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In clinical trials, you can have it both ways

 "Were you in the vax group or the placebo?" It sounds like a simple question, that should have a simple answer, right? And usually it does. Unless it doesn’t. Welcome to the world of the cross-over trial!The garden variety randomized trial is a parallel or concurrent trial: people get randomized to one of 2 or more groups, and they continue on their...

Clinical Trials - More Blinding, Less Worry!

She's right to be worried! There are so many possible cracks that bias can seep through, nudging clinical trial results off course. Some of the biggest come from people knowing which comparison group a participant will be, or has been, in. Allocation concealment and blinding are strategies to reduce this risk.Before we get to that, let's look at the...

A Science Fortune Cookie

This fortune cookie could start a few scuffles. It's offering a cheerful scenario if you are looking for a benefit of a treatment, for example. But it sure would suck if you are measuring a harm! That's not what's contentious about it, though.It's the p values and their size that can get things very heated. The p value is the result you get from a standard...

The Highs and Lows of the "Good Study"

Imagine if weather reports only gave the expected average temperature across a whole country. You wouldn't want to be counting on that information when you were packing for a trip to Alaska or Hawaii, would you?Yet that's what reports about the strength of scientific results typically do. They will give you some indication of how "good" the whole study...

Cupid's Lesser-Known Arrow

Cupid's famous arrow causes people to fall blindly in love with each other. That can end happily ever after. Not so with his lesser known "immortal time bias" arrow! That one causes researchers to fall blindly in love with profoundly flawed results - and that never ends well.This type of time-dependent bias afflicts observational studies. It's a particular...

More Than Average Confusion About What Mean Means Mean

She's right: on average, when people talk about "average" for a number, they mean the mean.The mean is the number we're talking about when we "even out" a bunch of numbers into a single number: 2 + 3 + 4 equals 9. Divide that total by 3 - the number of numbers in that set - and you get the mean: 3.But then you hear people make that joke about "almost...

AGHAST! The Day the Trial Terminator Arrived

Clinical trials are complicated enough when everything goes pretty much as expected. When it doesn't, the dilemma of continuing or stopping can be excruciatingly difficult. Some of the greatest dramas in clinical research are going on behind the scenes around this. Even who gets to call the shot can be bitterly disputed.A trial starts with a plan for...

ARR OR NNT? What's Your Number Needed To Confuse?

I used to think numbers are completely objective. Words, on the other hand, can clearly stretch out, or squeeze, people's perceptions of size. "OMG that spider is HUGE!" "Where? What - that little thing?"Yes, numbers can be more objective than words. Take adverse effects of health care: if you use the word "common" or "rare", people won't get as accurate...

AR OR NNT? What's Your Number Needed to Confuse?

I used to think numbers are completely objective. Words, on the other hand, can stretch out, or squeeze, people's perceptions of size. "OMG that spider is HUGE!" "Where? What - that little thing?"Numbers can be more objective than words. Take adverse effects of health care: if you use the word "common" or "rare", people won't get as accurate an impression...

Let's Play Outcome Mash-up - A Clinical Trial Shortcut Classic!

Deciphering trial outcomes can be a tricky business. As if many measures aren't hard enough to make sense of on their own, they are often combined in a complex maneuver called a composite endpoint (CEP) or composite outcome. The composite is treated as a single outcome. And journalists often phrase these outcomes in ways that give the impression that...

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