The Earth is an Antioxidant P < 0.05

A week ago, a new study published in Frontiers Physiology titled, “Effectiveness of Grounded Sleeping on Recovery After Intensive Eccentric Muscle Loading” investigated the effects of grounding on recovery in athletes.1 What the Heck Is Grounding? For those who are unaware of what grounding is, the authors give a very brief explanation here in their introduction, Grounding, earthing, or grounded sleeping, is a process in which the athlete becomes grounded via an electrically conducted device. Read More

A Critical Look At The REDUCE-IT Trial

It’s finally here. The results of the REDUCE-IT trial were presented today at the American Heart Association conference and the paper is also up on The New England Journal of Medicine. I’ve been excited to see the results of this trial ever since the announcement in September (which I wrote about here) so let’s get right into it. I’ll just copy and paste what I’d written before in September regarding the inclusion/criteria and statistical analyses so that I can get right into the results. Read More

The Rise, Fall, and Rise Again of Fish Oil?

With the exception of this past week, it hasn’t been a very good year for fish oil. In early 2018, a large meta-analysis and systematic review of several randomized trials was published in JAMA. This large pooled analysis (77,000 + participants) assessed the impact of supplementing fish oil on cardiovascular disease events and found that there was no statistically significant effect (p=.10). The relative risks (RR) and coverage of the confidence intervals (CI) also suggested a very small effect (RR: 0. Read More

Seductive Surrogates Can Be Deadly

In clinical trials, it’s not always possible to measure hard endpoints like cardiovascular disease events and cancer remission rates. Studies that use clinical outcomes often dichotomize these variables, and as a result, they need to have a large number of participants and be long in duration to detect differences between groups. Again, this type of research is expensive and not always feasible. In many scenarios, a more practical alternative is to focus on intermediate markers. Read More

Problems with the Number Needed to Treat

The number needed to treat (NNT) is a popular statistic used in medicine and its use is even encouraged by groups like Cochrane and CONSORT. Why is it so popular? Most believe that the NNT is more understandable than effect sizes like odds ratios or risk ratios or statistics like the absolute risk reduction. The NNT is also believed to convey more meaningful information. In this blog post, I am going to discuss: Read More

The Story of Antidepressants and Bad Journalism

Setting the Narrative Nearly a decade ago, a researcher by the name of Irving Kirsch conducted one of the most extensive studies on antidepressants. He compiled the published clinical trial data on antidepressants, and to make sure that he wasn’t analyzing data that only supported antidepressant effectiveness, he also invoked the Freedom of Information Act and dug up all the unpublished pharmaceutical data. Before starting this ambitious project, Kirsch, a medical researcher at Harvard, was the man who spearheaded most of the research behind the placebo effect. Read More