Effect of regression to the mean on decision making in health care

Knowledge of regression to the mean can help with everything from interpreting test results to improving your career prospects. All healthcare professionals should be aware of its implication

Evidence for risk of bias in cluster randomised trials: review of recent trials published in three general medical journals

Objective To examine the prevalence of a risk of bias associated with the design and conduct of cluster randomised controlled trials among a sample of recently published studies. Design Retrospective review of cluster randomised trials published in the BMJ, Lancet, and New England Journal of Medicine from January 1997 to October 2002. Main outcome measures Prevalence of secure randomisation of clusters, identification of participants before randomisation (to avoid foreknowledge of allocation), differential recruitment between treatment arms, differential application of inclusion and exclusion criteria, and differential attrition. Results Of the 36 trials identified, 24 were published in the BMJ, I I in the Lancet, and a single trial in the New England journal of Medicine. At the cluster level, 15 (42%) trials provided evidence for secure allocation and 25 (69%) used stratified allocation. Few trials showed evidence of imbalance at the cluster level. However, some evidence of susceptibility to risk of bias at the individual level existed in 14 (39%) studies. Conclusions Some recently published cluster randomised trials may not have taken adequate precautions to guard against threats to the internal validity of their design

Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomised trials

BACKGROUND: Hormone replacement therapy (HRT) is often seen as the treatment of choice for preventing fractures in women. We undertook a recent meta-analysis of randomised trials which suggested that HRT reduced non-vertebral fractures by 30%. In this analysis we extend that analysis to vertebral fractures. METHODS: We searched the main electronic databases until the end of August 2001. We sought all randomised controlled trials (RCTs) of HRT where women had been randomised to at least 12 months of HRT or to no HRT. RESULTS: We found 13 RCTs. Overall there was a 33% reduction in vertebral factures (95% confidence interval (CI) 45% to 98%). CONCLUSIONS: This review and meta-analysis showed a significant reduction in vertebral fractures associated with HRT use

Transition frequency shifts with fine-structure constant variation for Yb II

In this paper we report calculations of the relativistic corrections to transition frequencies (q factors) of Yb II for the transitions from the odd-parity states to the metastable state 4f^{13}6s^2 ^2F_{7/2}^o. These transitions are of particular interest experimentally since they possess some of the largest q factors calculated to date and the $^2F_{7/2}^o$ state can be prepared with high efficiency. This makes Yb II a very attractive candidate for the laboratory search for variation of the fine-structure constant alpha.Comment: 5 page

Evolution of Cooperative Thought, Theory, and Purpose

The evolution of agricultural cooperative thought, theory, and purpose in the United States is reviewed from the standpoint of the reemergence of interest in how cooperatives can provide some of the security and benefits that might be lost with gradual phasing out of federal government farm support programs. By accomplishing group action for self-help, the early development of cooperatives drew considerable attention from economists, social theorists, and politicians. Alternative schools of cooperative thought developed, but most proponents of cooperatives regarded them as having enormous potential to provide a public service role in building a more economically stable and democratic society This paper also surveys how cooperative theory was developed more rigorously in the post-WWII period. It has provided better analytical tools for understanding how and why cooperatives have changed in response to technological and economic developments, as well as to social trends, like individualism. Given the new perspectives on cooperative theory and the scope of changes in how cooperatives operate and are structured, cooperatives have even greater potential for coordinating self-help actions, but this potential needs the support of cooperative education services.Agribusiness,