What makes something a “landmark” critical care trial?

I receive quite a bit of feedback regarding one of my more popular mobile applications, ICU Trials by ClinCalc.  Often, these emails involve a request to add a particular “landmark” trial with the next application update.  With 10-20 recent requests for new trial additions, I’ve been forced to re-evaluate my criteria for what constitutes a seminal paper in the area of critical care medicine.

Although there isn’t an official scoring system or absolute list of must-have criteria, I’ve developed a simple list of ten important factors that help differentiate important trials from paramount, landmark gems in evidence-based medicine.

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What is the best evidence for pharmacologic VTE prophylaxis in trauma patients?

Is there a preferred agent for VTE prophylaxis in trauma patients?  Is there a superior dosing strategy for these high-risk patients?

The selection and dosing of pharmacologic VTE prophylaxis in trauma patients has a troubled, controversial past.  The literature surrounding the topic is riddled with small, conflicting trials and methodological flaws.

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New Calculator – Phenytoin Correction for Concurrent Valproic Acid

Phenytoin (PHT) and valproic acid (VPA) compete for the same binding sites on albumin.  In patients taking both PHT and VPA, the free fraction of phenytoin will be increased, which causes a total PHT level to falsely represent a patient’s active PHT status.

To supplement the recent video on Total vs. Free Phenytoin and the existing correction calculator for hypoalbuminemia, a new correction calculator for concurrent valproic acid has been released.

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