Willis R. Whitney, a chemist, who founded the General Electric Company laboratory once said ‘Necessity is not the mother of invention. Knowledge and experiment are its parents’ [1]. Twardowski and Misra reject the primacy of experimentation. They wish us to abandon the necessity to demonstrate by rigorous randomized trials that longer duration and/or more frequent is superior to intermittent di...

BACKGROUND Calculation of numbers needed to treat (NNT) is more complex from meta-analysis than from single trials. Treating the data as if it all came from one trial may lead to misleading results when the trial arms are imbalanced. DISCUSSION An example is shown from a published Cochrane review in which the benefit of nursing intervention for smoking cessation is shown by formal meta-analys...

BACKGROUND High rejection rates of subject recruitments for research studies have been reported in immigrants in many countries. However, the barriers in recruiting members of the expatriate population in Kuwait have not yet been investigated. This study was therefore designed to identify barriers in recruiting expatriates for research studies in the state of Kuwait. METHODS A population-base...

BACKGROUND AND OBJECTIVE Electronic patient record (EPR) systems are widely used. This study explores the context and use of systems to provide insights into improving their use in clinical practice. METHODS We used video to observe 163 consultations by 16 clinicians using four EPR brands. We made a visual study of the consultation room and coded interactions between clinician, patient, and c...

the technical term of acceptance and refusal in the case of patrimonium (the estate of deceased); which has been used in inheritance procedure act; dose not mean; automatically; the acceptance and refusal of inheritance; because it is occurred by the law and; inheritance; acceptance and refusal of the estate deceased has no role in its occurrence. however; the existence of the principle of acce...

UNLABELLED Diabetic foot complications are a significant source of morbidity and mortality. Patients who undergo recurrent admissions for the same diabetic foot problems represent a difficult subgroup to treat. From July 2007 to June 2008, there were 38 such patients who were admitted recurrently. Eighteen patients (47%) were re-admitted because of previous refusal of surgical treatment. Eighte...

Study sample No sample size appears to have been determined in the planning phase of the study. All patients undergoing a scheduled lobectomy between January 1994 and January 2004 were included in the study. No patient appears to have refused to participate in the study or was refused access to their medical records. A total of 639 consecutive patients underwent a scheduled lobectomy, of which ...

Fundamental bias can be introduced in randomised trials if patients cannot be masked for the allocated strategy and assess subjective outcomes. In such a trial, on the effectiveness of outreach stroke care in addition to standard care, we masked patients by modifying the informed consent procedure. Before discharge home we informed patients that we were studying their needs six months after dis...

Medico-legal death investigation systems have the potential to play an important role in disease surveillance. While these systems are in place to serve a public function, the degree to which they are independent of central government can vary depending on jurisdiction. How these systems use this independence may present problems for public health initiatives, as it allows death investigators t...