If something is described as ‘reliable’, what springs to mind? Dull but dependable? Solid and sure? It’s a word that gets bandied about with respect to clinical studies and I’ve often wondered quite what the user of the word means, apart from some kind of overarching sense of ‘good science stuff’. When I think of […]
Presented without context
Looking backwards, a whole bunch of studies which were undertaken may be seen as either astoundingly obvious, or startlingly pointless. Why on earth, for example, would you want to trial the effects of dexamethasone in suspected preterm labour, or see if doxorubicin was a useful to drug in treating sarcoma, in the 21st century? The […]
How much of a good thing do you need?
There could be a variety of answers to the title drawn from the repertoire of popular music, ranging from a dusting to a life embodied. In the setting of evidence-based medicine … like almost every question that’s asked … the answer is probably “It Depends”. If our question regards the use of a significantly toxic […]
Confused, ambiguous or uncertain?
Not-sure-ness … a word sadly missing from the dictionary at the moment … is thick in the air at the moment, like sunseekers on a August beach or beer bottles the morning after a party* Not-sure-ness can come in many angles and shades, and if we can distinguish them we may be able to seek […]
Looking back and mistaking things
The aged among you may be aware wing mirrors in other countries carried a warning .. “Objects in the rear view mirror may appear closer than they are”. Those of a certain persuasion may be unable to read that without singing too. There’s a physical and psychological truth to the statement which we should be […]
If eleven people say one thing, and a twelfth disagrees, where do we go with the decision? Let us start with a simple question. What if it’s “Are the chips any good at the canteen?” Straightforward – the 11 probably outweigh the 1. But … what if the 11 all report hearsay … “Simone always […]
Sat in my garret, I have only the palest of similarities to Virginia Woolf, but a space to think and reflect as the UK pandemic moves on is a definite opportunity. The common description of evidence-based medicine commences with ‘Ask A Clinical Question’, but omits the step before that; ‘Be Uncomfortable With Your Knowledge’. Being […]
Questioning the minutiae
It’s when big stuff hits and happens that the machinery of state (or the hospital or household) seems to step up and move fast and effectively to undertake activities it seemed to need months to do previously. Enormous clinical trials of agents to treat the complications of SARS-CoV2 have sprung into existence within weeks; hospitals […]
Don’t Panic Dr Mainwaring!
The novel coronavirus pandemic of 2020 has brought about many changes in what we’ve been doing, some of which might stay and some of which might go. One of the striking things was about how we, as a community, have communicated new aspects, theories, ideas, uncertainties and changes in understanding. Some of the messaging may […]
The problems and power of peer review
A traditional approach to assuring oneself of quality of a journal article was to look at the reputation of the journal (via the impact factor, perhaps) and an assurance of peer review. The process of peer review may be poorly understood and shrouded with a cloak of mystery, and papers emerge from it with a […]