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Am J Emerg Med. 2019 Feb;37(2):338-343. doi: 10.1016/j.ajem.2018.11.017. Epub 2018 Nov 17.

Methodological characteristics of randomized controlled trials of ultrasonography in emergency medicine.

Author information

1
Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Diderot, Paris, France.
2
Emergency Département, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Pierre et Marie Curie, Paris, France.
3
Emergency Département, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Pierre et Marie Curie, Paris, France; INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France.
4
Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Diderot, Paris, France; INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France. Electronic address: anthony.chauvin@aphp.fr.

Abstract

INTRODUCTION:

Interest in ultrasonography in emergency medicine has increased in recent years, as reflected by a marked increase in publications on the topic. The aim of this study was to 1) describe and evaluate methodological characteristics of randomized controlled trials (RCTs) evaluating an ultrasound intervention in emergency department and 2) estimate whether the reports adequately described the intervention to allow replication.

METHODS:

We searched MEDLINE via PubMed for RCTs published in 2015 assessing an ultrasound intervention, regardless of type, that were performed in an emergency department or evaluated in an emergency situation. Two researchers independently screened titles, abstracts and full texts. Data from all included studies were independently extracted. The Cochrane Collaboration Risk of Bias tool was used to assess risk of bias of reports, and the intervention reporting was evaluated by using the Template for Intervention Description and Replication checklist.

RESULTS:

We identified 11 reports. The most frequent topic was vascular access/identification (n = 4). Random sequence generation and allocation concealment were performed correctly in 55% and 27% trials. Three quarters of reports (73%) showed improper reporting or absence of participant blinding. Risk of bias due to assessor blinding was rated low for 3 RCTs (27%), risk of attrition bias low for all reports, and risk of selective outcome reporting unclear for most reports (n = 10). Only 3 reports (27%) provided an optimal description of the intervention.

CONCLUSION:

The quality of these trials raises questions. In our sample, the authors did not correctly report blinding of participants and assessors or allocation concealment.

KEYWORDS:

Emergency department; Review; Ultrasound

PMID:
30503277
DOI:
10.1016/j.ajem.2018.11.017

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