Tag Archives: Patient

Exercise as a treatment for brain injury

7 Aug

In the past rest has been widely recommend as the appropriate treatment for brain jury. Now this conventional wisdom is being challenged:

“Over the course of a year, Klein tracked more than 600 patients with brain injury, getting more than half of them up and out of bed as early as the first day they were admitted to the ICU. What she found was that getting up and moving had clear benefits. Patients who started their rehabilitation earlier spent less time in the ICU and less time in the hospital. “They have less (sic)  pressure ulcers, less (sic) infections and spend less time on the ventilator if they need ventilator therapy,” says Klein. And most say they feel a lot better.”

Bed rest was a traditional treatment for many illnesses, such as heart disease. Increasingly, physicians are seeing the benefits of getting up and moving.

 

 

“Stepping out of time?” Maybe not

10 Jun

Last week the Ellisnelson blog ran a piece titled “Stepping Out of Time.” The post included this bit about a study on the effectiveness of prayer:

“Leonard Leibovici, MD conducted a double-blind, randomized trial of 3393 hospitalized patients all suffering with a sepsis infection. Leibovici was interested in whether prayer could affect patient outcome. The patients were divided with half being prayed for and half not being prayed for. Dr. Leibovici collected data on the length of fever, length of stay in the hospital, and death as a result of infection. Turns out the prayed for patients had an earlier reduction in fever and shorter hospital stays. The death rates for both groups were not statistically different. The results may shock some, but science has been doing prayer studies for quite a while ( Healing Words-The Power of Prayer & The Practice of Medicine by Larry Dossey, MD). The truly mind- numbing thing about the study is that those praying in 2000 were praying for patients who were hospitalized in the period 1990 to 1996. The conclusion drawn here was that patients who were prayed for in 2000, actually got better in the 1990s.”

This is an extraordinary claim, so I looked up the abstract on line. Just from reading the abstract I could see that there might be problems with the study so I posted a comment to the blog. However, Nelson did not post my comment. Of course, one of the great things about the internet is that I can have my own blog.

I looked up and read the entire paper and it is much worse than I originally thought. The paper is badly written and unclear on several critical points. The author did not specify in advance which outcome variable was of interest. This is a problem because of the possibility of HARKing (Hypothesizing After the Results are Known).

Note that difference reported between the two groups was for the length of hospital stay. There was no difference between the groups in terms of mortality, that is, you were equally likely to die whether you had been prayed for or not. In other words there was no effect for the variable that we would care most about.

In addition, the variable hospital stay is operationalized as days until release from the hospital or death. In other words, some of the shorter hospital stays could have been the result of the patient dying.

 

 

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