We’ll all remember that we are meant, with grown-ups, to allow the patient to make a choice about their care. When the patient is not really due to be in the atmosphere for another 2 months, and hasn’t quite learned to open its eyes rather let alone discuss UVC vs Groshong lines, then we’re sort […]
Category: archimedes
Basics. NNT
The NNT – number needed to treat – is thought by many to be a central core of EBMing. (I’d argue that the numbers in EBM are only a small part of the equation – and that understanding the question and the biases inherent in the study design are greater – but I’d still agree […]
Basics: Where’s the art of medicine in EB medicine?
It’s suggested, often by those who are faced with EBM as a rather coarse stick waved to stop them acting in one way, or to force them to act in another, that practicing EBM destroys any ‘art’ in medicine. I’d argue that it integrates and emphasises the need for art. The three-ringed combination of good […]
Populations matter
So, as I occasionally bang on about, I spend a fair bit of time with children and young people with cancer. We do a lot of transfusions of blood components in this population, frequently because we heartlessly pour toxins into them in order to try to kill of their malignancy. We’ve been debating hard recently […]
Basics. Size vs. bias
There’s a beautifully clear explanation behind the BMJ-EBM-journal paywall of a concept I’ve been struggling to express for some time, which is partly there in GRADE and partly grounded in common sense. Take the parachute argument — do you really need an RCT for parachutes (as there are survivors of non-‘chuted falls) — and reductio ad […]
Basics. What is evidence based medicine?
Evidence based medicine – EBM – is a framework for thinking. It’s a process. It’s a method. It’s taking the most unbiased, patient-oriented, clinically relevant research, combining that with the wishes and opinions of the child/young person and family before you and integrating your own skills, expertise and resources to co-produce the most appropriate decision […]
Trial registration. Free, easy and important.
As part of our commitment to the International Committee on Medical Journal Editors, we at the Archives of Diseases in Childhood have supported the idea that all trials with a health-related outcome should be registered before they are undertaken, and made it obligatory for trials in our journal. The reason for this is clear – […]
#TakeoverDay 2013.
Do you know a young person who would want to blog to a worldwide group of children/young people’s clinicians? Run the twitter account of an international journal for a day? Next Friday, 22 November 2013, is the Children’s Takeover Day 2013 in the UK and we at the Archives of Diseases in Childhood, despite the fusty […]
Knowledge translation – making it happen
There’s a really clear and neat idea that researchers do research, which gets published, and clinicians take this and do it in their practice. We know this isn’t true. But how to make the translation from study/publication at the clinic, onto the wards or out into the community is tricky. Prof Trish Greenhalsh gave a really […]
Debating devices
It’s really hard to persuade people that devices need evaluation like drugs do. This might be to do with the physical nature of a device: after all, if you can see the new cannula attachment, or special breathing mask, you know what it’s doing and what it must be making. Or it might be in […]