Most of us agree that the fairest and more objective way to test if a treatment works is the randomised controlled trial (RCT). We may also agree that there are situations where a RCT is not feasible, practical or ethical, or situations where the effect is so obvious that you don’t need to test it. An […]
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Cracking the mould
While Archimedes does, not infrequently, get all concerned about invasive fungal infections, this post is not of the issue of beta-D-glucan testing, or problems of azole interactions. Instead, its a swipe at the problem of how, given a transparent system of asking questions, acquiring information, and appraising the evidence we can come to such […]
Should Archimedes be exiled?
Well … it never happened in antiquity. Archimedes got killed by an invading soldier. But back to Archi in the ADC – should we abandon this column as the articles are not ‘proper’ systematic reviews, or is a good short-cut review nearly as good as a 12-month long ‘full’ review? This is, as you would […]
It’s all the same
I am regularly faced with questions comparing two management approaches, and sometimes struggle to work out if the data which supports them shows that one thing is better, one thing is maybe not better, but not worse, that the two things are the same, or that we can’t really tell what the differences might be. […]
Tarnished gold
What can you do when a ‘gold standard’ isn’t actually that good at diagnosing a condition? It can be terribly problematic in interpreting sensitivity and specificity – for example comparing polymerase chain reaction diagnosis of microbiological infection with culture results. The ‘false positive’ may actually reflect real, and otherwise missed, diagnosis, and the ‘false negatives’ […]
Short-cuts to effectiveness information
A while ago Archimedes reviewed the benefits of using ‘pre-appraised’ search resources, short-cuts to the best methodological quality evidence to answer clinical questions. The favoured database of many, PubMed [www.pubmed.gov] has now receieved a new addition to the range of resources on offer. […]
When is a result not a result?
Hot on the heels of this great Archimedes on whether or not you should routinely do an LP in infants with a urinary tract infection, comes another publication, covered with a fairly critical review in Journal Watch. What’s fascinating here is both “sides” drawing a conclusion that they can’t draw. […]
Probiotics here, probiotics there, probiotics everywhere
Probiotics are everywhere these days. They are supposed to prevent all kinds of diseases, from infectious to immunological to allergic. Some of the claims have strong evidence, some not. A pilot study by Youngster I, et al, in which the role of probiotics before immunisations is studied, is yet another positive discovery, but there are […]
Slice, DICE and eventually something will happen
Did you know that aspirin following MI doesn’t work for those with Gemini and Libra star signs? No, it’s true*. The ISIS-2 trial, which demonstrated the mortality benefits for anti-platelet agents after myocardial infarction with a p<0.00001 only showed benefit for people born in ten of the twelve signs of the zodiac.So if you believe […]
Secrets and lies. Truth and beauty.
… and other Bohemian aphorisms … There is a quite brilliant paper from the under-advertised PLoS One which shows how, in the are of incubation periods for respiratory disease, Truth By Citation is quite strikingly different than the reality of the evidence. The networks of citations demonstrate how repetition, sometime but not always with a […]