{"id":733,"date":"2013-10-02T21:52:49","date_gmt":"2013-10-02T20:52:49","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc\/?p=733"},"modified":"2013-10-02T21:59:52","modified_gmt":"2013-10-02T20:59:52","slug":"debating_devices","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2013\/10\/02\/debating_devices\/","title":{"rendered":"Debating devices"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" alt=\"\" src=\"http:\/\/www.sudburyshrineclub.com\/images\/EOS%20imaging.jpg\" width=\"125\" height=\"188\" \/> It&#8217;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&#8217;s doing and what it must be making. Or it might be in the immediate satisfaction of a result, seeing the saturations rise or the respiratory rate decrease. Or it might be in the overwhelming common sense of the physiology\/biomechanics\/clinicopathological reasoning. But whatever the cause, it&#8217;s really tricky to have such things evaluated.<br \/>\n<!--more--><br \/>\nThere&#8217;s a device which takes special weight-bearing X-rays of the spine for scoliosis assessment, and provides fewer x-rays than a CT scanner. It&#8217;s terribly expensive. And the evaluations which have been undertaken of it are &#8230;troublesome. They establish neatly its technical success, but don&#8217;t go on to assess if it actually makes a difference to patients [<a title=\"Systematic review of EOS\" href=\"http:\/\/link.springer.com\/article\/10.1007\/s00586-012-2469-7\">1<\/a>] Of course, the failure to use patient-important outcomes and an obsession with measuring the measurable is not exclusive to x-ray machines or devices [<a title=\"Idolatry of the surrogate\" href=\"http:\/\/www.bmj.com\/content\/343\/bmj.d7995\">2<\/a>] \u00a0but we really should remember to be increasingly cautious the more we move away from a <a href=\"https:\/\/stg-blogs.bmj.com\/adc\/2010\/03\/10\/what-would-jack-want\/\">real-person outcom<\/a>e and the closer we get to a machine-read outcome.<\/p>\n<p>&#8211; Archi<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>It&#8217;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&#8217;s doing and what it must be making. Or it might be in [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2013\/10\/02\/debating_devices\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[79],"tags":[],"class_list":["post-733","post","type-post","status-publish","format-standard","hentry","category-archimedes"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=733"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/733\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=733"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=733"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}