Which patients with blunt chest trauma are most likely to develop complications? This 2015 journal club examines the derivation and validation of a prognostic score, considering outcome definitions, reliability of recorded risk factors and the further evidence needed before a model should guide admission or discharge.
JC: What’s the ‘best’ test for a broken chest? Read More
A 2014 appraisal of MR CLEAN, an early positive trial of intra-arterial treatment for selected patients with acute ischaemic stroke. Simon Carley examines imaging-based selection, pragmatic treatment choices and functional outcomes, while asking how confidently one trial could support wider adoption at the time.
JC: Intra-arterial treatment for Stroke Read More
This 2014 journal club examines the PARAMEDIC trial of mechanical versus manual CPR in out-of-hospital cardiac arrest. Alongside the cluster-randomised design and survival findings, Simon Carley reflects on separating life support from treatment of the underlying cause and how resuscitation teams divide their attention.
JC: PARAMEDIC trial m-CPR at St.Emlyn’s Read More
A critical response to NICE’s 2014 acute heart failure guidance, questioning whether varied presentations can be treated as one condition. The author examines the evidence behind diuretics, nitrates and non-invasive ventilation, and argues for clearer definitions and research that better reflects the sickest emergency department patients.
Should ultrasound or CT be the first investigation for suspected renal colic? This 2014 appraisal examines a trial comparing emergency physician ultrasound, radiologist ultrasound and CT, focusing on patient outcomes, missed diagnoses, cumulative radiation and the need for additional imaging after the initial test.
JC: Should USS be first investigation for renal colic? St.Emlyn’s Read More
Does a lack of evidence for benefit mean paramedic trauma training does not work? This 2014 critique of a Cochrane review examines its small, dated and methodologically limited evidence base, distinguishing uncertainty about educational interventions from a justification for withdrawing investment in training.
JC: Is there any point teaching paramedics? St.Emlyn’s Read More
An introduction to planning sample size and understanding statistical power, linking effect size, precision and the risks of false positive and false negative results. Worked examples cover continuous outcomes, proportions and diagnostic accuracy studies, helping readers understand the assumptions behind calculations and ask better questions about research.
An introduction to sample size calculations. St.Emlyn’s Read More
What happens when later research overturns an established medical practice? This 2014 journal club examines a decade of medical reversals reported in one major journal, considering publication bias, the limits of that sample and the need to question both new treatments and familiar clinical beliefs.
JC: A decade of reversal: an analysis of 146 contradicted medical practices. Read More
