NewEngland

Guest Skeptics: Clay Odell. Clay is a paramedic and Executive Director of Upper Valley Ambulance, a regional EMS system covering nine communities in rural New Hampshire and Vermont. He’s been involved in EMS for over 30 years in a variety of roles including urban paramedic, flight paramedic, an emergency nurse, and Chief of the State EMS Office in New Hampshire. Clay is very interested in EBM for EMS and says he’s trying really hard to learn, but continues to procrastinate about actually taking a statistics course again.  

 

Positron emission tomography (PET) scanning immediately after chemotherapy for Hodgkin’s lymphoma can identify patients who are likely to have good survival without radiotherapy, a study reported in the New England Journal of Medicine has found.1  

After ammoniagenesis, ammonium is taken up into the medullary interstitium via a process called medullary recycling. It is then pumped back into the tubular fluid at the level of the collecting duct, where it undergoes what is called ammonium trapping after which it is excreted.  

Extensive catheter ablation is no more effective than more targeted ablation to isolate the pulmonary veins in reducing the rate of recurrent atrial fibrillation in patients with persistent atrial fibrillation, a trial reported in the New England Journal of Medicine has found.1  

Therapeutic hypothermia, in which the whole body is cooled, does not improve survival or reduce brain injury any more than normal temperature control in infants and children who have had a cardiac arrest out of hospital, shows a study reported in the New England Journal of Medicine.1  

In an editorial introducing a series of articles looking at the relationship between industry and academia, the New England Journal of Medicine’s editor, Jeffrey M Drazen, asks whether medical journals have made it too hard for researchers to write review articles and editorials.1  

In an editorial introducing a series of articles looking at the relationship between industry and academia, the New England Journal of Medicine’s editor, Jeffrey M Drazen, asks whether medical journals have made it too hard for researchers to write review articles and editorials.1  

Much of the variation seen in outcomes among infants born at 22, 23, or 24 weeks of gestation can be explained by differences in hospitals’ practices on whether to initiate active treatment to save the lives of these extremely premature newborns, concludes a new study in the New England Journal of Medicine.1  

Giving cardiopulmonary resuscitation before emergency medical services arrive more than doubles the 30 day survival rate in people who have a cardiac arrest out of hospital, shows a Swedish study reported in the New England Journal of Medicine.1  

A combination of two drugs used to correct levels of the transmembrane protein that is defective or deficient in cystic fibrosis significantly improves patients’ lung function, show the results of two randomised studies published in the New England Journal of Medicine.1  

A combination of two drugs used to correct levels of the transmembrane protein that is defective or deficient in cystic fibrosis significantly improves patients’ lung function, show the results of two randomised studies published in the New England Journal of Medicine.1  

Removing additional tissue around the cavity left after excising a tumour during partial mastectomy in women with early breast cancer halves the rate of positive margins that require further surgery, a randomised study reported in the New England Journal of Medicine has shown.1  

0 Introduction 0 Recently the New England Journal of Medicine launched a media campaign challenging the negative perception of industry conflicts of intere  

 

Liraglutide significantly reduces body weight and improves metabolic control in people who are obese or overweight and have dyslipidaemia or hypertension, a randomised trial reported in the New England Journal of Medicine has shown.1  

Percutaneous transluminal angioplasty using a paclitaxel coated balloon notably improves arterial patency at one year when compared with the same procedure using a standard uncoated balloon in patients with femoropopliteal artery disease, a study in the New England Journal of Medicine has shown.1  

Initiating antiretroviral therapy immediately after HIV diagnosis rather than waiting until a patient’s CD4+ count has declined is of considerable benefit, a large international study published in the New England Journal of Medicine has found.1 The results of the study were also released at the International AIDS Society conference in Vancouver, Canada, on 20 July.  

The following institutions cooperated in this project: Beth Israel Hospital, Boston, Massachusetts; Boston City Hospital, Boston, Massachusetts; Brigham and Women's Hospital, Boston, Massachusetts; Baystate Medical Center, Springfield, Massachusetts; Hartford Hospital, Hartford, Connecticut; Memorial Hospital, Pawtucket, Rhode Island; Memorial Hospital, Worcester, Massachusetts; Mount Auburn Hospital, Cambridge, Massachusetts; New England Medical Center, Boston, Massachusetts; Rhode Island Hospital, Providence, Rhode Island; St. Vincent Hospital, Worcester, Massachusetts; University Hospital, Boston, Massachusetts; University of Massachusetts Medical Center, Worcester, Massachusetts; Worcester City Hospital, Worcester, Massachusetts; and Veterans Affairs Medical Center, Boston, Massachusetts.  

The field of medical statistics is poorly understood by many doctors and by most patients. An article in the New England Journal of Medicine that surveyed over 100 articles published in reputable medical journals stated that over 50% of them used medical statistics incorrectly, and furthermore stated that this misuse invalidated the clinical conclusions of many of these articles. In this blog I will not discuss esoterica such as when to use a two-tailed t-test rather than a one-tailed test, or the uses and misuses of the Cox regression analysis. Instead I will try to point out fallacies in reasoning and statistics that should cause you to doubt a result quoted in the journal or in the newspapers.