Columns
Not a single trial, but several read together — an overview of how to think about the topic. Every page names the guidelines it draws on. The full text is for Premium members; some are open during the free trial, others once your subscription starts.
Thirty years of atrial fibrillation — 31 trials, and a question replaced three times
“Should we restore sinus rhythm?” The question at the centre of atrial fibrillation was answered no in 2002.
The discipline of adding on — 16 trials, and how heart, kidney and metabolism became one field
If a drug works, surely more of that mechanism works better. In 2013, VA NEPHRON-D said plainly that it does not.
In sepsis, give fluid or take it away? — 22 trials on volume, choice and when to stop
In 2011, in 3,141 African children, the group given a 20 mL/kg bolus was the group that died more often.
Open the ARDS lung, or use less of it? — the answer 12 trials took 17 years to give
Recruit the collapsed alveoli and you widen the usable lung. The reasoning was elegant, and the physiology agreed.
The rise and fall of tight glycaemic control — 13 trials, and a question that got replaced
Bring glucose near normal and patients do better. The intuition held in clinic and in the ICU — until 2008–2009, when both were overturned.
Does stable coronary disease need revascularisation? — 23 trials, and where the line falls
COURAGE denied the prognostic benefit, FFR-guided selection rescued it once, ORBITA doubted even the symptom relief, and ISCHEMIA settled it.
This page is educational commentary on the medical literature and is not a substitute for clinical judgement in an individual patient. Please check the current guidelines that apply where you practise.