Shared decision making

So the model of EBM that we espouse is one grounded in the patient ‘dilemma’ being the start and end point of the process. You’ll recall it’s a patient’s situation that triggers the asking of a PICO question, and particularly the selection of patient-oriented outcomes are vitally important. The acquisition and appraisal of studies that […]

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Can our children’s trials work better than they do?

We’re all well aware of the problems of doing randomised clinical trials in paediatrics – small numbers, uncertainty about sample size estimates, lack of funding to undertake the studies – but are we as aware of some alternative approaches that have been used [1]?   “Sequential design” studies look at comparing a series of treatments […]

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Hard science in difficult areas

It’s one of the delights of my professional clinical practice that (nearly) all the time, the diagnosis of a malignancy is hard & sound, reproducible, based on good data showing discrimination from other settings and with minimal interpersonal variation. Take a chunk of a particular renal tumour and show it to half a dozen paeds pathologists, […]

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