Here’s one for free (really)
23 Jul, 08 | by BMJ Group
A blog post of questions that are calling out to be answered.
Ever looked at the Archimedes section and thought “I wonder what I could write about?” or “I wish they’d look at this?” Here’s the space you were looking for.
Well, here’s the first one. Feel free to add some more:
Q: Encouraging adolescents to take their medication
Question- In adolescents with malignant disease on chronic medication (>3 months duration) [patients] does text messaging [intervention] or emailing [intervention] or phone contact [intervention] or anything [desperate intervention] compared with just keeping telling them how important it is [comparison] improve adherence to prescriptions and survival/morbidity [outcomes]
Context - So my primary interest is oncology, but it could be adapted to any area, I guess. How do you help adolescents keep taking the medicines that might save their lives?
Feel free to register your interest and intention to answer the question as a comment on this post. We can then turn it into it’s own little blog-stream and remove it from the pool. You’d have 3 months to come back with something (see here for hints) or we’d pop it back into the pot for answering.
(Remember if you’re posting, follow this format)
Topic Area
Question- structured format
Context - 100 words max
[ Contact details - optional, if the poster wishes]
OK, a couple of ideas; I’ve not looked these up myself before. If they don’t make sense, I’d be happy to explain further.
1.
Question. Do babies with long bone fracture (population) always cry immediately (outcome) following the fracture (intervention) [Garbled question; happy for edit to clarify]
Context. Long bones are hard to break. I’ve always assumed that absence of history of crying is highly suspicious. But are we looking at 100% of babies, or 95% who cry? Are there any series of witnessed fractures in (normal) babies which can verify this?
2.
Question. In children with pneumothorax (population) does supplemental oxygen (intervention) improve resolution of the pneumothorax (outcome)
Context. (obviously this ignores tension or any other treated pneumothorax). The physics is supposed to be thus: You give 100% oxygen. The nitrogen component of the gas in the pneumothorax (pneumothoraxate?) is slowly replaced with increased oxygen. This is better absorbed and the pneumothorax resolves faster. This sounds… plausible. But fanciful. Are there any RCTs or is this just “good physics” in the same way that we used to hyperventilate patients with head injury? Or is the oxygen tubing just being used to pin patients to the bed?
iwacogne
April 20th, 2008 at 6:26 pm
Here’s a third.
(occasioned by our Editor in Chief giving himself a tension pneumothorax by falling out of a tree onto a fence…)
Question. In children with pneumothorax (tension or otherwise) what amount of time should be left before flying?
Context. Our EIC has been told by his traumatologist that he’s allowed to fly after 6 weeks, and that in any case commercial airliners should be OK. The former sounds a bit made up to me, and the latter must be something to do with pressurisation; of course this assumes no problems with the aircraft in flight…
iwacogne
May 14th, 2008 at 12:44 pm
Hi,
CareSpeak provides a free medication reminder service that uses text messaging. We have been running a clinical study with a leading NYC hospital using our technology with young children and teenagers who had organ transplants and where medication compliance to immuno-suppressant drugs is crucial. Preliminary results show significant improvements in medication compliance. We will be publishing results later this year (2008) once the study is completed. In the mean time feel free to recommend our service at http://www.carespeak.com.
Let me know if you have any questions/comments,
Serge
Serge
July 6th, 2008 at 2:58 pm
Re Q2:
Resolution of experimental pneumothorax in rabbits by graded oxygen therapy.
J Trauma Sep 09, 1998 GJ England, RC Hill, GA Timberlake, JD Harrah, JF Hill, YA Shahan, M Billie
CONCLUSION: These results show a statistically significant (p < 0.01) dose-dependent improvement in the resolution of pneumothoraces with increasing levels of inspired oxygen. Supplemental oxygen therapy may be used to facilitate the resolution of small, uncomplicated pneumothoraces.
richard nicholl
November 26th, 2008 at 3:04 pm