Journal Club Summary

Landmark Article Series
Nielsen N, et al.; TTM Trial Investigators. N Engl J Med. 2013 Dec 5;369(23):2197-206.
Methodology Score: 5/5                            
Usefulness Score: 5/5
In this multicenter, international RCT of 950 unconscious adults after out-of-hospital cardiac arrest, hypothermia at a targeted temperature of 33°C did not confer a mortality or neurologic function benefit as compared with a targeted temperature at 36°C.  The group uniformly agreed that methodologically, this study was exceptionally-well run, making it a landmark, practice-changing study for Emergentologists & Intensivists everywhere. 
By: Dr. Aseem Bishnoi
(Presented Dec 2013)

Epi lessonHazard Ratio (HR) 

The hazard ratio is akin to relative risk but is used for survival analyses such as Cox proportional hazards regression. It is most often used to describe the outcome of therapeutic trials where the question is, to what extent can treatment shorten the duration of an illness. The hazard ratio is an estimate of the ratio of the hazard rate in the treated versus the control group. For example if there are two groups, group 1 and group 2, HR = 4.5 for treatment means that the risk (of relapse) for group 2 is 4.5 times that of group 1. 
By: Dr. Ian Stiell