So the model of EBM that we espouse is one grounded in the patient ‘dilemma’ being the start and end point of the process. You’ll recall it’s a patient’s situation that triggers the asking of a PICO question, and particularly the selection of patient-oriented outcomes are vitally important. The acquisition and appraisal of studies that […]
Category: archimedes
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 […]
Damned if you do, damned if you don’t?
The field of systematic review, of which Archimedes we believe sneaks in under the ‘rapid review’ heading, has long since held a solid foundation to what a systematic review needs to do. It needs to have a clear question, with a comprehensive search, and assessment of included studies bias / quality, a synthesis (which may be mathematical; […]
Cases and controls
I’ve noticed that there are a fair few phrases in the world where there actual meaning can be unclear or uncertain, or possibly interpreted differently by folk. Take “maybe later” when used by parent to child – clearly means “no” to the parent and “yes but not now” to the child. Or “brexit”. But the […]
But if it’s significant it must be true?
One thing that I keep coming across, from a huge range of folks involved in clinical practice, is the idea that if something is statistically significant, then it’s true. Some folk nuance that a bit, and say things like “true 95% of the time” for confidence intervals or p=0.05 … Of course, there’s an ongoing argument […]
“We thank the reviewer …”
In our previous post we unpeeled the sticker a little bit on how the magic process of submission to … well, let’s just stick with ‘publication’ and be optimistic … happens. Step 11 compresses the process of being offered a second chance into a few brief words. It’s probably a good idea to think a […]
Hard science in difficult areas
It’s one of the delights of my professional clinical practice that (nearly) all the time, the diagnosis of a malignancy is hard & sound, reproducible, based on good data showing discrimination from other settings and with minimal interpersonal variation. Take a chunk of a particular renal tumour and show it to half a dozen paeds pathologists, […]
How the magic works
It’s become fairly clear that most people don’t really know how articles get from the pen into the ‘accepted’ queue at a journal. At the most wonderful paediatric / child health journal on the planet (*) the process works like this: * ADC of course! […]
Vague, unsure or imprecise?
Trials and tribulations we all have. The not-knowing of the future can create anxiety, distress and an unhealthy desire for chocolate. Some days, knowing what’s for tea can provide the only concrete grounding in an otherwise fluctuant universe. And along with that, the naming of things can sometimes be enlightening. So, for un-knowing, you could […]
Does fear of missing a diagnosis drive your every action?
If there was a chance that you missed a diagnosis about which you would be able to intervene 2:1,000 times, and that the test which could diagnose it cost about £3 and was minimally invasive – wouldn’t you be daft not to use it? Or would you think “what a waste of time!” and wonder […]