In the last post I discussed the ‘p’ problem (not enuresis, which is subject to an upcoming NICE guideline) but statistical significance is only the first problem in deciding if something actually works. This post takes up the challenge of not just saying that something is likely to work, but just how well it works. […]
Category: archimedes
What about benefits?
It’s worth taking some time to return to basics every now and again, and one thing that continues to befuddle medics the world over is the issue of ‘statistical significance’. […]
Q: Can a quick ultrasound save an UGI contrast series?
A bit of greenish vomiting, not feeding so well and some concern that the newborn in front of you has volvulus. So do you really need to go through the hassle and pain of organising a contrast upper GI series, especially as the parents are already worried about getting feeding established, or could normally placed […]
Do children and adults really differ?
@giordanopg recently tweeted a link about a paper in pre-publication from The Journal Of Pediatrics. It’s an analysis of a bunch of Cochrane reviews that had both child and adult RCTs included in a meta-analysis and asked the question “Do children and adults really differ?” Their technique was to compare the key outcomes by comparing […]
Q: Who’s still prescribing 0.45% saline for rehydration?
Me … well, actually I don’t anymore, but that’s mainly because I don’t do rehydration. I tend to do hyperhydration to stop the methotrexate causing any more damage than I know it’s going to. BUT if I did prescribe any fluids for a dried up sprogling, I’d reach for 0.45% saline with a sniff of […]
Q: Should you test Asian patients for HLA-B*1502 before presecribing AEDs?
I think this is a fascinating question. In paediatric oncology, we’re been doing a tiny bit of genetically personalised medicine for a while now, testing the allelic variations of thiopurine metabolisers so we don’t (over~) poison a small proportion of children with ALL. There are suggestions […]
Motherhood, apple pie, psychosis and anaphylaxis
I’ve been worrying about this for some time now. How should we, as health professionals, address the deeply held beliefs of our patients when they aren’t true? Especially when they may harm others, although in a fairly obscure or indirect way? […]
Novelty or reality?
There’s a rather old study of playground renovation that’s been re-circulating recently (via Twitter, via @drbengoldacre and @cebmblog) which claims to demonstrate that really fancy multicoloured markings in primary school playgrounds get kids moving much more. […]
What would Jack want?
Or perhaps it should be ‘What would Mohammed want?’, or Alyx, or Devine, or Vladimir … when we’re asking clinical questions, do we really think what outcome our patient and family want, or do we just think what we think they would want? To put it another way – how close are the outcomes that […]
FAST appraisals
I’m fairly sure you’ll remember the RAMbo method of reviewing the validity of single randomised controlled trials. And so I think that many readers will have been having sleepless afternoons, struggling through the lengths of a ‘User’s Guide’ checklist for systematic reviews thinking “Which action hero can rescue me from this mire?”. Or perhaps not. […]