Journal of evaluation in clinical practice
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Medical scientists have expressed scepticism about whether philosophy is relevant to medicine. We challenged this in a conference on the topic of "too much medicine" (TMM) held in Oxford in April 2017. The topic of TMM provided an opportunity to bring the two disciplines together because of its history both in philosophy and in medicine. ⋯ First, both disciplines had to avoid discipline-specific jargon. Second, each discipline had to engage with the other. Specifically, medical scientists had to engage with some philosophical literature, and philosophers had to "get their hands dirty with data." In this conference report, we provide an overview of our discussions and summarize the other papers in the series.
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Functional magnetic resonance imaging (fMRI) is used widely to study reorganization after early brain injuries. Unilateral cerebral palsy (UCP) is an appealing model for studying brain plasticity by fMRI. ⋯ The models of reorganization are variable, depending on the development and function of each neural system and the extent and timing of the damage. The plasticity patterns may guide therapeutic intervention and prognostics, thus proving the fruitiness of the translational approach in neurosciences.
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The difference between the pth quantiles of 2 survival functions can be used to compare patients' survival between 2 therapies. Setting p = 0.5 yields the median survival time difference. Varying p between 0 and 1 defines the quantile survival time difference curve which can be straightforwardly estimated by the horizontal differences between 2 Kaplan-Meier curves. ⋯ The user-friendly SAS software macro %kmdiff enables the straightforward application of this exploratory graphical approach. The macro is described, and its application is exemplified with breast cancer data. The advantages and limitations of the approach are discussed.
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Selected variables for the French Paediatric Intensive Care registry. ⋯ The necessary variables that ought to be included in a French paediatric critical care registry were identified. The challenge now is to develop the French registry for paediatric intensive care units.
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Cross-country comparisons of cystic fibrosis (CF) outcomes can potentially identify variation in care but are dependent on data quality. An important assumption is that the UK annual review FEV1 is only collected during periods of clinical stability. If this assumption does not hold, results of FEV1 comparisons may be biased in favour of registries with encounter-based FEV1 . We aimed to test the assumption that CF annual reviews in the UK are only performed during periods of clinical stability. ⋯ Annual review FEV1 underestimates lung health of adults with CF in the UK and may bias cross-country comparisons.