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Informed Consent for Research

This may be a bit of a divergence form my normal discussions on evidence-based practice, but in my professional life I also wear a hat as a human protections administrator for a chiropractic college. That title is not something made up; it is actually a legally required link between an institution that accepts federal...
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Seminal Works in Evidence-Based Medicine

Below I have provided a brief list of many of the more seminal papers about evidence-based medicine. I have also included a few chiropractic-specific papers as well. These are excellent reading about this topic, and I highly recommend them to you. Bates DW, Kuperman GJ, Wang S et al. Ten commandments for effective clinical...
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Confidence Intervals

Imagine that you want to take a measurement on a group of 100 people. Perhaps you are measuring their glucose level, as a conceptually easy measure to think about. In that group of 100 people, you find that the mean glucose level is 87. Now what if you were to find another group of...
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Evidence, Science and Belief, Writ Small

A long time ago I read a book called “The Hot Zone,” by Richard Preston. It was a book about the discovery of Ebola virus in a primate laboratory located in Reston, Virginia, and it detailed the history of the emergence of Ebola virus in Zaire in 1976, and in Sudan shortly thereafter. The...
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More Words on Diagnostic Testing: Likelihood Ratios and Test Probabilities

Over the past three blog entries that I have presented, I looked at measures related to diagnostic testing. I started with this question: how do we know a diagnostic test measures what we think it is measuring, since we all know of cases where someone has a condition yet tests negative when we use...
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Some Not-So-Final Words on Diagnostic Testing

  In my past two columns, I provided you with information related to sensitivity and specificity, as well as both positive and negative predictive values. These are measures of the effectiveness of a diagnostic test; that is, they provide you information about whether the test can identify people with and without the condition the...
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More and More on Diagnostic Testing

In my last blog post I discussed the importance of assessing the sensitivity and specificity of a diagnostic test. We asked the question: how well do our diagnostic tests help identify those with (sensitivity) and without (specificity) a condition of interest? I defined sensitivity as the ability of a diagnostic to correctly identify those...
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More on Diagnostic Testing

Within our profession we have many technique systems, and in each of those systems, we have diagnostic procedures whose primary goal seems to be to locate subluxation so that we can then provide an effective adjustment for our patients. So much of our education is didactic; that is, we take courses in which we...
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Informed Consent for Participation in Human Subject Research

All of us who are involved in the practice of chiropractic are well acquainted with the concept of informed consent. We know we should sit down with our patients and describe our treatment plan with them, letting them know of the possible risks that might occur should they wish to be treated. This is...
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Epidemiological Research Study Designs

Epidemiological research is designed to answer the kinds of questions clinical trials cannot. For example, if we wish to study the effects of smoking on lung cancer rates, the most effective way to do so would be to design a clinical trial that divided a population into a group that did not smoke and...
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