Does your neonatal unit have parents present when you’re doing medical rounds? Would that be a good thing? (Or if you already do it, is that a bad, limiting thing?) Could the presence of parents inhibit honest medical discussion? Could it compromise confidentiality? May the opportunities for bedside teaching be severely reduced? Could the stress of […]
Category: archimedes
Basics: Rapid Reviews
Systematic reviews in health care aim to answer a specific, highly structured, clinical question by extensive searching, careful sifting and appraisal of the studies, a considered synthesis and well tempered conclusions. They can take very many months – 18 or more – to complete. Where we undertake and use systematic reviews to provide the very best estimates […]
Predicting IvIg Resistance
It would be nice, wouldn’t it, if we could work out which patients would not benefit from an intervention, in order to a) not use it and b) use something (probably more toxic) instead? It’s a frequent thought of mine, as an oncologist, when I sign off another chemotherapy chart with multiple agents on it. I know […]
Basics: Intention To Treat
The principle of an ‘intention to treat’ analysis is that the participants in a randomised trial are analysed in the group to which they were randomised, regardless of what treatment they received. So in a hypothetical trial of salbutamol vs. aminophiline infusion for severe asthma, regardless of what the child got, they are placed in their ‘you […]
Bunging up the flow
I was intrigued to see the meta-analysis of diosmectite in acute diarrhoea appear in the Arch Dis Child recently – partly ’cause I’d no idea what diosmectite was, and partly because I spend a lot of my time with folk who poo too little or too much. When taking a look at a systematic review, […]
How do you add up if there are no numbers: Qualitative Synthesis
Regular readers of this blog will know of its penchant for systematic review techniques (evidenced in the recent I-squared blog ). The process of qualitative synthesis uses many of those familiar methods – defining a clear question, systematic literature searching, selecting appropriate research and assessing the risk of bias. Following this, however, qualitative syntheses begin […]
What about mixedupness?
The subject of heterogeneity (mixed~up~ness) in systematic reviews is tricky. A bit like ‘significance‘ you can think about it as both a clinical and statistical concept, and in the same way, you can get results that aren’t always concordant. Many old lags will remember a blog post about a statistically significant association between platelets and renal […]
When is enough enough?
I know that’s a tricky question, and may make you think of cream pouring on apple crumble, discussions about chemotherapy, or episodes of Octonauts depending on exactly what frame of mind you’re in and background you have. Within a research setting, however, how do we decide when something has been researched so much and folk have […]
When did you last ask about the manufacturer?
It’s been a week of finding out things I didn’t know I didn’t know about. iCarly, for one. Life expectancy in young people with deliberate self harm for another. And fake medicines. […]
What would you like (for Christmas / Birthday / Leaving present …)?
Now, when you’ve got someone who’s older than – say – five, and you’re not Santa … actually, even if you are … and they have a gift-related event coming up, you tend to ask them what they might like for a present (if you’re in the UK). (If you’ve not had this experience, you […]