Journal Club Summary
Methodology Score: 3.5/5
Usefulness Score: 2.5/5
Egerton-Warburton D, Meek R, Mee MJ, Braitberg G.
Ann Emerg Med. 2014 May 9. pii: S0196-0644(14)00223-6.
This prospective placebo-controlled trial found that there is no difference between Ondansetron, Metoclopramide and Placebo in reducing nausea severity in ED patients over 30 minutes [Mean VAS reduction 27 mm (95% confidence interval [CI] 22 to 33 mm), 28 mm (95% CI 22 to 34 mm) and 23 mm (95% CI 16 to 30 mm) respectively]. The group agreed that these results are not generalizable to our patient population, however a future meta-analysis may offer practice changing guidelines.
By: Dr. Michael O’Brien
Epi lesson: Use of Continuous Data as Primary Outcome
Beware of studies that compare the effectiveness of interventions by using continuous data outcomes, such as pain scales (1-100), oxygen saturation values, and minutes to pain relief. These kinds of data can produce statistically significant differences between groups with relatively small sample sizes but often give you little information about clinical importance. Far better and almost always the norm are outcome measures given as proportions or percentages, such as % of patients who achieve: 20 points improvement in pain, an oxygen saturation of 90%, pain relief in less than 2 hours, or survival.
By: Dr. Ian Stiell