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Mashup Score: 5The Petty/Bone RCT - 28 day(s) ago
Yes. The Petty/Bone RCT is a term used for a unique pathological modification of the RCT which dominates critical care science. Two USA pulmonologists, Thomas Petty (1960s) and Roger Bone (1980s) developed the idea. The PB RCT applies a research shortcut which allows easy case finding and the use of a single RCT to test a treatment on a variable mix of different (but similar appearing) diseases called “heterogenous syndromes” (ARDS, Sepsis, AKI). This PB RCT shortcut has been the standard …
Source: discourse.datamethods.orgCategories: General Medicine News, Critical CareTweet
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Mashup Score: 25Problems with NNT - 10 month(s) ago
In talking to a patient or in making grand policy decisions, when the likely benefit of a treatment is being considered, it is wise to utilize both relative (e.g., hazard ratio) and absolute treatment effects. For the latter, two classes of effects are the life expectancy scale and absolute risk reduction (ARR). Many clinicians are taught to translate ARR to the number needed to treat to save one life or prevent one clinical event — the NNT. There are many reasons that I dislike the NNT. I t…
Source: discourse.datamethods.orgCategories: General Medicine News, Hem/OncsTweet-
Problems with NNT https://t.co/63iUriNfPi via @f2harrell
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Mashup Score: 25Problems with NNT - 10 month(s) ago
In talking to a patient or in making grand policy decisions, when the likely benefit of a treatment is being considered, it is wise to utilize both relative (e.g., hazard ratio) and absolute treatment effects. For the latter, two classes of effects are the life expectancy scale and absolute risk reduction (ARR). Many clinicians are taught to translate ARR to the number needed to treat to save one life or prevent one clinical event — the NNT. There are many reasons that I dislike the NNT. I t…
Source: discourse.datamethods.orgCategories: General Medicine News, Hem/OncsTweet-
Problems with NNT https://t.co/63iUriNfPi via @f2harrell
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Mashup Score: 3Random vs. fixed effects meta-analysis - 11 month(s) ago
Extremely helpful again. My informal take on the Ivermectin literature, having been one of the lead statisticians on two Ivermectin RCTs, is that Ivermectin has a beneficial effect that happens to be very small, almost inconsequential. This matches a meta-analyses of RCTs we were not involved in. We need to do more inference on a clinical scale. In our case we compute a Bayesian posterior probability that patients recovered from COVID-19 more than 1/2 day quicker with Ivermectin than with pla…
Source: discourse.datamethods.orgCategories: General Medicine News, Hem/OncsTweet-
RT @PavlosMsaouel: Further discussion on this topic in the #DataMethods forum here: https://t.co/kQQfgFikyA @f2harrell @Lester_Domes
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Mashup Score: 2
Editorial Notes As Sander Greenland has so well stated below, this initial draft was still too “dichotomous” in that it was written assuming we would have different language for “positive” vs. “negative” studies. This implies a threshold for “positive” which is what we’re trying to get away from. So I’m trying to develop more “positive/negative agnostic” language. One initial stab at this is below in the Generic Interpretation section. The examples demonstrating incorrect and confusing sta…
Source: discourse.datamethods.orgCategories: General Medicine News, Oncologists2Tweet-
RT @5_utr: Great discussion here https://t.co/xegK860Kf2
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Mashup Score: 9Individual response - 1 year(s) ago
I can see how important patient/treatment qualitative interactions could be missed as a result of poor RCT design (e.g., inappropriate “lumping” of patients in disparate clinical states into a single trial). Failure to do adequate preparatory study to optimize disease definition, trial inclusion criteria, and measurement tools would be analogous to a drug company skipping preclinical or early phase clinical studies and jumping to phase III- the chance of success would be very low (see below). I…
Source: discourse.datamethods.orgCategories: Cardiologists, Latest HeadlinesTweet-
RT @f2harrell: Great discussion at https://t.co/nvDWNyxfyR . "the counterfactual approach requires a faithful belief in metaphysical obje…
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Super important concept to understand, both for clinicians reading papers and for researchers doing them. https://t.co/StZvcXrPKU thanks @PatientStormDoc