Thought about posting this in the research help thread but it’s a little more robust of a challenge for us than I reckon can be pinned on the kind few but extremely intelligent souls that man that thread. You may have heard the intravenous fluids aren’t used in African hospitals. Conventional wisdom pinned this on poor resourcing. An RCT was stopped early which found African children actually have a much higher septic shock mortality when given the fluid bolus (IV). We still use that drip in the West. The obvious question is, how good was the initial analyses indicating the Western data to IV fluid. One author of the African study raised that quesetion but didn’t seem keen to do it herself. Can you help me dig up the original data, or perhaps the ‘original’ paper on whatever the guidelines are based off. Some easy lives can be saved with a bit of statistical analyses here I reckon and the LW hivemind can get this done!
Get up to speed:
The issue—WHO guidelines for IV bolus for septic shock haven’t been updated 2 years since the release of a paper leaving it beyond doubt that children will die more with IV treatment. There’s shitty evidence for the guidelines and we don’t know (ok, there’s the regular reasons like this why the relevant guidelines aren’t evidence based yet given how easy it is to get an infectious disease in Africa...
The cost—estimated at 100,000 lives over 2 years by the studies authors one of whom recently appeared on Australian radio
I’m not sure whether “African children” is a good mental category. Africa is very diverse. Just because something holds for one African country doesn’t mean that generalizes across Africa.
WHO guidelines for IV bolus for septic shock haven’t been updated 2 years since the release of a paper leaving it beyond doubt that children will die more with IV treatment
Why do you think that a single paper leave’s something beyond doubt? A lot of papers don’t replicate.
There’s shitty evidence for the guidelines and we don’t know (ok, there’s the regular reasons like this why the relevant guidelines aren’t evidence based yet given how easy it is to get an infectious disease in Africa...
Why do you use “we”? What do you mean with it?
It might very well be true that you lack the understanding of how the WHO works. While likely a lot of people on LW don’t have a strong understanding on WHO internal politics I don’t think it’s nice to start a post by claiming that your audience is ignorant of a subject (if we is supposed to mean the readers of your post).
Thought about posting this in the research help thread but it’s a little more robust of a challenge for us than I reckon can be pinned on the kind few but extremely intelligent souls that man that thread. You may have heard the intravenous fluids aren’t used in African hospitals. Conventional wisdom pinned this on poor resourcing. An RCT was stopped early which found African children actually have a much higher septic shock mortality when given the fluid bolus (IV). We still use that drip in the West. The obvious question is, how good was the initial analyses indicating the Western data to IV fluid. One author of the African study raised that quesetion but didn’t seem keen to do it herself. Can you help me dig up the original data, or perhaps the ‘original’ paper on whatever the guidelines are based off. Some easy lives can be saved with a bit of statistical analyses here I reckon and the LW hivemind can get this done!
Get up to speed:
The issue—WHO guidelines for IV bolus for septic shock haven’t been updated 2 years since the release of a paper leaving it beyond doubt that children will die more with IV treatment. There’s shitty evidence for the guidelines and we don’t know (ok, there’s the regular reasons like this why the relevant guidelines aren’t evidence based yet given how easy it is to get an infectious disease in Africa...
The cost—estimated at 100,000 lives over 2 years by the studies authors one of whom recently appeared on Australian radio
what is fluid bolus therapy? here’s a neatest summary
Downvoted for being a stream of consciousness.
I’m not sure whether “African children” is a good mental category. Africa is very diverse. Just because something holds for one African country doesn’t mean that generalizes across Africa.
Why do you think that a single paper leave’s something beyond doubt? A lot of papers don’t replicate.
Why do you use “we”? What do you mean with it?
It might very well be true that you lack the understanding of how the WHO works. While likely a lot of people on LW don’t have a strong understanding on WHO internal politics I don’t think it’s nice to start a post by claiming that your audience is ignorant of a subject (if we is supposed to mean the readers of your post).