My mum insists that we, at home, always cut off the green bit & splice the strawberry in case it had a slug in it. For Ian Wacogne it’s sitting with his back against a radiator. Why? Well, in my case it’s so that you can’t eat a slug … that’s managed to get into […]
Category: archimedes
Quality Improvement: Why it’s not turfing the RCT to the long grass
We’ve started to publish a fair few quality improvement reports in the Archives recently, aiming for 1200 words, 5 references and a readable SQUIRE-compliant paper that gets across the key messages about how a #QI project was undertaken. These aren’t trials, don’t have control arms, and may suffer from significant publication bias. (It’s not surprising to […]
Subgroups and multiple analysis. Truth or herrings?
We recently published, in the F&N edition, a paper reporting an RCT looking at inhaled steroid in wee premature babies to see if the treatment reduced the incidence of death and chronic lung disease. Did we do a good job? The trial was prospectively registered, before enrolling patients, randomised and stated it was […]
Dethrone the “Landmark Trial”
There is a long honoured tradition in a number of specialities, and sub-specialities, of knowing The Landmark Trials. The studies that demonstrated that something works or that some method is better than another. But Landmark Trials are bunkum. […]
Overdiagnosis in paediatrics
WHY is the rate of admission for bronchiolitis skyrocketing? HOW CAN we combat this clearly terrible condition? Perhaps we can stop diagnosing it as worth of hospitalisation? […]
Basics: Blame it on me
In my clinical role, it’s fairly easy to take the blame for most bad things that happen to my patients. I give them cytotoxic chemotherapy (for good reason, honest) and it’s a group of substances that we label with TERATOGENIC! HARMFUL! QUITE BAD FOR YOU! tags a lot of the time. But how do we […]
How often can you cry “Wolf”?
The fable of the bored shepherd boy, alone on a hillside (except for the sheep – sheep don’t count as company*) waiting for something to happen, is one that I hope most of us know and can recount if needed at any dinner table. In my folk-recollections of the tale, it’s three times that the […]
How do health care teams talk about very-low-success interventions?
The situation is clear. The child has an illness which is very likely to end their life – and soon – in days, not months or years. They may be hooked to a ventilator, drizzled with inotropes, or osmosed. The health care team is talking – once again – about the outcomes and what we […]
Getting the message across
There’s a rather neat editorial in BMC Medicine that discusses how academics might better write their papers to inform and influence policy makers. I was taken with how much the tone of this, and the excellent mini-series of blogs on presentation skills by @ffolliett, were similar and applied to all sorts of layers of ‘policy’ making. Take […]
Steroids are bad for you. Lifesavingly so.
There are two newish articles on steroids in the Archives – one is a systematic review of adverse drug reactions (ADRs) from short-course use, and one the initial creation of a quality of life tool intended to be used to look at how steroids, particularly dexamathasone, affect the life of those children and young people […]