It’s worth taking some time to return to basics every now and again, and one thing that continues to befuddle medics the world over is the issue of ‘statistical significance’. […]
Category: critical appraisal note
Do children and adults really differ?
@giordanopg recently tweeted a link about a paper in pre-publication from The Journal Of Pediatrics. It’s an analysis of a bunch of Cochrane reviews that had both child and adult RCTs included in a meta-analysis and asked the question “Do children and adults really differ?” Their technique was to compare the key outcomes by comparing […]
What would Jack want?
Or perhaps it should be ‘What would Mohammed want?’, or Alyx, or Devine, or Vladimir … when we’re asking clinical questions, do we really think what outcome our patient and family want, or do we just think what we think they would want? To put it another way – how close are the outcomes that […]
FAST appraisals
I’m fairly sure you’ll remember the RAMbo method of reviewing the validity of single randomised controlled trials. And so I think that many readers will have been having sleepless afternoons, struggling through the lengths of a ‘User’s Guide’ checklist for systematic reviews thinking “Which action hero can rescue me from this mire?”. Or perhaps not. […]
Trials are not needed
Sometimes, EBM is accused of being slavishly devoted to the Randomised Controlled Trial. This is clearly garbage if you look to answer a question outside of therapeutics: see our Archi posts on diagnosis and prognostication, for example. But even within the setting of picking the right treatment for the patients you see, the RCT is […]
Finding the question
It’s one of the tenets of the evidence-based practice process that questions are framed as ‘PICO’: patient, intervention, comparison and outcome. But what happens when the question is bigger than PICO? […]
Move over reading, ‘riting and ‘rithmatic …
“The 3Rs are dead; long live the 3Rs.” So might a herald cry from the battlements of an evidence-based hill. Sharon Straus and Brian Haynes have captured beautifully the need to move beyond just publishing your paper to making evidence available that is ‘reliable, relevant, and readable’. Why these three Rs? […]
Why (wo)men always think they are right.
Have you ever been involved with a debate with a partner or colleague, travelling from one place to another, and when the course they took has got you to the destination safely, they turn to you and say “So, [add endearment here], you see my way was right.”? If you have, I doubt that you […]
Risk vs. prognostic factors
The separation of ‘risk’ factors and ‘prognostic’ factors at first seems the sort of obsessive fine detail that gives epidemiologists and statisticians a bad name. Sadly, the difference is actually worth understanding for any clinician that’s going to try to cut through an observational study and understand what it might be truthfully telling us. (This […]
Confused by confounding.
Sometimes we are in situations where we think that something causes problems, and we can’t do a trial randomising one group to get something which we think causes problems! How do we then go about finding out – how to we avoid the problems of ‘confounding’ – and what is that anyway? For example, think […]