Can J Emerg Med
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ABSTRACTObjective:The objective of this study was to measure the current knowledge of Canadian emergency physicians and emergency medicine residents regarding computed tomography (CT) radiation dosing and its associated risks. ⋯ Canadian emergency medicine physicians and emergency medicine residents demonstrated identifiable gaps in knowledge surrounding CT radiation dose and risk.
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Clinical questionFollowing transient ischemic attack or acute minor stroke, does the combination of clopidogrel and aspirin reduce the risk of stroke greater than aspirin alone?Article chosenWang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. ⋯ ObjectiveThe primary outcome measured in this study was ischemic or hemorrhagic stroke at 90 days of follow-up in groups assigned to treatment with a combination of aspirin and clopidogrel or aspirin alone following transient ischemic attack or acute minor stroke. The secondary outcomes were new clinical vascular events, including vascular death.
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ABSTRACTNoninferiority (NI) trials aim to show that a new treatment or drug is not inferior to a standard, accepted treatment. The rapid proliferation of NI trials within the literature makes it imperative for emergency physicians to be able to read, interpret, and appraise critically this type of research study. Using several emergency medicine examples from the recent literature, this article outlines the key differences between traditional, superiority randomized controlled trials and NI trials. We summarize four important points that an emergency physician should consider when critically appraising an NI trial: 1) Does the new treatment have tangible benefits over the standard treatment? 2) Was the choice of the NI margin appropriate? 3) Was the effect of the standard treatment preserved? Does the trial have assay sensitivity? and 4) What type of analysis strategy was employed: intention-to-treat (ITT) or per protocol (PP)?
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ABSTRACTCloud-based applications such as Google Docs, Skype, Dropbox, and SugarSync are revolutionizing the way that we interact with the world. Members of the millennial generation (those born after 1980) are now becoming senior residents and junior attending physicians. ⋯ This material was developed by residents and improved over the course of 18 months. This is an innovation report about a process for enhanced communication and collaboration as there has been little research to date regarding the augmentation of learner-driven initiatives with virtual resources.
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Clinical questionCan ultrasonography be used in lieu of chest radiography to diagnose pneumothorax?Articles chosen1. Ding W, Shen Y, Yang J, et al. Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. ⋯ Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest 2012;141:703-8.