There’s a not-so-new kid on the systematic review block that seeks to cogently and comprehensive look at if, why (or why not) an intervention ‘package’ works in practice. They are ‘realist reviews‘ which, in brief, take a slightly different idea to how things work than the standard medical researchers might. The reviews aim to unpick […]
Category: archimedes
Well I never thought of that …
For no particular reason I can think of I bumped into this RCT of “Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial” and thought, initially, “Well that’s a waste of money and effort and quite unreasonably uncomfortable for the poor little things that got un-anesthetised”. (My very first job was on an […]
Moral conflict and paternalistic thinking
I’ve been reading, Tweeting, FaceBooking and thinking about self-asphyxial behaviours (SAB) for the best part of two weeks, and have driven myself partly potty worrying about the moral implications of my actions and a desire to parent the world. (I should emphasise – very very clearly – that this relates to a systematic review published by the journal before […]
What’s stopping you?
Actually turning the fascinating discussions you all have (I’m sure) over breakfast, beer or bovril about the latest systematic reviews, touching on all elements of critical appraisal from their complex search to their use of mixed logistic regression meta-analysis into action is, sometimes, difficult. We all stop on our course from asking questions, through acquiring […]
Interventions without evidence should not be undertaken. Discuss.
It’s been a ‘debate topic’ from a number of conferences, medical student societies and online fora. Should an intervention without evidence ever be undertaken? There’s a couple of key elements here: one – the idea that there can be an intervention ‘with no evidence’, and two – that an absence of evidence should be interpreted an evidence of absence […]
Re-building pyramids
The idea of the pyramid of evidence – where a systematic review, or even better, a meta-analysis, trumps all below it – is something that’s passed into mythical status in evidence based practice. Actually, mythical is probably a good way of thinking about it. It’s not real, not really real. But it’s not quite truthless […]
Messed up references
Those who are writing a thesis, have just upgraded from one bibliographic manager to another, or have spend a week flying around your (ex) region collecting printed forms to tell a prospective employer you are not a danger to their staff, patients or cutlery may read the title one way. Those who have been pondering […]
Triple targets
There’s a triple target that I often splurge about evidence based medicine being the ‘combination of patient preference, clinical expertise and best-available research’ which in context addresses an EBM-is-copying-the-trial critique. The #RealEBM hashtag (go on … give it a go ..) is addressing this quite eloquently and has been graven in stone by the superb @RichardLehman1 in […]
Nice and easy doesn’t do it.
With very little need to comment – this model of getting research into practice by dr prof Trish Greenhalsh – can be used to slap down anyone who turns to you and claims all you need to get X, Y or Z working is just … You’re welcome. […]
Collecting patients’ views
There’s a hugely understandable drive to make health care centre around the person with the health condition and include them in their care, rather than place the focus on the operator of the health machinery or the accountant that balances the cash flows. There’s the recent launch of the Me First! initiative from the UK, for […]