Dar Howard,
being a question about effectiveness of radiotherapy I think right to seek
first for a RCT. Here (as always) I think very important to set well the
PICO frame:
P = people with carachteristic similar to your patient
I = Intervention = Palliative radiotherapy
C = Comparison = corticosteroids alone?
O = Outcomes = ... right outcomes ...
Hope it was useful...
Kind regards.
dott. Federico Barbani
Health Care Purchasing Unit
Health Authority Modena
41100 MODENA, Italy
-----Messaggio originale-----
Da: Evidence based health (EBH)
[mailto:[log in to unmask]] Per conto di Olive Goddard
Inviato: venerd́ 13 marzo 2009 13.43
A: [log in to unmask]
Oggetto: Re: Help!
Dear Colleagues,
I am sure Howard would be extremely grateful for your help on this
palliative care question.
All good wishes,
Olive
Olive Goddard
Centre and Editorial Manager
Centre for Evidence-Based Medicine
Department of Primary Health Care
Old Road Campus, Headington
Oxford, OX3 7LF
.....................................................................
Tel: +44 (0)1865 289337 email: [log in to unmask]
Fax: +44 (0)1865 289336 web: www.cebm.net
Mobile: 07804 625002 web: www.cebmh.com ( http://www.cebmh.com )
>>> "Howard Friend" <[log in to unmask]> 13/03/2009 11:26 >>>
Dear Olive,
Thank you for your offer of help. I am a GP doing the
Cardiff Diploma in Palliative Medicine and struggling with
a question in my module on research. If anyone would be
prepared to guide me - using the most simple language I
would be most grateful.
The scenario is as follows:
Angela is a 41 year old lady with breast cancer metastatic
to liver and bone who has been diagnosed with brain
metastases following admission with right-sided weakness
and dysphasia. She has been commenced on steroids and both
her mobility and dysphasia have improved. She is anxious
for a quick discharge to be at home with her daughter
(aged 12) and son (aged 7). You wonder if you should also
refer her for palliative radiotherapy.
The question I have to answer for this is, What type of
study design would be best able to address the question
and why
I am tempted to say a RCT but I am not sure if a cohort
study would be better. I have had a look at your web page
with details of the different types of study designs but
am - quite honestly - completely lost!
Thank you for your help
Yours sincerely and hopefully,
Howard Friend
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