeding associated with factor Xa inhibitors? This 2016 appraisal examines an interim report, distinguishing laboratory reversal from clinical haemostasis and questioning whether limited, unblinded data could establish effectiveness and safety.

What happens when clinical work makes us afraid? In this companion to his SMACC Dublin talk, Ross Fisher reflects on recognising fear, its effects on performance and teamwork, and the value of colleagues who support us through it.

Who should decide which medical research clinicians can read and trust? Reflecting on a 2016 SMACC debate, Simon Carley questions journal paywalls and traditional publishing incentives, while exploring open access, post-publication review and the unresolved problem of sustainable alternatives.