Medical Evidence Blog

This is discussion forum for physicians, researchers, and other healthcare professionals interested in the epistemology of medical knowledge, the limitations of the evidence, how clinical trials evidence is generated, disseminated, and incorporated into clinical practice, how the evidence should optimally be incorporated into practice, and what the value of the evidence is to science, individual patients, and society.

Thursday, February 20, 2025

"Prophylactic" NIPPV for Extubation in Obese Patients? The De Jong study, Lancet Resp Med, 2023

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I got interested in this topic after seeing a pulmccm.org post on 4 studies of the matter this morning. "They" are trying to conv...
Thursday, January 23, 2025

Ignore Any Report of a Diagnostic Test that Highlights +/- Predictive Value rather than Sensitivity & Specificity

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I was reading about diagnostic tests for sepsis on www.pulmccm.org just now. Excellent site to keep yourself up-to-date on all matters Pulm...
Thursday, December 26, 2024

No, CXR for Pediatric Pneumonia Does NOT have a 98% Negative Predictive Value

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I was reading the current issue of the NEJM today and got to the article called Chest Radiography for Presumed Pneumonia in Children  - it c...
1 comment:
Monday, October 28, 2024

Hickam's Dictum: Let's Talk About These Many Damn Diseases

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This post is about our article on Hickam's dictum , just published online (open access!) today. I don't know if I read the 2004 NEJ...
Tuesday, September 26, 2023

The Fallacy of the Fallacy of the Single Diagnosis: Post-publication Peer Review to the Max!

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Prepare for the Polemic. Months ago, I stumbled across this article in Medical Decision Making called "The Fallacy of a Single Diagnosi...
2 comments:
Monday, June 26, 2023

Anchored on Anchoring: A Concept Cut from Whole Cloth

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Welcome back to the blog. An article published today in JAMA Internal Medicine was just the impetus I needed to return after more than a y...
1 comment:
Sunday, May 22, 2022

Common Things Are Common, But What is Common? Operationalizing The Axiom

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"Prevalence [sic: incidence] is to the diagnostic process as gravity is to the solar system: it has the power of a physical law." ...
Saturday, October 30, 2021

CANARD: Coronavirus Associated Nonpathogenic Aspergillus Respiratory Disease

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Cavitary MSSA disease in COVID One of the many challenges of pulmonary medicine is unexplained dyspnea which, after an extensive investigati...
Wednesday, April 14, 2021

Bias in Assessing Cognitive Bias in Forensic Pathology: The Dror Nevada Death Certificate "Study"

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Following the longest hiatus in the history of the Medical Evidence Blog, I return to issues of forensic medicine, by happenstance alone. In...
Sunday, February 16, 2020

Misunderstanding and Misuse of Basic Clinical Decision Principles among Child Abuse Pediatricians

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The previous post about Dr. Cox, ensnared in a CPT (Child Protection Team) witch hunt in Wisconsin, has led me to evaluate several more res...
Tuesday, January 28, 2020

Bad Science + Zealotry = The Wisconsin Witch Hunts. The Case of John Cox, MD

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John Cox, MD I stumbled upon a very disturbing report on NBC News today of a physician couple in Wisconsin accused of abusing their ado...
Thursday, December 5, 2019

Noninferiority Trials of Reduced Intensity Therapies: SCORAD trial of Radiotherapy for Spinal Metastases

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No mets here just my PTX A trial in JAMA this week by Hoskin et al (the SCORAD trial) compared two different intensities of radiother...
Saturday, November 23, 2019

Pathologizing Lipid Laden Macrophages (LLMs) in Vaping Associated Lung Injury (VALI)

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It's time to weigh in on an ongoing debate being waged in the correspondence pages of the NEJM .  To wit, what is the significance of...
1 comment:
Sunday, September 1, 2019

Pediatrics and Scare Tactics: From Rock-n-Play to Car Safety Seats

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Is sleeping in a car seat dangerous? Earlier this year, the Fisher-Price company relented to pressure from the AAP (American Academy o...
Sunday, July 21, 2019

Move Over Feckless Extubation, Make Room For Reckless Extubation

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Following the theme of some recent posts on Status Iatrogenicus  ( here and here ) about testing and treatment thresholds, one of our st...
Tuesday, May 7, 2019

Etomidate Succs: Preventing Dogma from Becoming Practice in RSI

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The editorial about the PreVent trial in the NEJM a few months back is entitled " Preventing Dogma from Driving Practice ".  If...
1 comment:
Thursday, April 25, 2019

The EOLIA ECMO Bayesian Reanalysis in JAMA

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A Hantavirus patient on ECMO, circa 2000 Spoiler alert:  I'm a Bayesian decision maker ( although maybe not a Bayesian trialist ) a...
2 comments:
Sunday, April 21, 2019

A Finding of Noninferiority Does Not Show Efficacy - It Shows Noninferiority (of short course rifampin for MDR-TB)

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An image of two separated curves from Mayo's book SIST Published in the March 28th, 2019 issue of the NEJM is the STREAM trial of a...
Sunday, December 23, 2018

Do Doctors and Medical Errors Kill More People than Guns?

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Recently released stats showing over 40,000 deaths due to firearms in the US this year have led to the usual hackneyed comparisons betwe...
1 comment:
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Scott K. Aberegg, M.D., M.P.H.
Professor of Medicine, University of Utah. Former affiliations: Outside Hospital x 7.5 years; Assistant Professor, The Ohio State University; Fellowship & MPH: Johns Hopkins Hospital & Bloomberg School of Public Health, Baltimore, MD; Residency: The University of New Mexico Health Sciences Center; MD: The Ohio State University; BA, Spanish: Miami University, Ohio. All views are my own with NO institutional endorsement.
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