Journal Club Summary

Methodology Score: 3/5
Usefulness Score: 2/5

Atkinson PR, et al. Ann Emerg Med. 2018 Oct;72(4):478-489

Question and Methods: This was the first multicenter, prospective, RCT examining the effect of POCUS on 30-day survival of undifferentiated hypotensive patients presenting to ED.

Findings: There was no important survival benefit with the use of POCUS, including no important differences in IV fluids, inotropes, advanced imaging, or admission/LOS rates.

Limitations: Study was underpowered and stopped early due to slow enrolment and presumed futility. Both inclusion and exclusion criteria likely diluted the beneficial effect of POCUS.

Interpretation: This study is pragmatic and attempts to answer an important clinical question, however, is not conclusive evidence that POCUS should be withheld in undifferentiated hypotensive patients.

By: Dr. Adam Parks 

Epi lesson

Binomial Distribution

“Normal distribution” represents the probability of observing a given value for a continuous variable. “Binomial distribution” is used when observing dichotomous variables which can only take one of two values. It represents the probability of observing one value or the other among n attempts/trials, given a probability p for each attempt. Similarly to the “smooth” normal distribution bell curve, binomial distribution is represented with a series of stepped columns.

Dr. Christian Vaillancourt