Spring Break questions…..

I’m not sure we’ve ever gone 10 days without a blog post, but clearly we have been on break here since the middle of March. My travel started with a trip to Atlanta for a HICPAC meeting, and ended at the beach pictured above. Eli spent some family time in Florida as well (perhaps he’s preparing to bring the Disney Experience to the VA system?). Mike is in an undisclosed location, no doubt preparing for this blog’s fourth birthday celebration.

The HICPAC meeting left me with many questions to ponder while walking the beach at Siesta Key:

• Should an underpowered or otherwise flawed randomized controlled trial carry more weight than a good quasi-experimental or observational study?
• Should certain “foundational” practices (e.g. hand hygiene) be evaluated similarly to other infection prevention interventions, particularly when the evidentiary base for their effectiveness in various settings is meager?
• If a “bundle” of practices is recommended with a specific evidence “grade”, should each individual practice within that bundle also be subject to a graded recommendation?
• Should HICPAC make graded recommendations only about the practice itself (what to do), or also about the implementation of the practice (how to do it)?
• If the evidence base for prevention is sufficiently poor, is it better to have no guideline at all (and to use those resources to fund studies to improve the evidence base)?

Having answered these questions to my own satisfaction, I was able to spend the rest of the week pondering larger questions about meaning and existence. Such as, why were the Iowa Hawkeyes left out of the NCAA men's basketball tournament but Middle Tennessee State made it in?