Looking backwards, a whole bunch of studies which were undertaken may be seen as either astoundingly obvious, or startlingly pointless. Why on earth, for example, would you want to trial the effects of dexamethasone in suspected preterm labour, or see if doxorubicin was a useful to drug in treating sarcoma, in the 21st century? The […]
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How much of a good thing do you need?
There could be a variety of answers to the title drawn from the repertoire of popular music, ranging from a dusting to a life embodied. In the setting of evidence-based medicine … like almost every question that’s asked … the answer is probably “It Depends”. If our question regards the use of a significantly toxic […]
Learnable moments
Sat in my garret, I have only the palest of similarities to Virginia Woolf, but a space to think and reflect as the UK pandemic moves on is a definite opportunity. The common description of evidence-based medicine commences with ‘Ask A Clinical Question’, but omits the step before that; ‘Be Uncomfortable With Your Knowledge’. Being […]
The problems and power of peer review
A traditional approach to assuring oneself of quality of a journal article was to look at the reputation of the journal (via the impact factor, perhaps) and an assurance of peer review. The process of peer review may be poorly understood and shrouded with a cloak of mystery, and papers emerge from it with a […]
How to manage babies born to mothers who test SARS-CoV2 positive
Bright New Beginnings For me, one of the most emotionally taxing thing about the SARS-CoV2 pandemic infection control precautions in the challenges at the start and end of life. To be the parent of a child who dies at this time must bear additional agonies, and the joy of a new birth may be tempered […]
Words matter
We’re pretty much fans of being clear when we discuss evidence based practice, clinical things and research topics. Being understood, sharing meanings and having a consistent view is hugely important, and we keep being told (and although silently questioning the methodologies, believe it to be true) that the majority of complaints are about failures of […]
Uncertainty, imprecision, and unknowing
Now it might not be quite the right way of describing the challenges in communicating what we don’t know, but I find we can often tie ourselves up in knots when it comes to explaining our lack of knowledge about an effect or prognosis. Take a child with a new diagnosis of metastatic rhabdomyosarcoma. We […]
Big events and the problems of predictions
We’d all like to know what will happen in the future. Well. In some circumstances. For some people. Sometimes. (I’d personally like to know where the Leeds Rhinos will finish next season, but less happy about knowing if and when I’ll become a Grandfather.) But this basic idea, knowing the answer to “If I do […]
Cut once, measure twice
As every child health practitioner knows, children’s telly is awash with moral learnings, repetitive messages and ear-worms. It can be a superb tool for the education and distraction of poorly children, and irritating barrier to bedtimes and homework, and a torture-device … try humming “Baby Shark” when you next go for your team coffee/drink and […]
GUEST POST: Primary Care Paediatrics…Is this the future for service provision?
As junior doctors, we often feel there is no time to effect change in a short rotation through a department. Having taken time out of training, I have had the opportunity to witness how change can, and does happen within the NHS. I’ve observed how one inspirational consultant working a rural DGH had the vision […]