Annals of Emergency Medicine, in 2014, and Essay

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Annals of Emergency Medicine, in 2014, and is titled Apneic oxygenation was associated with decreased desaturation rates during rapid sequence intubation by an Australian helicopter emergency medicine service." The article studies a new technique that was introduced in 2011, to see if that technique has proven effective at meeting its objectives.

The Wimalasena (2014) article does not have a literature review. It moves straight from the introduction to the materials and methods. The background section of the introduction serves the purpose of a literature review to some extent. There is no problem statement written into this section. The problem statement can be found in two other places, however. First, it is in the abstract under "study objective": "We evaluate the association between the introduction of apneic oxygenation and incidence of desaturation during rapid sequence intubation in both out-of-hospital and interhospital retrievals." This is rephrased for the box "editor's capsule summary," so taking the two together the problem statement is fairly clear, even though it is not included in what is de facto the literature review.

The purpose statement is therefore clear -- the purpose of the research is to determine whether this technique of apneic oxygenation is associated with less desaturation during intubation, as noted in the editor's capsule summary. This is also elaborated in "goals of this investigation" which says much the same thing, about why this study is warranted. They have introduced a new technique and are checking back a few years later to see if it has been effective at delivering the desired and expected outcomes.

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The research question is the same as the purpose statement, or more specifically the research question can be obtained by restructuring the purpose statement for grammar. This is never actually phrased in the form of a question, but the research question is quite clear. There is, however, no hypothesis stated. It is possible that this is not an oversight -- the study is retrospective, so there is no point in having a hypothesis to either confirm or not confirm. The study's results are what they are. However, it is also reasonable to suggest that the study should have a clear hypothesis. This is because the data will still need to be validated for statistical strength. It is important, given the nature of the study, to understand whether the findings are sufficiently robust to guide future policy. Having a clear hypothesis should help with that. The fact that this study lacks a clear hypothesis despite having a clear research question should be taken as a fault.

There are sample sizes clearly stated. The patients affected were divided into different categories, but there is a sample size for each. The total number of samples was n=728. This was actually not a sample, as the entire population was used. The authors note that the population was "all patients who had….....

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