Which O for PICO?

  We’ve mentioned before about the COMET initiative, that was born from lots of work in rheumatology, and seeks to standardise a core set of outcomes collected in clinical trials so that the trial Measures things of importance to patients, clinicians and researchers and Provides a degree of homogeneity that makes systematic reviews more powerful […]

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A picture paints a thousand words

  Pretty much sure that you’ve all hit something complicated and, after trying to explain it, have grabbed pencil, paper and said something like “Look, you see, it’s …”   And your picture may be completely unlike the thing you’re describing.   Well, hot on the tails of our Archi blog about the challenges with […]

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Words, listening, and the art of applying the general to the specific

A little bit of a swirl around a decade-old paper by @iona_heath on the trouble with turning a patient’s experience into something that might require medically fixing that was floated about twitter recently. The paper, which is densely written and has lots of lovely quotes from proper writers, and speak of many aspects of doctoring, holds to a […]

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StatsMiniBlog: Kappa

After a short pause while brain cells were diverted elsewhere, we’re returning with the critically acclaimed (well, slightly positively tweeted) StatsMiniBlog series. (As an aside – do let me know via comments, Facebook or Twitter if there’s an issue you’d like to see covered) Kappa (κ) is a measure of agreement, usually between two observers […]

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“Compared to standard care”

There’s a decent argument in the analysis of quantitative studies of therapies, particularly using RCT designs, that says that we should be looking at the totality of unbiased evidence (systematic reviews) rather than looking at individual, cherry-picked, studies. The best estimate from this come from a pooling of all the results: meta-analysis. There’s a challenge to this, […]

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The despair of the box-ticking paediatrican

So, as the annual assessment of learning by paediatric trainees reached fever pitch in many ares of the UK, a question rang out across Twitter: In (trainees approaching ARCP), does (shoehorning logbook to curriculum) compared to (reflecting on clinical experiences) improve outcomes? And while this, I feel, is more of an emotional outpouring to garner […]

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StatsMiniBlog: Rethinking meta-analysis

The concept of meta-analysis was addressed previously, essentially pulling together data from a range of different studies and assuming that they are only (fundamentally) different by chance, or differ by real things too as well as chance, and you’re seeking an average effect across the average of these differences. The maths under this takes each study as […]

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When a test isn’t a test

There are many reasons why we request tests, in medicine. One imaginary patient’s journey picks up a number of them. Take a patient who presents with a painless lump on their arm, who’s tired and a bit pale & washed out. You might send a series of blood tests, including a full blood count to […]

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