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......................m......................... Specific guide to this web site for:
Additional Topics: Large Randomized Clinical Trials
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There is considerable variability in the information that the public and physicians receive regarding the results of medical trials. One contributing factor is the incorrect application of statistics in the medical literature. A more common source of error is that the conclusions of a study are not always a reasonable reflection of the data presented. SOME TOPICS ON THIS WEB SITE THAT MAY BE OF GENERAL INTEREST: 1. Death of the oat bran fad How an improperly interpreted study led to the death of the oat bran fad. 2. Are Geminis really different? -The Pratfalls of Subgroup Analysis. Excessive subgroup analysis can lead to the invalid conclusion that treatment outcome is determined by an astrological sign. 3. Biased meta-analysis conclusions Can you really bias the conclusions of a meta-analysis? You decide which slanted version of these conclusions you would pick. 4. The ALLHAT hypertension trial controversy that occurred immediately following publication was a marker for conclusions that extended beyond a reasonable and conservative interpretation of the data. What are the problems with the ALLHAT trial conclusions that a diuretic is the preferred initial therapy for hypertension? download (pdf) 5. NEW Another meta-analysis mishap. This Harvard associated meta-analysis creates information that does not exist in the study: monounsaturated fatty acids replacing saturated fatty acids. Seemingly sophisticated statistical manipulation leads to unreliable information. 6.
The Columbia University 'Miracle' Study 7. Limitations of meta-analysis What are some of the pitfalls that can occur in the summation of clinical trials (meta-analysis) that can lead to invalid conclusions? 8. Celebrex How the initial article that admirably and beneficially 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? 9. Self-correcting nature of science. Comments on the self-correcting nature of science. 10,
List of questions to consider routinely asking when a medical trial is published. Several topics are available as downloadable files: click here Misadventures in Medical Statistics & the Interpretation of Clinical Trials: 1.
A trial led by Harvard Medical School faculty with a protocol so biased (unintentionally) that the trial was inherently
invalid. details 2. A statistical analysis in a major medical journal JACC (Journal of American College of Cardiology) which was so bad, that it may have led to a subsequent improvement in the review process of JACC.
details
4. How an incorrect review of the literature in in a single article in the medical literature could potentially adversely affect patient care. details 5. The ALLHAT trial. How conclusions that extend beyond the data can provoke controversy. details 6. Death of the oat bran fad. (Murdered by a poorly conceived study.) details 7. Pregnancy and alcohol, what do some of the studies really suggest? details 8. The Hazards of Subgroup Analysis (Are Geminis really different?) 9. The
Columbia University 'Miracle' Study- The unfortunate saga of possible fraud in a medical study
with a medical journal and a medical school failing to respond
appropriately. 10. Perspectives: The Very Large Randomized Clinical Trial (Strengths and Limitations) Beware of Meta-analyses Bearing False Gifts Network meta-analyses, a problem with reliability 11. How science has reparative processes that limit problems resulting from poor statistics or inappropriate conclusions ( How these particular issues might look "10 years later".) 12. Effect on p Values when the difference in outcome events remains constant as the number of background events increases for a constant sample size _
Topics available in a download file:
Lessons from an unusual saga of possible fraud in the literature
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The hazards of subgroup analysis. Are Geminis really different?
Can a meta-analysis be biased? Tale of Two Trials- A superbly conducted trial contrasted to a suboptimally interpreted trial: pdf download
Miscounted and Misinterpreted. How not to conduct a
study.
A detailed critique of the ALLHAT trial and subsequent
meta-analysis
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