Can TEG or ROTEM improve outcomes when added to major haemorrhage care? Natalie May reviews the iTACTIC trial's comparison with conventional coagulation testing, separating faster treatment decisions from demonstrated patient benefit and examining the limits of its size and subgroup findings.
Iain and Simon review August 2020 on the blog, from hydroxychloroquine and emerging COVID-19 research to the ACTS sepsis trial and GBL intoxication. The episode notes also highlight the personal costs of clinical leadership and the growing collection of St Emlyn's lesson plans.
A September 2020 appraisal of REMAP-CAP's hydrocortisone results in critically ill patients with COVID-19. Dan Horner and Simon Carley explain adaptive trials, Bayesian analysis and organ support outcomes, weighing the findings against early stopping, treatment crossover and the wider corticosteroid evidence.
A 2020 appraisal of intravenous haloperidol for acute benign headache. The review considers pain relief, adverse effects and patient selection, asking whether a placebo-controlled trial can tell us enough when the useful clinical comparison would be with usual headache treatment.
What did HALT-IT establish about tranexamic acid for gastrointestinal bleeding? This 2020 appraisal examines the lack of a mortality benefit and the increased venous thromboembolism and seizure signals, alongside questions about recruitment, treatment timing and the trial's primary outcome.
Journal ClubEvidence-Based Medicine
An early June 2020 response to RECOVERY's announcement that hydroxychloroquine had not shown benefit in hospitalised patients with COVID-19. Simon Carley explains the platform trial design and why the limited information released at that stage still required a full critical appraisal.
Practical perspectives on trauma care and team leadership.
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