Intravenous Droperidol or Olanzapine as an Adjunct to Midazolam for the Acutely Agitated Patient: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Journal Club Summary Methodology Score: 3/5                 Usefulness Score: 2/5   Chan EW, Taylor DM, Knott JC, Phillips GA, Castle DJ, Kong DC. Ann Emerg Med. 2013 Jan;61(1):72-81   Abstract Link   This randomized, double-blind, double dummy study comparing olanzepine plus midazolam or droperidol plus midazolam suggested these combinations were more effective than midazolam alone for sedation of the acutely agitated […]

Validation of the Simplified Motor Score in the Out-of-Hospital Setting for the Prediction of Outcomes After Traumatic Brain Injury

Journal Club Summary Methodology score: 3/5 Usefulness score: 2/5 Thompson DO, Hurtado TR, Liao MM, Byyny RL, Gravitz C, Haukoos JS. Ann Emerg Med. 2011 Nov;58(5):417-25 Article Link   This retrospective registry study demonstrated poor performance of either the Simplified Motor Score or GCS scores for predicting clinically important outcomes after traumatic brain injury when calculated by prehospital providers.  Journal […]

Hydroxyethyl Starch 130/0.42 versus Ringer’s Acetate in Severe Sepsis

Journal Club Summary Landmark Series Methodology Score: 4/5                 Usefulness Score: 4.5/5   Perner A, et al.; 6S Trial Group; Scandinavian Critical Care Trials Group. N Engl J Med. 2012 Jul 12;367(2):124-34   Article Link   This multi-centre, double-blind, RCT found that resuscitation of severely septic patients with Hydroxyethyl Starch 130/0.42 conferred a greater risk of renal replacement therapy and of […]

Meta-analysis of Usefulness of D-dimer to Diagnose Acute Aortic Dissection

Journal Club Summary Methodology Score: 3/5                 Usefulness Score: 3/5   Shimony A, Filion KB, Mottillo S, Dourian T, Eisenberg MJ. Am J Cardiol. 2011 Apr 15;107(8):1227-34   Abstract Link   This meta-analysis of seven studies shows a pooled sensitivity (using random effects model) of 97% (94-99) negative LR 0.06 (0.03-0.12) specificity 56% (51-60) and positive LR 2.43 (1.89-3.12) for the […]

Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis Therapy: a Randomized Clinical Trial

Journal Club Summary Methodology Score: 3.5/5               Usefulness Score: 3.5/5   Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA; Emergency Medicine Shock Research Network (EMShockNet) Investigators. JAMA. 2010 Feb 24;303(8):739-46.  Article Link    This multi-centre, randomized, non-inferiority trial looked at using lactate clearance of 10% instead of ScvO2 as the tissue oxygen delivery target in early goal […]

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

Journal Club Summary Landmark Series Methodology Score: 3.5/5               Usefulness Score: 4/5   Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C. N Engl J Med. 2013 Jan 3;368(1):11-21 Article Link   This RCT comparing a restrictive versus liberal transfusion strategy (N=921) […]

Oral Dimenhydrinate versus Placebo in Children with Gastroenteritis: a Randomized Controlled Trial

Journal Club Summary Methodology Score: 2.5/5               Usefulness Score: 2/5   Gouin S, Vo TT, Roy M, Lebel D, Gravel J. Pediatrics. 2012 Jun;129(6):1050-5.   Article Link    This randomized, double-blinded, placebo-controlled trial of 144 children in Montreal found that the prescription of oral dimenhydrinate did not significantly decrease the frequency of vomiting in children with acute gastroenteritis compared with placebo […]

Diuretic Strategies in Patients with Acute Decompensated Heart Failure

Journal Club Summary Methodology: 3.5/5 Usefulness: 2/5 Felker GM, et al. NHLBI Heart Failure Clinical Research Network. N Engl J Med. 2011 Mar 3;364(9):797-805 Article Link This double-blind double-dummy RCT (N=308) found that there was no difference in the patient global assessment of symptoms between furosemide infusion vs bolus (mean AUC, 4236±1440 and 4373±1404, respectively; P = 0.47), low dose vs high […]

Subclinical cerebral edema in children with diabetic ketoacidosis randomized to 2 different rehydration protocols

Journal Club Summary Methodology Score: 2/5   Usefulness Score: 2/5   Glaser NS, Wootton-Gorges SL, Buonocore MH, Tancredi DJ, Marcin JP, Caltagirone R, Lee Y, Murphy C, Kuppermann N. Pediatrics. 2013 Jan;131(1):e73-80 Abstract Link   This pilot randomized controlled trial found that DKA treatment protocols using different rates of fluid infusion were not associated with differences in MRI measures of sub-clinical […]

Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence

Journal Club Summary Landmark Article Series Methodology Score: 4.5/5  Usefulness Score: 4.5/5 Colman I, Friedman BW, Brown MD, Innes GD, Grafstein E, Roberts TE, Rowe BH. BMJ. 2008 Jun 14;336(7657):1359-61 Article Link    ​In this well performed meta-analysis, a single dose of 10mg IV Dexamethasone administered before discharge demonstrated an important reduction in migraine recurrence rates (RR 0.74, 95% CI […]