tag:blogger.com,1999:blog-4519234397783312626.post6021840708558282261..comments2023-10-09T11:42:57.305-04:00Comments on Healthcare, etc.: To guideline or not to guideline, that is the question in... pneumonia?Marya Zilberberghttp://www.blogger.com/profile/16080475886113209344noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4519234397783312626.post-14982322874881861692011-01-21T08:57:32.315-05:002011-01-21T08:57:32.315-05:00Hi, Brad, thanks fro your kind comment. What I mea...Hi, Brad, thanks fro your kind comment. What I mean by my de-escalation comment is that perhaps there is something harmful about not de-escalating in the absence of a bug to treat. Alternatively there may be something harmful about complying with de-escalation even in the absence of an identifiable bug in some patients. After all, culture is a pretty blunt instrument -- only about 50-75% of all patients with HCAP ever grow anything out.Marya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-62593679277060465402011-01-21T07:12:36.473-05:002011-01-21T07:12:36.473-05:00Great post, your stuff is just great, and keep it ...Great post, your stuff is just great, and keep it up.<br /><br />On your addendum, when you state that by omitting deescalation in analysis, we might miss explanation for findings, meaning:<br /><br />1) There is no difference, Type I error regardless<br /><br />2) there is something more to continuing 2 vs 1 abx and we are harming patients.<br /><br />Thanks.<br /><br />Also, love the little comment on placing the post submission sentence into discussion from reviewer re: deescalation. It is that kind of nuance that I would never detect, and it is hugely helpful for someone who likes appraisal, but is not an active researcher or reviewer. Please add more of this insight in future posts.<br /><br />BradAnonymousnoreply@blogger.com