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Showing posts from February, 2013

Accuracy and Quality of Clinical Decision Rules for Syncope in the Emergency Department: A Systematic Review and Meta-analysis

Randomized clinical trial of antibiotics in acute uncomplicated Diverticulitis

Methodology: 3/5  Usefulness: 3/5 Chabok A, PĂ„hlman L, Hjern F, Haapaniemi S, Smedh K; AVOD Study Group. Br J Surg. 2012 Apr;99(4):532-9
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An open label multicenter RCT from Sweden comparing usual antibiotic treatment versus no antibiotics (IV fluids only) in the treatment of acute uncomplicated diverticulitis showed that there was no statistical difference in rate of complications while in hospital or in a 12 month follow-up period (1.0% vs. 1.9% complication rate in Abx vs no Abx group P=0.302). Due to study limitations such as the lack of blinding, possible selection bias for milder cases and lack of power, JC attendees were not convinced to yet change our current practice. By: Dr. Lisa Harman (Presented January 2013)
Epi Lesson: Open label trials may be promoted as pragmatic trials but a lack of blinding to treatment allocation is a fundamental threat to internal validity. Blinding reduces ascertainment bias (the likelihood of differential assessment of outcome). It is not alwa…

The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis