The academic debate surrounding the strengths & weaknesses of the CRASH 2 trial & TEG has been heating up.  Dr. Walsh’s comments have been met with both contention and praise… either way, an educated discussion is always welcomed here at MarylandCCProject.org.  We were fortunate enough to have the master of EMCRIT.org Dr. Scott Weingart weigh-in with his thoughts about CRASH-2, Dr. Walsh’s initial response, and finally gives some insight into his thoughts about methodology.
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Major points of contention here….
- Effectiveness trial vs. Efficacy trial – CRASH2 was meant to show TXA was effective when used in trauma patients in a real world scenario.
- Equipoise trial enrollment – A trial designed to assign patients to a treatment or control arm if there is true uncertainty about which arm is likely to benefit the patient. Â This usually leads to a negative study – CRASH2 was positive!
- “One of the most successful Critical Care clinical trials in the past 10 years…”
- The TEG isn’t sensitive enough to determine who needs TXA. Â BLOOD = TXA.
Is either side right? Take a listen and you decide! Â We’d love to hear your thoughts & comments below…. Join the conversation!
