Jump to comment:

• A Poor Statistical Approach is Better than Not Having an Approach
  Shayan Majidi
  Published on: 19 October 2023

• Published on: 19 October 2023

  A Poor Statistical Approach is Better than Not Having an Approach

  • Shayan Majidi, General Practitioner Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran

  Dear BMJ Quality and Safety,

  Having perused the article titled "Diagnostic error among vulnerable populations presenting to the emergency department with cardiovascular and cerebrovascular or neurological symptoms: a systematic review," I found it captivating and of great significance. The notion behind this study is quite innovative, as it tackles the concerns of policymakers who worry about the potential to erroneously misdiagnose emergency patients, who indeed are in the most need of care. I firmly believe that this article will provide invaluable insights into a topic that greatly interests a wide audience.

  Given my keen interest in this study, and to enhance its quality and the reliability of the final findings, I would like to offer a few suggestions.

  I find that the authors have stated that they dropped the chance for a quantitative meta-analysis as they found substantial heterogeneity. I agree with them on decreased reliability of a pooled estimate with high heterogeneity. However, I believe that a quantitative estimate, even accompanied by considerable heterogeneity, is still much more convenient for readers to infer and relate. In fact, having a high heterogeneity is a good chance for authors to investigate the factors and covariates, providing a more precise insight into the complex relationships, and substantially improving the quality of the study. Therefore, I suggest an appendix that provides such data. Providing the limitation...

  Show More

  Dear BMJ Quality and Safety,

  Having perused the article titled "Diagnostic error among vulnerable populations presenting to the emergency department with cardiovascular and cerebrovascular or neurological symptoms: a systematic review," I found it captivating and of great significance. The notion behind this study is quite innovative, as it tackles the concerns of policymakers who worry about the potential to erroneously misdiagnose emergency patients, who indeed are in the most need of care. I firmly believe that this article will provide invaluable insights into a topic that greatly interests a wide audience.

  Given my keen interest in this study, and to enhance its quality and the reliability of the final findings, I would like to offer a few suggestions.

  I find that the authors have stated that they dropped the chance for a quantitative meta-analysis as they found substantial heterogeneity. I agree with them on decreased reliability of a pooled estimate with high heterogeneity. However, I believe that a quantitative estimate, even accompanied by considerable heterogeneity, is still much more convenient for readers to infer and relate. In fact, having a high heterogeneity is a good chance for authors to investigate the factors and covariates, providing a more precise insight into the complex relationships, and substantially improving the quality of the study. Therefore, I suggest an appendix that provides such data. Providing the limitations and defects in the quantitative synthesis of the evidence, together with a narrative review of the findings, will let readers draw conclusions at their discretion.

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top