Every now and then you’ll hit an EBM question, clinical dilemma or situation where you’ve got it at the back of your mind, or the tip of your tongue, you’ve seen something similar before. It may be a network meta-analysis, where people seem to have combined studies in a spidergram not a forest plot. A […]
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Underrepresentation
Not uncommonly, the issue of the generalisability or representativeness of a study population to the ‘real world’ is raised. There are some pretty big issues here, not least the idea that studies are undertaken in an unreal world, where troubles melt like chimney tops and sail above your lemon drops. Avoiding those sorts of mangled […]
Endocrinology is fun!
We hope that since the takeover of the @ADC_BMJ and @ArchivesEandP accounts by our social media team, you’ve enjoyed (and learnt something from) the flurry of thematic tweeting occurring each week as much as we have had generating them. The last week @ADC_BMJ has been focussed on the subspecialty of paediatric endocrinology and diabetes, and […]
Questions too tricky to answer
One of the challenges in seeking evidence to aid a difficult clinical dilemma is decided what the questions which are amenable to study might actually be. There are elements of the triad of clinical expertise, best-available research and patient situation and preferences which can only be brought by the individuals. There was a quote from […]
Confounded
There’s a lot of confusion on confounding. We need to understand confounding when we try to use non-randomised studies to see if doing a Thing is going to produce more good than harm, or looking for risk factors we then will hope to influence to produce goodness. If we look at observational data on time-to-diagnosis […]
Early adopter or reckless fool?
As we bang on about almost endlessly in Archi, we know that evidence is only part of a clinical decision. The story also includes the patient and their family, and sharing the decision is key to good medicine. There is the third leg on the tripod though – clinician expertise. In the simple iterations of […]
Guest Blog: 5 Tips Parents/Caregivers Can Use to Help Make Cancer Less Painful for Kids: #KidsCancerPain
Pain is one of the most distressing symptoms children living with cancer experience. It can be caused by the disease, procedures and side effects of medication. Pain can be pervasive and impact every part of a child with cancer’s life. Managing this pain has been shown to have a profound impact on a child’s health […]
Using the power of pathology
Back in the mists of pre-clinical training, I used to believe that disease states arose through disordered bodies. That illness was a disturbance of anatomy and physiology, and that by understanding the basics of normal, we could derive the pathological, and so predict the disorder and define the therapy. Then I learned of the influence […]
Incongruous
I’ve struggled with spelling for most of my life and in still occasionally do pronouncing terribly wrong. (For about 4 books, I pronounced Hermione “Hermy-one” in my head, instead of “Her-my-oh-knee”, for example.) So every time I see the word ‘incongruous’ I tend to get slight shivers of spelling-test related fear. It is, however, a […]
You can’t unknow it …
A pal of yours is told at a conference by a slightly drunk principal investigator about a drug trial, that’s been first-pass data cleaned and a basic analysis undertaken. The results are clear … even given the possibility of the effect shrinking with more complex adjustments … giving Drug A (the experimental use of an otherwise […]