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Adam Cifu
@adamcifu
, 7 tweets, 2 min read Read on Twitter
Began this year’s “Critical Appraisal of the Landmark Medical Literature” course Friday with RCTs. These are the studies we, appropriately, rely on most in medicine. However, they can be misleading, thus, a Tweetorial (my first) of reminders with references. What would you add?
How RCTS can be misleading #1
For studies with subjective endpoints, was the control really adequate.
amjmed.com/article/S0002-…
How RCTS can be misleading #2
Always be cautious when surrogate endpoints are used.
thelancet.com/journals/lance…
How RCTS can be misleading #3
Consider the “pre-study” probability that the treatment is effective.
jamanetwork.com/journals/jama/…
How RCTS can be misleading #4
When the results of a trial only barely reach statistical significance, consider the fragility index.
jamanetwork.com/journals/jamas…
How RCTS can be misleading #5
Remember that trials terminated early systematically overestimate the benefit of the intervention.
jamanetwork.com/journals/jama/…
How RCTS can be misleading #6
Never forget about publication bias and p-hacking.
ncbi.nlm.nih.gov/pubmed/22853650
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Adam Cifu
@adamcifu
Gave the "Clinical Reasoning and Diagnostic Test" lecture in our Medical Evidence class yesterday. How many times have you taught and/or learned sensitivity and specificity? Seven of my favorite slides, feel fee to steal!
Slide 2
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