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Critical appraisal for Emergency Medicine series by Steve Goodacre: A must read before your Critical Appraisal preparation

Skill in critical appraisal has always been valued in our specialty because it is essential for the practice of evidence-based emergency medicine. The new series of six papers written by Steve Goodacre will therefore be welcomed by both trainees and trainers alike. They provide a fresh, lucid and succinct description of the important aspects of this topic with the important points reinforced by examples from emergency medicine. The section covering evaluation …

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Surrogate endpoints and Composite endpoints

When you do a randomised controlled trial, you are supposed to say up front what your endpoint is going to be. For example, if you're studying a new cholesterol-lowering drug, then good endpoints to study would be heart attack, stroke, and death. (Not-so-good endpoints to study would be level of cholesterol. This is the infamous "surrogate endpoints" where we simply …

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Randomisation in Clinical Trial

It is a method which ensures that all the individuals entering into a study have an equal chance of being allocated to any group within the study. Randomisation can be divided into three  broad areas: Random number generation Randomisation methods Concealed allocation Random number generation: Researcher use a variety of technique to generate a random sequence Computer random number generation — the …

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Bias and Confounding Factor

Bias & Confounding Will this research produce valid findings? This is probably the most important question to address when designing a research project. But how can you ensure that your research will be valid? Techniques such as blinding and randomisation can enhance validity, but they do not guarantee validity and they may be inappropriate or impractical for your study. So …

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Methods of Sampling in Research

Why Sample? When organisations require data they either use data collected by somebody else (secondary data), or collect it themselves (primary data). This is usually done by SAMPLING, that is collecting data from a representative SAMPLE of the population they are interested in. A POPULATION need not be human.  In statistics we define a population as the collection of ALL …

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What is meta-analysis?

Trials, systematic reviews and meta-analysis In many medical specialties it is common to find that several trials have attempted to answer similar questions about clinical effectiveness; for example: Does the new treatment confer significant benefits compared with the conventional treatment? Often many of the individual trials will fail to show a statistically significant difference between the two treatments. However, when …

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What are the differences among different study designs, and what are the relative advantages of each?

The two classic types of studies in biomedical research are controlled (also called experimental or intervention) and observational (also called epidemiological). There are advantages and disadvantages to each, and an awareness of these differences makes for a savvier consumer of public health information. Controlled and observational studies come in many forms, and to complicate matters there is some language confusion: controlled studies are sometimes …

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What are confounding factors and how do they affect studies?

What are confounding factors and how do they affect studies? Designing a study is not easy. Suppose we want to understand the relationship between obesity and morbidity. Do obese people die earlier than normal-weight people? If we just compare the numbers – i.e. compare the rates of death for these two groups – we might find a misleading story. What …

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