The RAMbo acronym that Archi first chattered on about five years ago relied on the key suspected elements of risk of bias – the need for randomisation, accurate ascertainment of outcomes in the groups to which people were randomised, and being careful of measurement – thinking about what was actually measured and if it was […]
Category: archimedes
Missing. Presumed suppressed.
The last few years have seen clarity in the emergence of an insidious and tainting perversion of the truth through data obfuscation, suppression and misalignment. The challenge of unseen trials has been addressed in a number of ways; probably the best of these are the insistence on all trials in human subjects being prospectively registered with their […]
Harms, safety and certainties
How you know about stuff you don’t know about is a fascinating philosophical, statistical and downright practical topic. There’s the issue of ‘unknown unknowns’ – stuff you didn’t know you didn’t know – that can be frighteningly and sometimes dangerous. (How may of you know that failure to thrive is a common manifestation of a […]
Are you feeling sleepy?
You may have noticed a resurgence of interesting posts on this blog; it’s all part of an orchestrated campaign to get more paediatric clinical evidence discussion going. As part of that, Archi’s been touting for folk to write a couple of hundred words on something they’ve learned recently – a highlight – arising from evidence. […]
NSAIDs cause ulcers. Dog bites man?
There’s something to be said for papers that state the obvious. That’s generally that it’s not actually obvious until it’s been shown to be the case, ’cause it always might have been different. (For those of you who struggle with the idea about studying the obvious, have listen to this superb paper by Ruth Gilbert […]
Get it straight from the start
Over more than a decade Archimedes has presented clinical queries and the appraisal of the evidence that emerges. leading on to a clinical conclusion to the dilemma. What is strikingly common is that many questions can start in a muddle, and a failure to get an ‘evidence based answer’ might be a failure to ask […]
How do you improve services for Children
A paediatric tweeter, @kunbab (named with permission) working at intern/SHO level remarked on their frustration with the process of improving things in a workplace. They’d done something very simple; their patient had needed a referral, and so they’d emailed this referral to the relevant consultant. However, when their boss heard about this, the boss insisted on a paper […]
It’s getting better all the time
Well, it certainly appears to be, if you are lucky enough to be a clinician treating childhood cancers. That’s not to say that childhood cancer is in any way a ‘good’ thing to have, and not to understate in the slightest the unpleasantness of therapy. But things are getting better, and an extensive review by […]
Chorioamnionitis and NEC – the challenge of significant small associations
In a recent flurry of twittering, Archimedes noticed a meta-analysis linking chorioamnionitis with necrotising enterocolitis. Although a long time since doing neonates has passed, the consequences of NEC were profound enough to stick, and a potential association, perhaps a route in to stopping it happen, would be welcome. The meta-analysis showed that, on univariate examination, […]
New way to wee
There’s a paper in the Archives from January which presents a ‘new’ way of collecting urine from little babies. (I say ‘new’ as it is startlingly similar to the method employed by the Matron at my first SHO appointment, back in the last millennium, but this version is scientifically tested.) How should we, as clinical […]