The Petty/Bone RCT

[Lawrence_Lynn]

Amazing to watch this after over a decade of trying to induce introspection. One feels sorry for them and it’s sad after so much overconfidence in the past to see the characterization of the “hope and pray” RCT, which is actually the PettyBone RCT.

I spent about 8 million dollars of my own personal funds building the EMR software for the platform they are describing here and they had no interest in it in 2019 as they thought the task forces could define the thresholds X for RCT entry criteria.

For me this is both a wonderful and sad day. So much time has been lost but we can see through all the embarrassed laughter in this podcast that they now see the old PettyBone science is pathological.

There was little actual science discussed in that podcast (most was PettyBone pathological science), but I have to honor Dr. Angus for his courage. Almost no one in the main is that intrepid. Hats off.

I want to say a special thanks to Frank. I don’t think this would have happened without this forum. Over 7000 reads in this thread about the PettyBone RCT.

20.5k reads in the 2020 thread describing “What is a fake measurement and how are they used in critical care”.

What is a fake measurement tool and how are they used in RCT

I have linked an article below published this month. This provides more evidence that the measurement tools used for critical care RCT esp. for sepsis and mortality are often fake. Those who have studied this issue did not need more evidence but perhaps if enough of these studies are published the perceived bright star of SOFA will fade (as SIRS has faded). This study is no surprise given there has not been a single reproducibly positive sepsis RCT for 30 yrs. Now fake is a harsh word and I d…

and 20.1k reads of “The end of the syndrome in critical care”.

The End of the "Syndrome" in Critical Care

I have been periodically discussing the state of RCT in critical care. While there have been but few on-line comments, I have been encouraged by the off-line comments and approvals of that which I am trying to teach here. This work comes from 40 years in the ICU watching the evolution of the science and I speak primarily to the young who may still be developing an overarching cognitive construct of critical care science. This is the evolution I observed over 40yrs: The emergence of “thresh…

My goal in coming to datamethods back in ~2019 was to induce exactly the introspection and real (non synthetic) paradigm shift in critical care science which is evident in this podcast. They are not completely there yet but the dogma dam has broken.

The next step is to end the task force guessing of threshold sets (X) and acknowledge the source and pathological nature of PettyBone science.

We can’t have a two tiered system where the task-force promulgates the PettyBone rules to the masses (including low income countries) while the privileged at major US universities move the next generation critical care research.

Thanks to everyone for the discussion. Science is wonderful. It gives you chills when it self-corrects. It’s not there yet but the intellectual water is flowing through the dam.