There’s a near-oath we clearly all have to sign to when we commit to paediatrics … “Children are not little adults” … and while this is definitely true … after all, how often have you seen someone smile whimsically at a grown-up asleep in their unicorn onsie being carried home … we know it has […]
Category: archimedes
Experts and evidence
Every now and then you read something and it chimes with you to illuminate niggle you’d not known was there – and the flash of understanding makes you delight. Really good qualitative research can do that, as can fiction, drama, an off-the cuff comment, and – rarest of all – the output of a Working […]
“Look away now if you don’t want to know the results”
Those of a certain age (“Very Old” according to my children) will remember the usual way of getting association football scores on a Saturday afternoon was watching the TV, and the sports section would show them on the screen. For people who were still tensley awaiting the catch up show on the box later that […]
Does PPI make things better?
Those of you in the UK may be struggling to work out exactly which PPI is in this title: is it payment protection insurance? (no); is it that old government/company hospital building thing? (no, and that was private finance initiative, PFI); is it ‘patient public involvement’? Yes! The active engagement of people who use the […]
Looking under lamp-posts
There’s a tale told in the North of a man drunkenly scrabbling on the path at night, met by a neighbour also on the way home from the Hound Of The Roofers pub. “What’ye doin’ Arthur?” asks the upright man. “Loookin f’r mi key!” responds Arthur. “Did y’jus drop it?” asks his inquisitive pal. “Nay, […]
More than the medicine
The end of our profession is nigh! Chatbots and AI and Hal (I’m sort of hoping that there are either very very old people, or pre-millennial film buffs reading) will take over the world! Doctors are needed no more! While this is mainly the news about diagnostic flowbots, it’s not just there we have computers […]
When is a therapy experimental?
We’ve said before that EBM is about using the ‘best available’ evidence, and that while we’d love all our treatments to be supported by large RCTs and systematic reviews, Archimedes is living proof that this often isn’t the case. Sometimes we’ll be in the situation where the treatment could be quite reasonably subjected to a […]
Signal, noise, chance and chancers
For those who hold to personalised medicine as the future of therapeutics, the case is made that it’s about identifying the ones who will gain from the ones who don’t. Separating the signal from the background noise. If we did a randomised trial of ‘antibiotics for fever’ we may come away believing they had no […]
Spirals of re-validation
In the UK, revalidation, to the eyes of anyone in a permanent post, brings thoughts of GMC pleasing e-paperwork and the joy of yet more hours staring at a barely functional system to prove you are safe and sensible enough to not play with computers but auscultate bunnies (where necessary) and diagnose life-threatening disorders. To […]
Backing off
I know we’ve been away for a bit, and there are loads of good reasons (life, and that sort of stuff) but we are all sneakily hoping you are all still interested about how to put clinical evidence into clinical practice. In The Gap there has been much written and spoken about the problems of […]