Anaesthesia
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Review
Are most randomised trials in anaesthesia and critical care wrong? An analysis using Bayes' theorem.
False findings are an inevitable consequence of statistical testing. In this article, I use Bayes' theorem to estimate the false positive and false negative risks for randomised controlled trials related to our speciality. ⋯ By contrast, large, multicentre trials in critical care appear to have a high false negative risk. These findings suggest much of the evidence that underpins our clinical practice is likely to be wrong.
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Comparative Study
Clinical validation of bioreactance for the measurement of cardiac output in pregnancy.
Maternal cardiac dysfunction is associated with pre-eclampsia, fetal growth restriction and haemodynamic instability during obstetric anaesthesia. There is growing interest in the use of non-invasive cardiac output monitoring to guide antihypertensive and fluid therapies in obstetrics. The aim of this study was to validate thoracic bioreactance using the NICOM® instrument against transthoracic echocardiography in pregnant women, and to assess the effects of maternal characteristics on the absolute difference of stroke volume, cardiac output and heart rate. ⋯ Similar results were found when the analyses were confined to each individual trimester. The absolute difference between NICOM and echocardiography was not affected by maternal age, weight, height, race, systolic or diastolic blood pressure. In conclusion, NICOM demonstrated good agreement with echocardiography, and can be used in pregnancy for the measurement of cardiac function.