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Hi Terry, I have used the two articles published back to back in the NEJM on H. Pylori (one positive and one negative) in my session on Type I errors. There is different outcome methodology used and therefore different results. These were carried into two meta-analyses by Jaakkimainin and Laine on the same topic. RCTs Article #1. McColl K, Murray L, El-Omar E, et. al., Symptomatic benefit from eradicating Helicobacter Pylori infection in patients with nonulcer dyspepsia New Engl J Med, 1998; 339; 1869-74. Article #2. Blum AL, Talley NJ, O'Morain C, et. al., Lack of effect of treating Helicobacter Pylori infection in patients with nonulcer dyspepsia New Engl J Med, 1998; 339; 1875-81 Meta analyses Article 1: Jaakkimainen RL, Boyle E, Tudiver F., Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ 1999; 319: 1040-4. Article 2: Laine L, Schoenfield P, Fennerty MB., Therapy for Helicobacter pylori in patients with non-ulcer dyspepsia: A meta-analysis of randomized, controlled trials. Ann Intern Med, 2001; 134: 361-9 For really bad articles, I've used the following in the first two Journal Clubs I give to the first year students (but none are RCTs): #1: on study design: Good: Gold DR, Wang X, Wypij D, et. al. Effects of cigarette smoking on lung function in adolescent boys and girls. New Engl J Med 1996; 335: 931-7 Bad: Reneman L, Booij J, de Bruin K, et. al. Effects of dose, sex, and long term abstention from use on toxic effects of MDMD (ecstasy) on brain serotonin neurons.. Lancet 2001; 358: 1864-9 Just ugly: Sporer KA, Firestone J. Clinical course of crack cocaine body stuffers. Ann Emerg Med 1997; 29: 596-601 #2: on sources of bias: Good: None Bad: Matser EJT, Kessels AG, Lezak MD, et. al. Neuropsychological impairment in amateur soccer players. JAMA 1999; 282: 971-3 and Stenestrand U, Wallentin L for the Swedish Register of Cardiac Intensive care (RIKS-HIA). Early statin treatment following acure myocardial infarctin and 1-year survival. JAMA. 2001; 285: 430-6 Also ugly: Rusnak RA, Borer JM, Fastow JS. Misdiagnosis of acute appendicitis: Common features discovered in cases after litigation. Am J Emerg Med. 1994; 12: 397-402 Hope that this helps. Best wishes, Dan **************************************************************************** Dan Mayer, MD Professor of Emergency Medicine Albany Medical College 47 New Scotland Ave. Albany, NY, 12208 Ph; 518-262-6180 FAX; 518-262-5029 E-mail; [log in to unmask] **************************************************************************** >>> Terry Shaneyfelt <[log in to unmask]> 9/25/2008 2:32:18 PM >>> Does any one have a good example of a fairly flawed therapy article for a course that I teach in EBM. Seems most of the articles I find arent too badly designed. Students always want to see some bad articles to critique. Thanks in advance ----------------------------------------- CONFIDENTIALITY NOTICE: This email and any attachments may contain confidential information that is protected by law and is for the sole use of the individuals or entities to which it is addressed. If you are not the intended recipient, please notify the sender by replying to this email and destroying all copies of the communication and attachments. Further use, disclosure, copying, distribution of, or reliance upon the contents of this email and attachments is strictly prohibited. To contact Albany Medical Center, or for a copy of our privacy practices, please visit us on the Internet at www.amc.edu.