Arch Surg Chicago
-
We hypothesized that review of randomized controlled clinical trials (RCTs) with nonstatistically significant or "negative" results published in the surgical literature do not have appropriate statistical power to demonstrate equivalency between treatment arms. ⋯ Many reports from negative RCTs published in the surgical literature lack sufficient statistical power to establish that clinically important differences are not present. Surgeons should perform appropriate sample size calculations when designing RCTs and recognize the utility of confidence intervals when reporting negative results.
-
Changing category 1 criteria to include primarily physiologic and anatomic indicators of injury, eliminating mechanism of injury criteria, decreases the rate of overtriage without compromising outcomes. ⋯ There was a significant reduction in overtriage of trauma patients demonstrated without an appreciable impact on patient outcome. Changing trauma response criteria to more physiologic and anatomic indicators allowed improved triage of trauma patients, which improves resource allocation.
-
Biography Historical Article
Moments in surgical history: James Thacher and his military journal during the American Revolutionary War.
-
Randomized Controlled Trial Clinical Trial
A prospective randomized trial of laparoscopic Nissen fundoplication with anterior vs posterior hiatal repair.
The technique used for repair of the esophageal hiatus during laparoscopic Nissen fundoplication can influence the likelihood of postoperative dysphagia. ⋯ Anterior suturing of the hiatus appears to be at least as good in the short-term as posterior suturing as a method of narrowing the hiatus during laparoscopic Nissen fundoplication.