You may have noticed a resurgence of interesting posts on this blog; it’s all part of an orchestrated campaign to get more paediatric clinical evidence discussion going. As part of that, Archi’s been touting for folk to write a couple of hundred words on something they’ve learned recently – a highlight – arising from evidence. […]
Latest articles
NSAIDs cause ulcers. Dog bites man?
There’s something to be said for papers that state the obvious. That’s generally that it’s not actually obvious until it’s been shown to be the case, ’cause it always might have been different. (For those of you who struggle with the idea about studying the obvious, have listen to this superb paper by Ruth Gilbert […]
Get it straight from the start
Over more than a decade Archimedes has presented clinical queries and the appraisal of the evidence that emerges. leading on to a clinical conclusion to the dilemma. What is strikingly common is that many questions can start in a muddle, and a failure to get an ‘evidence based answer’ might be a failure to ask […]
How do you improve services for Children
A paediatric tweeter, @kunbab (named with permission) working at intern/SHO level remarked on their frustration with the process of improving things in a workplace. They’d done something very simple; their patient had needed a referral, and so they’d emailed this referral to the relevant consultant. However, when their boss heard about this, the boss insisted on a paper […]
Best Practice – what would you like to see?
So, I’ve been commissioning a lot of new Best Practice articles – many of them in “15 minute consultation” format. Here’s my standard commissioning brief: Commissioning letter for Best Practice including 15 minute consultation papers My question is: What would you like to see as a 15 minute consultation paper? Bear in mind that I’ve […]
It’s getting better all the time
Well, it certainly appears to be, if you are lucky enough to be a clinician treating childhood cancers. That’s not to say that childhood cancer is in any way a ‘good’ thing to have, and not to understate in the slightest the unpleasantness of therapy. But things are getting better, and an extensive review by […]
Chorioamnionitis and NEC – the challenge of significant small associations
In a recent flurry of twittering, Archimedes noticed a meta-analysis linking chorioamnionitis with necrotising enterocolitis. Although a long time since doing neonates has passed, the consequences of NEC were profound enough to stick, and a potential association, perhaps a route in to stopping it happen, would be welcome. The meta-analysis showed that, on univariate examination, […]
New way to wee
There’s a paper in the Archives from January which presents a ‘new’ way of collecting urine from little babies. (I say ‘new’ as it is startlingly similar to the method employed by the Matron at my first SHO appointment, back in the last millennium, but this version is scientifically tested.) How should we, as clinical […]
Proof of equipoise
In order to test a new treatment, in a standard randomised controlled trial, we are ethically assumed to have ‘equipoise’: an honest uncertainty at the same chance of a patient being allocated to the new or old treatment. But, I hear you scoff, how can any investigator put themselves through the hell of ethical administration […]
When is it obvious?
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 […]