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
“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.