Research

Does prehospital whole blood improve outcomes compared with blood components in traumatic haemorrhage? We critically appraise the SWiFT randomised trial, including its findings on death or massive transfusion within 24 hours and the limits of testing a prehospital-only intervention.

This second collection of research from The Big Sick 2025 brings together brief appraisals of trials covering transfusion in brain injury, preoxygenation, sepsis care and out-of-hospital cardiac arrest. The post considers what the findings might mean for practice and where uncertainty remains.

Do physician-led prehospital teams improve outcomes for critically ill or injured patients? This appraisal examines a systematic review and meta-analysis, the differences between the patients and services included, and why largely observational evidence makes the size of any benefit uncertain.

How much should a test result change our estimate of disease probability? Rick and Greg explain likelihood ratios, using clinical examples to connect pre-test and post-test probability and explore how this approach can inform diagnostic decisions.

Rick Body reflects on publishing research through open, ongoing peer review, where articles appear before review and subsequent comments and revisions are public. His experience opens a discussion about transparency, delays and whether peer review should be a continuing conversation rather than a publication gatekeeper.