Beruflich Dokumente
Kultur Dokumente
Dr A C J Hutchesson
Chair of Examiners’ Panel, FRCPath
(Clinical Biochemistry)
So’s my horoscope.
Consider …
• Validity
– Has the research been conducted in such a
way as to minimise bias?
• Results
– If so, what do the results show?
• Relevance
– What do the results mean for the particular
patient or context in which a decision is being
made?
• Clearly stated?
• Importance? (e.g. majority or minority of
patients?)
• Change in standard treatment since
study commencement?
Validity - Research question
• Karl Popper
– Hypothesis testing
• Experimentum crucis
– E.g: homocysteine and heart disease
• “Black swans”
Validity - Subjects
• Inclusion/exclusion criteria?
– Uniform group/avoid confounding factors
– Clinical validity/recruitment rate
• Accurate, precise?
– E.g: BP measurement
• Confounding factors?
• End-point v. surrogate?
– E.g: carotid IMT v. CHD mortality
HbA1c v. complication rates
• Relevant?
Results - Analysis
• Intention-to-treat
• Appropriate statistics?
– Parametric v. non-parametric
– Univariate v. multivariate (?model)
– Multiple comparisons
• p-value v. effect size (CI, OR, NNT, etc)
Results - Presentation
• Numbers screened, randomised,
completed
• Results:
– Descriptive statistics
– Figures, diagrams, charts
• Absolute v. relative change
– E.g: 25% increase: - 20% 25%?
0.04% 0.05%?
Relevance
• Population studied?
• Implications of results?
• Balanced interpretation
• Other studies - agreement and differences
– What is already known?
– What does this study add?
Checklists
Systematic review
Meta-analysis