Research

The RESNET National Rater Test is an online multiple-choice test. The test is open book and raters have two hours to complete the test.

For trials that utilize clinical outcome assessments as their study endpoints, rater training is paramount in ensuring data integrity by improving inter-rater reliability. The consequences of inadequate rater training can result in increased measurement error and data variance, significant increases in study costs, and incorrectly failed trials. Which rater training method is most effective?

We recommend that practice guidelines should rarely, if ever, be based on evidence from single-center trials. Physicians should apply the findings of single-center trials only after careful evaluation of their methodology, and in particular after comparing the context of the trial with their own sit …

Academic grant Recherche sur la Recherche from the Délégation Interrégionale à la Recherche Clinique (DIRC), Ile de France, Assistance Publique-Hôpitaux de Paris (APHP).

Selective hepatic dearterialization for exsanguinating liver injury has been performed in two young children without untoward sequelae. It appears to be a safe, simple, life-saving maneuver, as has been shown in adults. Simultaneous cholecystectomy and drainage of the extrahepatic biliary tree does not seem necessary. Postoperative studies in these two patients showed normal liver functions, normal liver scintiscans, and in one case, early rearterialization of the devascularized lobe by translobar collaterals.

Adjustment for known prognostic covariates can lead to substantial increases in power, and should be routinely incorporated into the analysis of randomized trials. The potential benefits of adjusting for a small number of possibly prognostic covariates in trials with moderate or large sample sizes f …

Acute upper gastrointestinal bleeding--time for some new triggers?

Recommendations emphasize early risk stratification, by using validated prognostic scales, and early endoscopy (within 24 hours). Endoscopic hemostasis remains indicated for high-risk lesions, whereas data support attempts to dislodge clots with hemostatic, pharmacologic, or combination treatment of …

A liberal transfusion strategy, as compared with a restrictive strategy, did not reduce rates of death or inability to walk independently on 60-day follow-up or reduce in-hospital morbidity in elderly patients at high cardiovascular risk. (Funded by the National Heart, Lung, and Blood Institute; FOC …

Surrogate end points in clinical research pose real danger. A surrogate end point is an outcome measure, commonly a laboratory test, that substitutes for a clinical event of true importance. Resistance to activated protein C, for example, has been used as a surrogate for venous thrombosis in women u …

A large trial of transfusion strategies in older mechanically ventilated patients is feasible. This pilot trial found a nonsignificant trend toward lower mortality with restrictive transfusion practice.

clinicaltrials.gov Identifier: NCT01021631.

A restrictive strategy of red-cell transfusion is at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients, with the possible exception of patients with acute myocardial infarction and unstable angina.

DR. STANLEY ROCKSON, Director, Center for Lymphatic and Venous Disorders, Stanford University School of Medicine and Co-chair for the NIH Commission for Lymp...

A look at a system to provide rapid, automated information on patient clotting status—improving patient safety, workflow, and decision support.