Journal Club Summary
Methodology Score: 2/5
Usefulness Score: 2/5
Glaser NS, Wootton-Gorges SL, Buonocore MH, Tancredi DJ, Marcin JP, Caltagirone R, Lee Y, Murphy C, Kuppermann N.
Pediatrics. 2013 Jan;131(1):e73-80
This pilot randomized controlled trial found that DKA treatment protocols using different rates of fluid infusion were not associated with differences in MRI measures of sub-clinical cerebral edema. JC attendees agreed that while the results were thought provoking, this study was not sufficiently powered (n=18) to be considered practice changing.
By: Dr. Michael O’Brien
(Presented May 2013)
Epi Lesson – Blinding of Treatment Allocation
Open label trials may be promoted as pragmatic trials but a lack of blinding to treatment allocation is a fundamental threat to internal validity. Blinding reduces ascertainment bias (the likelihood of differential assessment of outcome). It is not always possible to undertake blinding in a RCT. But a critical reader will ask whether it was possible to blind outcome assessors. Doing so mitigates some of the bias introduced by open label trials.
By: Dr. Lisa Calder