и не только. Читаете ли вы его блог? Попробуйте! (http://blogs.bmj.com/bmj/2015/01/12/richard-lehmans-journal-review-12-january-2015/) Вот вам пример его критического чтенияNEJM публикует статью (http://www.nejm.org/doi/full/10.1056/NEJMoa1406281) с результатами неконтролируемого испытания препарата. Почему? Почему на HRB&
Василий Власов
When I see a cancer trial in one of the top journals, I generally scan the abstract to see if there is anything of general interest or importance. I drew a complete blank with this one. “Among women with predominantly stage I HER2-positive breast cancer, treatment with adjuvant paclitaxel plus trastuzumab was associated with a risk of early recurrence of about 2%; 6% of patients withdrew from the study because of protocol-specified adverse events.” Um, compared with what? Well, with what might have happened otherwise, elsewhere, possibly. “We recognize that a prospective, randomized trial would have been the best option. However, we did not believe that such a design would have been feasible given the accumulating evidence from retrospective studies. Patients and their providers may have been unlikely to enroll in a trial that included a group in which patients would not receive trastuzumab. Some clinicians and investigators might have argued for a trial of trastuzumab alone versus trastuzumab plus chemotherapy, but there are limited data indicating that trastuzumab alone is an effective approach.” Aha, but isn’t that exactly why people do RCTs? Why does this trial—which is just a large case series—get space in the New England Journal? Any time your well conducted, randomized, double blind trial gets rejected by the NEJM, you might like to ask them
