RCTs are the Basis of Good Clinical Practice - CON
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RCTs ARE the basis of good practise? Peter Brindley MD, FRCP-Can, FRCP-Edin, FRCP-Lond (20 weeks per annum ICU doc) Also: Professor of Critical Care Medicine; Medical Ethics; Anesthesiology Division of Critical Care Medicine
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Transcript of RCTs are the Basis of Good Clinical Practice - CON
RCTs ARE the basis of good practise?
Peter Brindley MD, FRCP-Can, FRCP-Edin, FRCP-Lond(20 weeks per annum ICU doc)
Also:Professor of Critical Care Medicine; Medical Ethics; Anesthesiology
Division ofCritical Care Medicine
“luddite”; ”science-denier”
Is Myberg god? Is RCT the “one truth?”
Time to put the trial on trial
RARELY CLARIFIES TRUTH
TOO LONGOFTEN
DOOMED
MEASUREMENT BIAS/VANITY SMALL DIFFs
POSITIVE-BIAS
FIRST VS LASTGENERALIZABLE?/RARELY REPEATED
END POINTS/IGNORE
REAL WORLD
EXCLUSIONS
Of Acute Care
Medicine
DATA
LOSE
20
B Dollars
in preventable medical errors
J Health Care Finance. 2012;39(1):39-50.
What’s most important in patient safety?
RCTs
Human FactorsHuman Factors
Human Factors
Hit the target; miss the point
L.S.D
Over/under ventilate
Over/under resuscitate
Hypo/hyper glycaemia
Give antibiotics
A,B,Cs
Skill: solo/team
Prognostication
P-value (p=patient)
Communication
EOL
Brainless Protocols
RCTs
MANY HUMBLE THANKS
