SGEM#361: Under My Umbrella, Ella, Ella – Review of Meta-Analyses in Emergency Medicine

Ensaios extraídos do podcast de Dr. Ken Milne

• 2021An umbrella review of effect size, bias, and power across meta-analyses in emergency medicineEmergency & ResuscitationAcross431 meta-analyses of emergency medicine therapies,experimental interventionsrarely showed unbiased, well-poweredbenefit on clinical outcomesversuscontrol.
• 2009Scientific Evidence Underlying the ACC/AHA Clinical Practice GuidelinesOtherAcross 53 ACC/AHA guidelines with 7196 recommendations, only a median 11% of recommendations rested on multiple randomised trials (level A), versus 48% on expert opinion (level C).
• 2019Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018OtherAcross 2930 recommendations in 26 current ACC/AHA guidelines, ACC/AHA documents carried 8.5% level A evidence versus 14.2% in ESC guidelines.
• 2021Common elective orthopaedic procedures and their clinical effectivenessOtherAcrossten common elective orthopaedic procedures,surgeryimprovedpatient reported outcomesovernon-operative care or placeboin only two of ten.
• 2016Systematic review and meta-analysis of intravenous thrombolysis in acute ischaemic strokeAnticoagulation & AntithromboticsIn 10 431 patients with presumed acute ischaemic stroke, intravenous thrombolysis improved functional outcome but raised early mortality compared with control.
• 2018PARAMEDIC-2Emergency & ResuscitationIn 8014 adults with out-of-hospital cardiac arrest, epinephrine improved 30-day survival but not survival with a favourable neurologic outcome versus placebo.
• 1816Dissertatio Medica Inauguralis de Synocho Castrensi (Lesassier Hamilton's bloodletting trial)OtherIn 366 soldiers with camp fever, withholding bloodletting reduced death compared with bloodletting.