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Half tidy (Editorial)

Half tidy
The other side of the hill

Half tidy


Welsh use of the English word ' tidy ' means that something is really rather good. Clearly the term for something that is excellent must be ' half-tidy '. The state of half-tidiness is quite difficult to attain. Those ferreting around for evidence encounter the half-tidy only rarely, and the tidy infrequently. All too often we have to make do with the downright untidy and try and make something of it.

Systematic reviews can be good or bad, and the studies they review can be good or bad. If it were like Mendel and his peas, then we might have one chance in four of a good review of good trials. This month Bandolier has one example of good reviews of good trials, and several heterozygotes. The systematic review process lets us down , usually because the building blocks for the reviews are inadequate.

But we counterpoise this disappointment with some half-tidy observational studies, predominantly from the United States. For instance, a Californian study of glucose self monitoring in 25,000 diabetics is counterpoised with a systematic review of randomised trials that assembled information on only 500, and those from inadequate trials. Half-tidy stuff too on troponin tests for cardiac damage, again from the United States.

The other side of the hill


Bandolier sometimes despairs of healthcare industries. Evidence should be their meat and drink, yet they shrink from helping us by giving us evidence the way we want it, in unbiased, independent, systematic reviews. Though there exceptions, too often they are afraid of what's on the other side of the hill. So after incredibly expensive research, carried out over a whole afternoon, Bandolier has come up with the answer. Anyone from industry bearing an unbiased, independent, systematic review of a company's product will be rewarded with a Bandolier coffee mug . That should do it!


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