Kamal R. Mahtani€¦ · Evans et al (2011) Testing Treatments: Better Research for Better...

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Kamal R. Mahtani

Baby and Child Care” has actually sold more that 50 million copies, only outmatched in sales by the Bible

‘…disadvantages to a baby’s sleeping on his back. If he vomits he’s more likely to choke on the vomitus. ..I think it is preferable to accustom a baby to sleeping on his stomach from the start.’

Dr Benjamin Spock

Evans et al (2011) Testing Treatments: Better Research for Better Healthcare

Evans et al (2011) Testing Treatments: Better Research for Better Healthcare

Over four fold increase risk of sudden infant death

syndrome

Causes harm Does not causes harm

1970

1980

1990

2000

On average – inconclusive

The importance of considering a summary of all available the evidence

Causes harm Does not causes harm

1970

1980

1990

2000

On average – does not cause harm

The importance of considering a summary of all available the evidence

Causes harm Does not causes harm

1970

1980

1990

2000

On average – inconclusive

The importance of considering a summary of all available the evidence

The importance of considering a summary of all available studies

BUT….. How many studies are carried out but not published?

≈50%

Causes harm Does not causes harm

1970

1980

1990

2000

On average – no difference

The importance of considering a summary of all available the evidence

Four more studies – never published!

On average – causes harm!

Patients with atrial fibrillation

Old blood thinners (warfarin)

New blood thinners (NOACs)

Risk Risk