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Debate: Neuro-epistemology: RCTs are the gold standard in neurorehabilitation. NO! by D. Muresanu, Romania by Mind Map: Debate: Neuro-epistemology: RCTs are the gold 
standard in neurorehabilitation. NO! by 
D. Muresanu, Romania
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Debate: Neuro-epistemology: RCTs are the gold standard in neurorehabilitation. NO! by D. Muresanu, Romania

RCT's are the gold standard in neurorehabilitation: position NO

making decisions based on evidence

How to apply generatlisations to individuals?

Feinstein AR. The problem of cogent subgroups: a clinicostatistical tragedy j clin epidemio

Link to Paper

RCT

Internal validity

pocock sj clinical trials a practical approach, chichester, john wiley 1983, Link to Paper, (publishers' site)

Friedman LM fundamentals of clinical trials 3rd edn. springer 1998, Link to review of book

external validity

often limited, jacobson ebm and general practice 1997, Link to paper, david smith

No accepted guidelines on how external validity of rct's should be assessed

limitations of evidence j r coll physicians

One explanation for widespread underuse

External validity needs clinical rather than statistical review

The "Gulf"

Volker Homberg, 6th SSNN congress

RCT results are not applicable to small heterogenous samples

problems with subgroup analyses

not all relevant information is used in MA

individual dispositions for treatment responsivity

very expensive

How to bridge the "Gulf"

derive the elemntary rules from basic science

apply such elementary rules to invent therapeutic procedures for individual use

re-evaluate in more sophisiticated RCTs theses therapeutical approaches for individual use

In practice

Repair

Endogenous basic biological processes

Damage

Pathophysiological processes

Inflammatory mechanisms after ischemia and stroke, Danton GH, J. Neuropath Exp

Link to paper

Meeting notes by

Paul de Roos

www.twitter.com/paulderoos

www.paulderoos.com

Mindmap hosted on

www.neurologytraining.eu, Twitter:, www.twitter.com/trainneurology

Meeting

Controversies in Neurology, Linkt to website

Meeting Overview mindmap, Link to mindmap

New in neuro rehabilitation

learning by imitation

role of mirror neurons!

imagination and mental practice

focusing attention and self induced neuroplasticity

Schwartz 2002 the mind and the brain, Book @ Amazon

quantum physicis in neuroscience and psychology: a neurophysical model

Design

randomised

controlled

multiple

crossover

trial

patient serves as it's own control

well conducted n of 1 trials to individualize therapy has led to a recent revision of the hierarchy of evidence for interventions, placing the n of 1 trial at the top of the levels of evidence

improving treatment compliance in large RCTs

refining estimates of treatment effectiveness in populations and individuals

the information acquired from other patients' responses in nof-1 trials can also be used to aid other patietns

Convention

Congress of the society for neuroplasticity and neuroprotection?! (is this correct - missed)

SSNN eastern european neurology summer school for young neurologists