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 against […]

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Proof of equipoise

In order to test a new treatment, in a standard randomised controlled trial, we are ethically assumed to have ‘equipoise’: an honest uncertainty at the same chance of a patient being allocated to the new or old treatment. But, I hear you scoff, how can any investigator put themselves through the hell of ethical administration […]

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Tarnished gold

What can you do when a ‘gold standard’ isn’t actually that good at diagnosing a condition? It can be terribly problematic in interpreting sensitivity and specificity – for example comparing polymerase chain reaction diagnosis of microbiological infection with culture results. The ‘false positive’ may actually reflect real, and otherwise missed, diagnosis, and the ‘false negatives’ […]

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Secrets and lies. Truth and beauty.

… and other Bohemian aphorisms … There is a quite brilliant paper from the under-advertised PLoS One which shows how, in the are of incubation periods for respiratory disease, Truth By Citation is quite strikingly different than the reality of the evidence. The networks of citations demonstrate how repetition, sometime but not always with a […]

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