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According to pre-experiment planning, 700 patients would be necessary to provide sufficient statistical power to address the hypothesis. The authors drew study participants from 22 medical centers in Australia and New Zealand. Given the nature of the inclusion criteria, a multicenter approach was needed to recruit such a large number. In the end, they did not recruit a buffer to allow for drop-outs and this cost them their statistical power. This was not appropriately planned. It is unusual to include patients as young as 16. In the US, the age of majority, required for consent without a parent is 18, as is the formal definition of “adult.” 18 is a very commonly used definition of "adult" in the medical literature, so it is unusual to use a different definition. The use of standardized body temperature was good, but their choice to use axillary temperatures is a concern. This is the least accurate method for measuring a body temperature. Oral temperatures may be obstructed by mechanical ventilation and rectal temperatures would require moving patients who may have interventions making this dangerous, however, an otic or …show more content…

Patients who required cooling as part of their treatment, or who had hyperthermic disorders in which the cause of fever was not the infection were also excluded. Patients who were expected to die within 24h or who had advanced directives barring the use of aggressive life-saving measures were also excluded. Pregnant patients were excluded as the study’s authors hypothesize acetaminophen use is potentially harmful to the patient. Patients who were not expeditiously enrolled and did not start the study protocol within 12h of ICU admission were excluded. The rationale for these seems appropriate to rule out patients who do not fit the study’s parameters and who might bias the

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