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Ondansetron and the Risk of Cardiac Arrhythmias: A Systematic Review and Postmarketing Analysis

Methodology Score:    3.5/5                
Usefulness Score:  2/5

Freedman SB, Uleryk E, Rumantir M, Finkelstein Y.
Ann Emerg Med. 2014 Jul;64(1):19-25.e6.


This retrospective review of adverse drug reaction (ADR) registries and case reports found that there were no reported events of arrhythmia after a single PO dose of ondansetron but found 59 cases of arrhythmias within 24hours of administration of parenteral ondansetron and chronic PO use.  The authors found there was a weak association between ondansetron administration and the arrhythmias reported.  The group agreed that the QT prolongation effects of ondansetron are likely clinically underappreciated and that it should be avoided in high-risk groups, as there are anti-emetics without QT prolongation as a side effect. 
By: Dr. Shawn Mondoux
(Presented Sept 2014)


Epi lesson:  Review of Grey Literature in Systematic Reviews

There are many definitions of grey literature, but it is usually understood to mean literature that is not formally published in sources such as books or journal articles. Conference abstracts and other grey literature have been shown to be sources of approximately 10% of the studies referenced in Cochrane reviews. A recently updated Cochrane methodology review showed that published trials showed an overall greater treatment effect than grey literature trials. Conference abstracts are a particularly important source of grey literature although such work has not undergone the extensive peer-reviewed required for most scientific manuscripts. There are numerous on-line grey literature databases. 
By: Dr. Ian Stiell

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