Every now & then you bump into something that makes your heart sing. For me, I sometimes struggle to come up with good examples of an ‘EBM’ tennet – for instance, the difference between statistical and clinical significance – which has an actual origin. Well, in a paper entitled Platelet Counts in Children With Henoch–Schonlein Purpura—Relationship […]
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StatsMiniBlog: Will Rogers Phenomenon
The American humorist, Will Rogers, was reported to have said (of the migration of folk from Oklahoma to California): When the Okies left Oklahoma and moved to California, they raised the average intelligence level in both states While this is a deeply unkind comment reinforcing geographical stereotypes, it does a neat job of capturing an […]
Deliberation and determination
What does it mean to have a choice in your care? It’s an interesting question, I think. And may not be as neatly answered as the pat response to an exam: “for example, let the child choose which book to look at while you do the venipuncture!. If you can’t influence the final yes / no […]
Guest Blog: Beyond the stereotypes – getting to the heart of medical management
When you think of a manager, what image springs to mind? For me, earlier in my career, I may have pictured Montgomery Burns, the quintessential evil capitalist manager of Springfield Power Plant in ‘The Simpsons”, or David Brent , the hilariously incompetent regional manager of Wernham Hogg, in “The Office”.. Perhaps our opinions are influenced […]
Urban Road Speeds – any of our business?
There’s a growing movement in the UK – and around the world – to reduce urban speed limits. New York City recently reduced their limit to 25 mph, to quite a lot of chatter. Some UK cities are considering extending small 20 mph pilots to cover larger areas. Is it something we should be supporting? […]
Should we stand up for parity of esteem wherever we see it?
We have worried on here about parity of esteem between physical and mental ill health previously, and there’s a generally increasing feel that we health types should be whistleblowers when we see foul play. So if we see an example of mental ill health being treated poorly in comparable to physical illness, should we be blowing a whistle on […]
The crumbling of the pyramid of evidence
The ‘old way’ of thinking about the hierarchy of evidence was classically envisaged as a systematic review at the top, falling through RCT, cohorts and case-control to expert opinion (and below that, in some iterations, case law & legislative decisions). There’s been a move against this, with the GRADE system as explained recently in our popular […]
Always question your question
I was recently at a wonderful conference in Toronto, where 1900 folk interested in childhood cancer came together to learn, argue, network, present and be merry – #SIOP2014. There was a particularly interesting debate between two very clever oncologists about whether or not we should use antifungal prophylaxis in children with AML and post-stem-cell-transplant. (Both are […]
Guest post: The Systematic Review Speaks The Truth …… Or Does It?
A good quality systematic review should identify and synthesise all the available evidence, for a particular question, through meta-analysis. Conclusions can then be made about the effect of the intervention on the outcome. As, in theory, all the available evidence is gathered and assessed, surely the conclusions from the meta-analysis must be the truth and […]
Explosive!
Well, I thought that was a better title than ‘Volatility’ which, to be fair, is closer to what this meandering post is all about. When we’re struggling our way through medicine, we have to face all sorts of uncertainties. Some of these are the frank face of ignorance (we just don’t know something), some of […]