A few suggestions........
Thrombolysis in MI and stroke
If including Canadian cervical spine rule, should also include NEXUS as
there are some arguments for using this rule instead. Jerry Hoffman...has a
conflict of interest as he was involved in the design of nexus but he has
some very persuasive arguments.
Wells criteria for risk stratifying thromboembolic disease
Is the CRASH trial a Key clinical trial, as many people believed steroids
were never going to be effective in the first place?
Andy Webster
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Robin Illingworth
Sent: 11 March 2007 20:22
To: [log in to unmask]
Subject: Key clinical evidence in Emergency Medicine
I would be grateful for help in identifying the most important clinical
evidence in Emergency Medicine.
I have been asked to help with the Emergency Medicine section of a new
Oxford Handbook, the "Oxford Handbook of Key Clinical Evidence". This
will cover all the medical and surgical specialties, with summaries of
the "landmark clinical trials" which currently influence clinical
practice. These should, if possible, be level 1 evidence, i.e. RCTs,
randomised controlled trials published in peer-reviewed journals.
Not much of the clinical work in Emergency Medicine is based on level 1
evidence, but there is some.
Some clinical decision rules, such as the Canadian C-spine rule and the
Ottawa ankle and knee rules, are based on cohort studies rather than
RCTs, but I think they should be included as "key clinical evidence".
One RCT which should be included is the MRC CRASH trial of
corticosteroids in head injury (Lancet 2004; 364: 1321-8). Another is
the Nasal Diamorphine Trial (BMJ 2001; 322: 261-5).
Clinical management of acute coronary syndromes is based on many RCTs
which are relevant to Cardiology as well as Emergency Medicine. There
will be discussions with cardiologists to choose the most important
trials. I am looking through various SIGN guidelines and Cochrane
reviews.
I would be grateful for ideas and suggestions about the "key clinical
evidence" which influences current practice in Emergency Medicine.
Robin
Dr Robin Illingworth
Consultant in Emergency Medicine
St James's University Hospital, Leeds.
--
Robin Illingworth, Leeds ([log in to unmask])
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