Summer’s here in Yorkshire, and the fruit of the season is strawberries. But strawberry naevi can be troublesome, and cause lots and lots of worries for parents. So how well do we know their natural history? Resolution of 50% at 5 years, 70% at 7 years and 90% at 9 years?

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“The 3Rs are dead; long live the 3Rs.” So might a herald cry from the battlements of an evidence-based hill. Sharon Straus and Brian Haynes have captured beautifully the need to move beyond just publishing your paper to making evidence available that is ‘reliable, relevant, and readable’.

Why these three Rs? more…

You have a 7 year old in the ED that needs sutures to a wound inflected when he and his twin were playing Pirates of the Caribbean with kitchen knives … he’s not the sort of chap that will lie still while you stitch him up … so what would you use to keep him down? more…

Does having the a worried mum or fretful dad in the room with you make a lumbar puncture less likely to succeed? It’s an interesting question, and one that has been posed following an evening on call in Yorkshire. What’s the opinions of folk out there - and any evidence that you can quote to substantiate them?

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Have you (yet) had a parent ask for a referral for tongue tie division to assist with a poorly feeding baby? What is the right answer to this question; more…

Have you ever been involved with a debate with a partner or colleague, travelling from one place to another, and when the course they took has got you to the destination safely, they turn to you and say “So, [add endearment here], you see my way was right.”? If you have, I doubt that you took the opportunity to explain that they may be suffering from a methodological reasoning problem, of which the conterfactual argument and the possibility of differential verification bias may be important to consider. more…

The separation of ‘risk’ factors and ‘prognostic’ factors at first seems the sort of obsessive fine detail that gives epidemiologists and statisticians a bad name. Sadly, the difference is actually worth understanding for any clinician that’s going to try to cut through an observational study and understand what it might be truthfully telling us. (This isn’t the true of the difference between a Peto odds ratio meta-analysis and a DerSimion & Laird random effects meta-analysis. That is a pointlessly academic difference.) Fortunately, the difference between risk and prognostic factors is straight forward. ‘Risk’ factors are those which as associated with causing a condition (like smoking for lung cancer, being premature for chronic lung disease, or soft light and wine for falling in love). more…

Sometimes we are in situations where we think that something causes problems, and we can’t do a trial randomising one group to get something which we think causes problems! How do we then go about finding out - how to we avoid the problems of ‘confounding’ - and what is that anyway? For example, think about necrotising enterocolitis. Which babies develop NEC? more…

If you were offered a choice of medication to treat an ailment you were suffering from, and you’d asked about how effective they were (and there’s a huge chunk of the population that wouldn’t, and would be happy to just do as they are told), then what information would you like? more…

That’s it really - it’s a very simple question. Does the time, effort and printing resources we use in creating asthma action plans have a measurable benefit in terms of stopping the kids getting as poorly? Or is it a job-creation scheme for these financially strapped times?