COMMENT 20 March 2019 Scientists rise up against statistical significance Valentin Amrhein, Sander Greenland, Blake McShane and more than 800 signatories call for an end to hyped claims and the dismissal of possibly crucial effects. Valentin Amrhein, Sander Greenland & Blake McShane Nature 567, 305-307 (2019) When was the last time you heard a seminar speaker claim there was ‘no difference’ between two groups because the difference was ‘statistica...

EDITORIAL Tranexamic Acid for Trauma Patients — More Lives to Save and Outcomes to Consider Haleema Shakur-Still, Ian Roberts N Engl J Med June 14, 2023DOI: 10.1056/NEJMe2305075 Traumatic hemorrhage accounts for approximately 2 million deaths each year worldwide.1 In 2010, the results of the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH)–2 trial showed that tranexamic acid reduces mortality among patients with bleeding tr...

Cardiovascular Subphenotypes in ARDS Acute respiratory distress syndrome (ARDS) is a frequently observed condition in mechanically ventilated patients in ICUs and is associated with a high mortality rate. The presence of shock in ARDS indicates poor prognosis, with echocardiography studies suggesting that right ventricular dysfunction (RVD) plays a significant role in the cardiovascular dysfunction observed in this condition. However, the definition of RVD in the c...

Practice Practice Pointer Towards net zero: critical care Heather Baid, Eleanor Damm, Louise Trent, et al BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2021-069044 (Published 01 June 2023)Cite this as: BMJ 2023;381:e069044 What you need to know Critical care is resource intensive, using large amounts of energy, pharmaceuticals, and single-use consumables, all of which potentially have a harmful impact on the environment We can view environmental s...

ICU Management & Practice, Volume 23 - Issue 1, 2023 The Footprints of a Gigantic Hound – Biomarkers in Intensive Care Biomarkers hint at the pathophysiology behind a clinical entity, leading to better treatments. Access to biomarker testing may improve drug discovery in clinical trials, responses at the bedside and personalised patient management. The human body is a construct of chemical fires – each with a characteristic smoke signal. The smoke signal...

Editorials Understanding the burden of post-covid-19 condition Qiao Wu BMJ 2023; 381 doi: https://doi.org/10.1136/bmj.p932 (Published 31 May 2023)Cite this as: BMJ 2023;381:p932 A complex picture is emerging, along with urgent priorities for future research Covid-19 cases and deaths have decreased globally,1 yet, the long term consequences of infection, including post-covid-19 condition (often known as long covid), are still being managed. Most people ...

Editorial  May 21, 2023 Conversations on Goals of Care With Hospitalized, Seriously Ill Patients Douglas B. White, Sarah K. Andersen JAMA. Published online May 21, 2023. doi:10.1001/jama.2023.8970 Goals-of-care conversations between clinicians and patients with serious illness have been shown to improve measures of patient and family well-being, while also decreasing health care costs and high-intensity treatments at the end of life.1,2 ...

EDITORIAL Video Laryngoscopy for Intubation — Time for a New Paradigm? Yonathan Freund, Ben Bloom N Engl J Med June 16, 2023DOI: 10.1056/NEJMe2305596 Endotracheal intubation — a potentially lifesaving procedure that is used for the care of many critically ill patients — demands precision, speed, and skill. It involves the placement of a tube into the trachea to protect the airways while ensuring adequate oxygenation and ventilation for patients who are in resp...

EDITORIAL A New Step in Postexposure Prophylaxis for Leprosy David M. Scollard N Engl J Med 2023; 388:1904-1905DOI: 10.1056/NEJMe2302667 Infection with Mycobacterium leprae is curable with a combination of dapsone, rifampin, and clofazimine (multidrug therapy), as recommended by the World Health Organization (WHO) in 1982. The use of this multidrug regimen led to an initial rapid decline in the global prevalence of M. leprae infection, a re...

Editorial  June 20, 2023 Revisiting the Analogy Between Clinical Trials and Diagnostic Tests by Interpreting a Negative Trial as a Negative Test for Efficacy Roger J. Lewis, Kert Viele JAMA. 2023;329(23):2023-2025. doi:10.1001/jama.2023.8972 As noted in JAMA more than 30 years ago,1 randomized clinical trials are like diagnostic tests in several ways. Clinical trials are designed to detect hypothesized treatment effects in the ...