SESAP question inaccurate

I would like to bring to your attention an error that has been transmitted through the SESAP question published in the February 2004 issue of CJS (Can J Surg 2004;47:56). The answer suggests that there is no role for the use of corticosteroids in reducing mortality related to acute acute respiratory distress syndrome (ARDS); the supporting reference is a textbook from 1997. I would direct readers to a more recent (though not new) randomized controlled trial of high-dose corticosteroids in ARDS.¹ To put the data in perspective, Canadian authors have also published a review of the topic.²

The correct answer should be B.

The SESAP questions are a good way to incite interest in a topic. However, in our current information explosion it is important for readers to question references, especially textbooks. The current series in JAMA of Users' Guides to the Medical Literature is a useful aid in this evaluation. Participation in the online learning tool, Evidence Based Reviews in Surgery, available through the Web site of the Canadian Association of General Surgeons (http://cags.medical.org), can also help surgeons evaluate the evidence and support best practice.

John W. Drover, MD, FACS, FRCSC Chair and Medical Director Critical Care Program Associate Professor Department of Surgery Queen's University Kingston, Ont.