Recently published papers: topical issues in pharmacology.
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Biomedical subjects
Publications and source records attributed to Jonathan Ball.
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The clinical syndrome of sepsis is common, increasing in incidence and responsible for as many deaths annually as ischaemic heart disease. Two recent interventional trials have demonstrated that early recognition and intervention can result in dramatic reductions in acute (28-day) mortality. This roundtable discussion was convened to identify ways in which these recent advances could be translated into clinical practice. The first obstacle surrounds the woolly and confusing terminology surrounding 'sepsis' with the systemic inflammatory response syndrome (SIRS) model largely discredited. Overcoming this should facilitate wider recognition, not only among health care providers (in particular those working in acute specialties outside intensive care units [ICUs]) but also politicians and the general public. Such education is vital if early recognition and intervention are to be successfully implemented.
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The present review introduces the general philosophy behind hypothesis (significance) testing and calculation of P values. Guidelines for the interpretation of P values are also provided in the context of a published example, along with some of the common pitfalls. Examples of specific statistical tests will be covered in future reviews.
The previous review in this series introduced the notion of data description and outlined some of the more common summary measures used to describe a dataset. However, a dataset is typically only of interest for the information it provides regarding the population from which it was drawn. The present review focuses on estimation of population values from a sample.
The present review is the first in an ongoing guide to medical statistics, using specific examples from intensive care. The first step in any analysis is to describe and summarize the data. As well as becoming familiar with the data, this is also an opportunity to look for unusually high or low values (outliers), to check the assumptions required for statistical tests, and to decide the best way to categorize the data if this is necessary. In addition to tables and graphs, summary values are a convenient way to summarize large amounts of information. This review introduces some of these measures. It describes and gives examples of qualitative data (unordered and ordered) and quantitative data (discrete and continuous); how these types of data can be represented figuratively; the two important features of a quantitative dataset (location and variability); the measures of location (mean, median and mode); the measures of variability (range, interquartile range, standard deviation and variance); common distributions of clinical data; and simple transformations of positively skewed data.
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