One of my favorite talks from smacc-Chicago was this elegant destruction of Tranexamic Acid (TXA) doubters by Karim Brohi. Courtesy of the folks from SMACC, TXA, the denier's handbook:
and then there was this almost surreal article published in one of the Blood Journals. Seemingly written by the titular deniers of Karim's talk, the authors are social media bashers as well.
Also check out the original TXA EMCrit Post
Editor-in-Chief, EMCrit.org at EDECMO LLC
An ED Intensivist from NY. No conflicts of interest (coi).
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In an environment where blood and blood products may not always be available (usually not), such as where I work, and where TXA is more readily available for the massively haemorrhaging trauma patient, there is certainly a role for this and detractors for its use should actually come and work with me and provide me with alternate solutions.
Sorry for the long post but this has me fired up in large part because it provides a fascinating conflict between the “traditional” ways of knowledge translation and the “FOAMed” ways of knowledge translation. The level of resistance to the CRASH-2 trial findings is intriguing considering that far more expensive and potentially dangerous interventions out there don’t receive this level of passion and scrutiny. It’s healthy to debate articles in the medical literature but the criticisms of CRASH-2 seem to frequently revolve around concepts that are far from scientifically rigorous. There are recurring themes to the criticisms, here are a… Read more »
Craig, Wonderful comment! So many great points made. You can see my response to the maniacal criticism here:
http://maryland.ccproject.com/2013/10/04/crash-2-got-right-counterpoint-dr-scott-weingart/
I find it interesting to see this as some epic battle between the FOAMed enthusiasts and the ‘traditionalists’. I didn’t experience the same level of emotion that seems to have been engendered in others regarding this debate. After all, it was a good review of the current evidence and the various commentaries that have accompanied this important clinical question. The tone may irk some but it could be easily said that the impassioned pleas from other blog sites are no different. I view information either from the Internet or from peer-reviewed journals as both requiring critical review. Whatever the source… Read more »
I think what got people’s goat (and I know it got mine) is the blending of science and editorializing. This blending should not take place in a journal. It should either be science or a letter to the editor. This blending is actually more consistent with FOAM. FOAM provides ways for people to respond and interact==to call out perceived mistakes. Journals should not delve there or they no longer represent what journals should.
And perhaps by doing so the authors undermined the inherent respect for an academic publication or…..revealed the flawed assumptions of how we attain knowledge. The artificial separation of fact and opinion. Author conclusions may not accurately reflect the demonstrated p-values and box plots (e.g. IST-3) and editorials may be just an alternative discussion of how the data should be interpreted. These authors by playing the same game as FOAMed, has shown that we need to turn a critical eye to anything we read. Nonetheless, we are starting to see similar functionality of social media outlets with peer-revewed journals. BMJ rapid… Read more »
Derek- It’s very important for authors and publications to clarify the nature of an article. Most journals have sections that are clearly delineated as being appropriate for commentary like letters to the editor or editorials. This was categorized as a review article which is supposed to be an expert review of the literature on a topic along with an objective assessment of the validity and applicability of individual studies being described that answer a specific clinical question. Editorials and letters to the editor and other parts of a journal that are clearly identified as containing opinion are important components of… Read more »