maggiekb — 2014-04-03T09:47:40-04:00 — #1
boundegar — 2014-04-03T09:55:02-04:00 — #2
I don't understand how they're going to control out the placebo effect.
karls — 2014-04-03T09:57:27-04:00 — #3
Now we can look forward to all those who interpret this as an argument in favor of alternative medicine.
chgoliz — 2014-04-03T10:10:01-04:00 — #4
And it wasn't even published on April Fools Day. Did it win an IgNobel prize?
samsam — 2014-04-03T10:29:19-04:00 — #5
Not precisely a joke study -- seems to be more of an argument through a satirical push-back against the idea that randomized studies should always be required.
What this study adds
Individuals who insist that all interventions need to be validated by a randomised controlled trial need to come down to earth with a bump
A call to (broken) arms
Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions[...]
othermichael — 2014-04-03T10:57:34-04:00 — #6
Homeopathic Parachute never failed me yet!
clamb — 2014-04-03T11:18:31-04:00 — #7
Parachutes should've been tested on rats before proposing any human experiments.
dobby — 2014-04-03T12:03:58-04:00 — #8
Sometime in the 1780s the first parachutes were tested by dropping equipped dogs from a hot air balloon.
jasonpj — 2014-04-03T13:02:50-04:00 — #9
I believe it was publish originally published in the British Medical Journal in December of 2003
nixiebunny — 2014-04-03T13:05:17-04:00 — #10
Having a kid who got through leukemia ten years ago by virtue of horrific chemotherapy treatment, I was naturally driven to read about the history of said treatments. Back in the old days of the fifties and sxties, when the odds of recovery for a leukemia patient were basically zero, people were willing to try just about anything.
So they did try a lot of things that failed, but a few things worked... for a while. It took a couple decades of trying before they got to the point they are at now, where kids tend to survive more-or-less intact. So, finally, the ideas expressed in the above-mentioned paper have become meaningful in the study of this disease.
nojaboja — 2014-04-03T13:53:23-04:00 — #11
Like so many things in life this is far from black and white and the point made here is far from a joke.
While the number of randomised clinical trials grew from fewer than 500 per year in 1970 to 15,000 in 2006, still less than 0.1% of patients are enrolled in these formal clinical studies. Those enrolled are not likely to be representative of the larger patient population, so those in medicine cannot honestly say that they learn much about the effects of a procedural, clinical, or pharmaceutical intervention for the remaining 99.9%. Sidney Dekker (2011) Patient Safety.
Meaning: phenomenology and the personal experience of both clinicians and the patients plays a far more significant role in the everyday practice of medicine than evidence gathered in randomised trials ever can in the foreseeable future. We have to recognise that medicine will never achieve the levels of evidence accepted and expected in aviation where 99.9% of flight data is monitored and therefore 99.9% data is available for analysis compared with the 0.1% in medicine. And mysteries still remain
For those of us working in medicine, trying to improve the safety and quality of care, the current battle is to a large extent about re-allowing for common sense i.e. evidence gained by experience into the clinical setting. The trend is to dismiss human judgement (is it or is it not safe to jump?) and justify every decision by often dubious "evidence."
Yes, there is a desperate need to create space and time for reflective practice to counter balance the many psychological biases which creep into professional practice and skew judgement but let's not kid ourselves evidence from randomised trials can only be relevant on the margins of medicine.
Maggie, please, re-read this article knowing that those making funding decisions in health care do believe that
"It is a truth universally acknowledged that a medical intervention justified by observational data must be in want of verification through a randomised controlled trial." (page 1459)
And nowhere more so than when it comes to women's bodies i.e. obstetrics!
samwinston — 2014-04-03T16:47:41-04:00 — #12
And soon after they added cats and a familure phrase was born.
jons — 2014-04-03T18:24:16-04:00 — #13
Yep. That's what it says at the bottom of each page.
othermichael — 2014-04-04T15:09:41-04:00 — #14
I believe they were tested on Frogs.
clamb — 2014-04-05T13:08:21-04:00 — #15
Well, that certainly explains the rains of frogs falling from the sky recorded in history. They must've been failed parachute tests. You'd expect them to test them on a smaller number though.
maggiekb — 2014-04-08T09:47:53-04:00 — #16
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