As people living in pain, our arguments and comments are more effective if we show that we know what we’re talking about.
It may not change someone’s mind if they are opiophobic or dislike and distrust people in pain, but it’s important to try.
These are some of the terms the public and people in pain need to understand: Continue reading
This article makes the increasingly forgotten, yet increasingly important, point that population statistics do NOT apply to individuals.
There was a time when the foretelling of future events was an undertaking of prophets, palm-readers, and weathermen. In recent years, however, the medical profession seems to have embraced this activity with a great deal of enthusiasm.
But hyperbole is also what comes to mind when one examines the claims that authors of such reports make. Continue reading
…I thought perhaps this was a time to explain systematic reviews (SR) and their closely related kin, the meta-analysis (MA).
Keeping up with the latest thinking and knowledge, even for specialists, is challenging.
Textbooks, given the time necessary to write, edit and print are repositories for the accepted ‘dogma.’
Journals and conferences bring new information forward more quickly. But even then it is difficult for individuals to synthesize multiple articles and sources to ‘know’ what is both correct and useful. Continue reading
Surrogate end points in clinical research: hazardous to your health. – PubMed – NCBI – Obstet Gynecol. 2005 May
Surrogate end points in clinical research pose real danger.
A surrogate end point is an outcome measure, commonly a laboratory test, that substitutes for a clinical event of true importance.
Resistance to activated protein C, for example, has been used as a surrogate for venous thrombosis in women using oral contraceptives.
Other examples of inappropriate surrogate end points in contraception include the Continue reading
In every industry, from education to healthcare to travel, the generation of quantitative data is considered important to maintain quality through competition.
Yet statistics rarely show what they see.
If you look at recent airline statistics, you’ll think that a far higher number of planes are arriving on schedule or early than ever before. But this appearance of improvement is deceptive.
Airlines have become experts at appearance management: by listing flight times as 20-30 percent longer than what the actual flight takes, flights that operate on a normal to slightly delayed schedule are still counted as arriving ‘early’ or ‘on time’. A study funded by the Federal Aviation Administration refers to the airline tactic as schedule buffering. Continue reading
Though this is an actual course, I found it useful as a quick reference when I wanted to understand some aspect of statistics being using in a study. Below, I’ve listed direct links to the 19 chapters/topics of statistics used in clinical trials.
This course is a survey of statistical methods and study design issues related to the testing of medical treatments.
Patients are deceived by the slick presentation of statistics – Michael Kirsch, MD | Physician | July 15, 2016
This article explains how drug companies use statistics to fool us into believing their products are effective.
“There are three kinds of lies: lies, damned lies, and statistics.”
Massaging numbers is raised to an art form by the pharmaceutical companies who will engage in numerical gymnastics to shine a favorable light on their product. Continue reading
Scientific thought abolished foolish superstition, yet somehow the over-reliance on measurement and mechanization also had a downside.
The Enlightenment project, dominant in Western thought since the Medieval Age, created a new scientific future where mechanization and measurement improved innumerable lives. Yet, the elimination of magical thinking also created a sterility of thought that enabled Nazism in Europe.
“Sterility of thinking” is a good phrase to describe how medicine has evolved into a metric-driven semi-automated algorithm-based practice. Metrics are guaranteed not to be sensitive or caring, yet that’s exactly what we need from our doctors. Continue reading
A new study published in the Journal of Urban Health could have a significant impact on the way heroin overdose cases are counted and may dramatically increase the number of reported heroin-related deaths across the country.
Researchers at the IU School of Public and Environmental Affairs at Indiana University-Purdue University analyzed accidental opioid overdoses in Marion County, Indiana, from 2010 through 2015 and discovered that deaths where heroin was present may be significantly undercounted. Continue reading