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Specific guide to this web site for:


 1.  Medical School
      Educators 
      in Statistics

 2.  Medical Students
 3.  Science media writers

 4.  High School & College
     Statistic Teachers


   Misadventures:


1. Harvard led MI study

2. JACC study 
   (J. of Amer. Coll.
   Cardio.)

3. NEJM cath study
4. Amer. J. of Cardio.
    review of literature
5. ALLHAT
     controversy 

6. Oat bran study
7. Pregnancy & Alcohol
8. Are Geminis really
    different?
      
9. Columbia 'Miracle' Study  
                                                 

Additional Topics:

Celebrex

Limitations of Meta-Analyses

Large Randomized Clinical Trials

Tale of Two Large
Trials

Advocate meta-analyses

Network meta-analyses


 

 

 


Media Guide to this Web Site

Your feedback is welcome:
email@improvingmedicalstatistics.com

Goals of this web site:

 The goal of this website is to increase awareness of what constitutes a valid and reliable medical study. By closely examining prior examples of poorly constructed and questionably interpreted studies, it is hoped that it will be easier to recognize limitations and pitfalls that may exist in current medical trials at the time they are being reported.

The center column of this web page is  a guide to some of the topics that may be of interest in this website.

Potential questions to consider asking of a medical study

1.  What did the trial actually prove and what part of the authors’ conclusions remains speculation?  (Conclusions that go beyond what the data warrants represent the most common problem in clinical trials published today.) 
2.  More questions
  

WEB SITE TOPICS OF POTENTIAL INTEREST FOR MEDIA:

Several topics are in download files:   click here

1.  A look at the study that ended the oat bran fad.
Death of the oat bran fad.  (Murdered by a poorly conceived study.)

2. Lessons from an unusual saga of possible fraud in the literature   The Columbia ' Miracle' Study

3. Celebrex:  How the initial article that admirably raised public awareness of the potential risks of Vioxx and Celebrex was right about Celebrex for the wrong reason.
What was invalid in the statistical analysis of the initial article in regards to the assessment of Celebrex?

4.  Inappropriate subgroup analysis is a recurring temptation in the medical literature. The Hazards of Subgroup Analysis 
(Are Geminis really different?)

5. ALLHAT Trial Critique.   The controversy that occurred immediately following ALLHAT trial publication was a marker for conclusions that extended beyond a reasonable and conservative interpretation of the data. ALLHAT trial critique

6.   The pregnancy and alcohol section is a bit of an eye opener in regards to the foundations of some of our general health recommendations.  The foundations of some of these recommendations may not be as secure as usually assumed. This area of the website discusses some of the strengths and limitations of epidemiologic research.   
Pregnancy and alcohol, what do some of the studies really suggest?

7. A list of questions to consider regarding a clinical trial

8.    A statistical analysis that was so bad that it may have led to improvement of a major medical journal. (A story of improvement.)

9. The Reparative Power of Science:  Revisit these controversies     "10 years later"

10.  Large randomized clinical trials and meta-analyses will define the guidelines for patient care. The following topics may help in understanding of some of the issues involved in these type of studies:

Limitations of Meta-Analyses
    A meta-analysis adds similar smaller trials together in an attempt to better assess the effects of a treatment.  Often a meta-analysis is thought of as the final word concerning a medical topic.  A topic that receives relatively little attention today regards potential weaknesses of meta-analyses.

The Very Large Randomized Clinical Trial (Strengths and  Limitations)
    (This type of trial is increasingly and appropriately used to make recommendations on how to treat patients.  Information on recognizing a well conducted large trial is presented.)

A Tale of Two Large Trials  
    A recent stellar large clinical trial is compared to a large clinical trial with poorly formulated conclusions. Both these trials effect current treatment guidelines for patients.

 Beware of Meta-analyses bearing False Gifts  
    A meta-analysis written by a strong proponent of one side of a controversy is particularly problematic

A few topics have download files in addition to the other information available: 

    The hazards of subgroup analysis. Are Geminis really different?    download (pdf) 

    Death of the oat bran fad    download (pdf) 

    The ALLHAT hypertension trial-- a detailed critique     download (pdf) 

    Is this meta-analysis biased?  You decide in 30 seconds.      download (pdf) 

     Celebrex-- an unreliable cross trial comparison      download (pdf) 

    An informal perspective on the sequence of events: A Perspective on Celebrex, Vioxx, and Naprosyn    download (pdf) 

    Miscounted and Misinterpreted.  How not to conduct a study.
             The NEJM cath study     download (pdf) 

    A Tale of Two Trials-  A superbly conducted trial contrasted to a suboptimally interpreted trial:
                  download (pdf) 

    Limitations of Meta-analysis: overview:       download (pdf) 

    Lessons from an unusual saga of possible fraud in the literature  
            The Columbia ' Miracle' Study       download (pdf) 

 

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