Journal Club Summary
Methodology Score: 3/5
Usefulness Score: 2.5/5
Florin TA, Shaw KN, Kittick M, Yakscoe S, Zorc JJ.
JAMA Pediatr. 2014Jul;168(7):664-70.
This single-centre triple-blinded study compared nebulized 3% saline (hypertonic) to 0.9% (normal) saline in infants with bronchiolitis and found infants treated with a single dose of hypertonic saline had less improvement than those receiving normal saline. Though the results suggest a possible benefit with the normal saline formulation, pre-existing data (Cochrane review 2013) suggest no clinically significant benefit with nebulized saline. Accordingly, JC attendees did not find this article particularly useful.
By: Dr. Kapil Goela
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