Journal Club by CanadiEM - E03: Randomized Controlled Trials (RCTs) - Part 2

CRACKCast & Physicians as Humans on CanadiEM

Purpose:

1. Learn the importance of treatment studies (RCTs) in EBM
2. Understand and interpret methods and results of treatment based studies
3. Become familiar with critically appraising treatment based studies

Hosts:

1. Dylan Collins
2. Levi Johnston
3. Dakoda Herman
4. Jayneel Limbachia
5. Jake Domm

Paper:

1. Warren, Jaimee, et al. "Antacid Monotherapy Is More Effective in Relieving Epigastric Pain Than in Combination With Lidocaine: A Randomized Double‐blind Clinical Trial." Academic Emergency Medicine 27.9 (2020): 905-909. https://onlinelibrary.wiley.com/doi/epdf/10.1111/acem.14069

EBM Checklist for therapy studies (University of Oxford:

• https://www.cebm.net/wp-content/uploads/2018/11/RCT.pdf

Episode takeaway

• RCTs are considered gold standard in terms of evidence since the randomization process controls for both known and unknown confounding variables
• Understanding how to quickly and efficiently appraise studies by assessing its methods is an important skill that can help you assess its utility to your practice and whether the authors adequately answered the question
• Use a validated critical appraisal tool. We used the CEBM tool, but there are others. The GATE from by Rod Jackson is another great method to learn. Know that sometimes people use publishing guidelines as critical appraisal tools, like the CONSORT for RCTs, but these are just work arounds.
• Be skeptical and curious. If there is a published protocol, check it. Look at who funded the study. Read the COI and method to mitigate bias.