Kitty
Senior Member (Voting Rights)
Who is Marina Hyde?
Columnist and political commentator at the Guardian newspaper. She has an edge like a scalpel, and is hilarious with it.
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Who is Marina Hyde?
is an 0.532 improvement in QALY a statistically significant improvement?
Hard to know exactly what they are claiming from the poster, but it looks like they are just looking at one year, in which case a 0.53 QALY gain is huge. That's essentially going from quite sick (somewhere around 0.4-0.5) to perfectly fine. But I think the scale they are using here actually allows negative QALYs and we don't know what the starting point was. Of course, there is no control group either. Without any details, it's pretty hard to know what's going on here and of course this crew is likely to try to goose the QALY numbers.
Hard to know exactly what they are claiming from the poster, but it looks like they are just looking at one year, in which case a 0.53 QALY gain is huge. That's essentially going from quite sick (somewhere around 0.4-0.5) to perfectly fine. But I think the scale they are using here actually allows negative QALYs and we don't know what the starting point was. Of course, there is no control group either. Without any details, it's pretty hard to know what's going on here and of course this crew is likely to try to goose the QALY numbers.
My concern is that they will now turn the results the other way around and proclaim cost effectiveness for online activity management that includes incremental increases in activity, in other words GET. I remember saying at the start of this trial that they had set it up so whichever group did better would be claimed a successful treatment.
I didn't read it as a 0.53 QALY gain but rather felt more likely that those were the final QALYs.
I didn't read it as a 0.53 QALY gain but rather felt more likely that those were the final QALYs.
I'm also not sure why they chose to use a quality-of-life measure for cost-effectiveness--is that standard, does anyone know?
I actually wasn't quite sure what they meant. But the relevant point for the poster was that the score for the intervention was only 0.002 QALYs better than for the comparison group of activity management--which was at that time the minimalist treatment recommended in the NICE guidelines (after CBT and GET). I'm also not sure why they chose to use a quality-of-life measure for cost-effectiveness--is that standard, does anyone know? What if they now report the "effectiveness" data--that is, the SF-36 results--and report that it's "effective"? Or if it's not cost-effective, does it make the effectiveness data essentially irrelevant.
Optimal timings of data collection and interpolation assumptions have not been proposed for fluctuating health states. But recommendations have been made in one study on total knee arthroplasty, in which a surgical intervention caused nonrecurrent short-term fluctuations in health-related quality of life. Health-related quality of life increased rapidly in the first 3 months until it stabilized at 6 months.
Long-standing, and very hard earned. In medical science those standards are written in patients' blood.This maxim applies in spades to Professor Crawley, a repeat violator of long-standing scientific standards.
and including all the bias and potential coercion (and perceived threats 'if you don't get better') involved..