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Web
Site Entry for Medical Students
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Your
feedback is welcome.
email@improvingmedicalstatistics.com
Medical studies from the perspective of a medical
student:
There is an overwhelming amount of information coming your way. Simply reading the conclusions in the abstract of a study represents an
accomplishment.
There may come a time, though, when a particular major clinical trial directly affects your chosen field of medicine in a substantial fashion. That will be the time that you may want to critically review a trial in detail.
This web site contains examples of medical studies with significant problems in statistics or properly formulated conclusions.
The goal of this web site is to encourage a discerning eye towards medical studies. Many studies are quite well done. Unfortunately, a number of medical trials come up with conclusions that will not withstand the passage of time.
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WEB SITE
TOPICS OF POTENTIAL INTEREST FOR MEDICAL STUDENTS:
1. A suboptimal study regarding the effects of oat bran (a soluble fiber):
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.
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?
4.
Can a meta-analysis be biased?
You
decide in 30 seconds download
(pdf files)
Limitations of Meta-analysis: overview: download
5. Are
Geminis really different?
Inappropriate subgroup analysis is a recurring temptation in the medical
literature. The Hazards of Subgroup Analysis
6.
List of questions to consider
regarding the reliability of a clinical trial.
7.
Large randomized clinical trials and meta-analyses will define the guidelines
for care in your future field of medical practice. The following topics may help in understanding of some of the issues involved in these type of studies.
Limitations
of Meta-Analyses
Often
a meta-analysis is thought of as the final word concerning a medical topic. A
meta-analysis can be performed in an optimal fashion or quite poorly. This web
site looks at this issue from a perspective that may not be readily available
from other sources.
A Tale of Two Large Trials
A
very well done large randomized trial is compared to a poorly interpreted large
clinical trial. Both these trials have and will affect clinical practice
guidelines.
The Very Large Randomized
Clinical Trials (Strengths and Limitations)
Appropriately,
clinical practice guidelines are being driven and defined by large randomized
trials. However, not all large randomized clinical trials have conclusions
which are valid. In addition, the degree to which the specific trial protocol
can be generalized and to what specific patient populations are two issues that
always need to be defined.
Good luck in your clinical
careers. You will see some of the truths of clinical practice taught today
overturned by subsequent, more definitive clinical studies. Well constructed,
conservatively interpreted studies will reduce the number
of clinical u-turns
clinicians will need to make in the future. Demand nothing less.
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