# Interesting Talk on Dichotomization

**URL:** <https://discourse.datamethods.org/t/interesting-talk-on-dichotomization/5329>\
**Category:** measurement\
**Tags:** categorization\
**Created:** [February 16, 2022, 12:53am UTC](https://discourse.datamethods.org/t/interesting-talk-on-dichotomization/5329 "2022-02-16T00:53:28Z")\
**Posts on this page:** 1\
**Showing post:** 8

<div class="post-metadata">

**Author:** ![R\_cubed](https://discourse.datamethods.org/user_avatar/discourse.datamethods.org/r_cubed/32/1518_2.png) [@R\_cubed](https://discourse.datamethods.org/u/R_cubed)\
**Post date:** [February 21, 2022, 4:55am UTC](https://discourse.datamethods.org/t/interesting-talk-on-dichotomization/5329/8 "2022-02-21T04:55:27Z")

</div>

This recent paper by @llynn is relevant to the issue of cut points being misleading:

> [@Critical Appraisal Checklist for Statistical Methods](https://discourse.datamethods.org/t/critical-appraisal-checklist-for-statistical-methods/1099/13):
>
> Raj, I found this forward looking post . I see @ADAlthousePhD point also. l debated some of the points below with him on twitter and I still do not know if we are in agreement. I think there has to be a checklist for basic components for all; clinician scientist , statistician and trialists. One that all can engage and discuss which, for example, assures the validity and reproducibility of the entry measurement (e.g criteria) as well as any tools used for adjustment in relation to both t…

From the actual paper

> **[Protocol Failure Detection: The Conflation of Acute Respiratory Distress...](https://pmc.ncbi.nlm.nih.gov/articles/PMC8780641/)**
>
> In medicine, protocols are applied to assure the provision of the treatment with the greatest probability of success. However, the development of protocols is based on the determination of the best intervention for the group. If the group is ...

> Blockquote  
> When a RCT is used to test the efficacy of a protocol applied to a syndrome comprised of a mix of diseases (or sub-phenotypes), the result only provides evidence of the average treatment effect on the mix under test as a whole, not whether the treatment used in the RCT will be beneficial or harmful for any particular disease or subphenotype within the mix.[29] In this regard, a problem posed by the construction of syndromes, which may not have been evident to those selecting the criteria, is that if the criteria are broad enough to include markedly different diseases, an RCT applied in the study of treatment of the syndrome may suffer from amplification of the HTEs. This is a fragile state, highly dependent on the mix of the diseases present. In 2020, the pandemic changed that mix of ARDS cases in a dramatic way and exposed the weakness of generalization of RCT results to disease populations which were not sufficiently represented in the RCT and worse, were not represented at all.

---

_[View the full topic](https://discourse.datamethods.org/t/interesting-talk-on-dichotomization/5329)._