‘Donate to charity for cash prizes!’

Kate Sahan, The Ethox Centre, Nuffield Department of Population Health, University of Oxford

Said one breathless charity rep who knocked at my door on a peculiar evening in late September. A grubby pamphlet was unfurled, designed to dazzle with pound signs, money fans, and testimonials. The charity reps, propping themselves up on the dodgy adjoining brick wall, were clearly at the end of another punishing day of pounding Oxford’s mean pavements. So my resistance to their win-win money-making idea was treated as just another of their usual street-side heckles: I blurted out something about perverse incentives, about how it would encourage gambling. I screwed up my face in a don’t-get-it-and-feels-icky kind of way.

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‘Donate to charity for cash prizes!’

It’s an emergency: should we ‘rescue’ vulnerable emergency care patients from research?

 pulpfiction

Kate Sahan, The Ethox Centre, Nuffield Department of Population Health, University of Oxford

A current emergency medicine trial, Paramedic2, which randomizes patients to adrenaline versus saline in cardiac arrest has put emergency medicine research (EMR) back under the spotlight. There are concerns that a ‘totally useless placebo’ will be more harmful than the standard adrenaline shot given during the resuscitation protocol. However, the history of EMR has taught us that some emergency interventions rest on an insufficiently-explored and updated evidence base[1]. For example, up until the early 2000s, corticosteroids were given to tens of thousands of severe head trauma patients in the belief they were medically beneficial. But it took a systematic, placebo-controlled research study of their use called CRASH to make an unwholesome discovery: steroids had no benefit, and caused actual harm by killing or severely brain-damaging more patients than placebo.

Continue reading “It’s an emergency: should we ‘rescue’ vulnerable emergency care patients from research?”

It’s an emergency: should we ‘rescue’ vulnerable emergency care patients from research?