How exactly do trialists proceed when deciding upon the appropriate acronyms for their soon-to-be blockbuster trial? Is the proper etiquette to follow a traditional prospective process, utilizing the first letter of each word in a trial’s longer title? Or is the selection of an acronym based on its ability to inspire and only then, retrospectively […]
EMNerd
The Nihilistic Ramblings of Rory Spiegel, MD
EM Nerd-The Case of the Inert Remedy
In 1959 Cobb et al published a trial of 17 patients investigating the efficacy of internal mammary artery ligation for the treatment of symptomatic angina. The authors randomized 17 patients “seriously limited by angina” to either bilateral internal mammary artery ligation or a blinded sham procedure (1). At 6-months follow up the authors reported the […]
The Case of an Ugly Truth
The great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact. […]
EM Nerd-The Case of the Divisive Tincture
The guiding physiological principles of resuscitation have for so long been based off the restoration of normal macroscopic hemodynamics in the hopes that the reversal of such circulatory perturbations will correct the underlying cellular injustices. And yet time after time such strategies have failed to show definitive benefits when empirically tested. The simple practice […]
EM Nerd-The Case of the Liberated Radicals
A recent publication in the NEJM by Hofmann et al (1) serves as a nice reminder that so many of our therapeutic staples while based on sound physiological reasoning fail to translate into clinically important realities when empirically tested. This mammoth undertaking, entitled the DETO2X trial, randomized 6629 adult patients (>30 years old) presenting to […]