Posted in Methodology on Nov 18th, 2011
I am very grateful to Dr. James Gaulte for pointing out the paper by Kravitz et al. on the vexing problem of heterogeneity of treatment effects (HTE). The article indeed provides a very clear and comprehensive explanation of the issues, and it is apparent that the proposal by Kent et al. discussed in the last [...]
Posted in Methodology on Nov 11th, 2011
I mentioned in the last post a recent proposal by Kent et al. that would improve clinical trial reporting and—in the authors’ words—lead to “actionable” clinical trial results. The proposal addresses “heterogeneity of treatment effect (HTE)” and the relationship of that effect to the baseline risk of clinical trial enrollees. HTE is the technical term [...]
Posted in Methodology on Nov 9th, 2011
In August 2010, a group of eminent statisticians and clinical trial specialists (Drs. Kent, Rothwell, Ioannidis, Altman, and Hayward) published online a proposal to deal with a major short-coming of clinical trials, the so-called heterogeneity of treatment effect (HTE). The authors offer a refinement in the way clinical trial results are analyzed and reported. Perhaps [...]
Posted in Methodology on Jul 29th, 2011
Pitirim Sorokin had coined the term to criticize the misapplication of quantitative methods to sociology. Murray Rothbard borrowed it from Sorokin to describe—in his usual lampooning style—the age-old fascination with mathematical modeling of economic phenomena. In his Economic Thought Before Adam Smith he points back to Pythagoras to show the influence of number mysticism on [...]
Posted in Methodology, Population medicine on Jul 25th, 2011
Of all the problems regarding large scale clinical trials cataloged by James Penston, the most compelling is the inverse relationship between practical value and trial size. This could almost be formulated as a law: The clinical value of a randomized controlled trial is inversely related to its size Of course, clinical is used in the [...]
Posted in Methodology on Jul 21st, 2011
It is the mark of an educated man to look for precision in each class of things just so far as the nature of the subject admits. Aristotle UK gastroenterologist and fellow contrarian James Penston has published two books critical of mainstream clinical research methodology. The most recent one, called Stats.con, deals with the misuse [...]
Posted in Database medicine, Methodology on Jul 11th, 2011
A recent post by Dr. Wes reminded me of the remarkable article Alvan Feinstein wrote in 1995 and titled “Meta-Analysis: Statistical Alchemy for the 21st Century.” In a few clearly written pages, the founding father of clinical epidemiology brilliantly identifies the wishful thinking underlying meta-analysis and exposes its methodological fallacies.
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