Is the Intranasal Flu Vaccine Worthless? Or Just as Good as the Shot? by Perry Wilson

A randomized trial appearing in Annals of Internal Medicine pit the intransal spray flu vaccine against the traditional shot. They both worked the same. So why will you NOT be offered the spray this year?  For the video version of this post, click here.

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Pasta, BMI, and Simpson's Paradox by Perry Wilson

A study appearing in the journal Nutrition and Diabetes suggests that pasta may actually lower your BMI. Can that actually be right?  A detailed look at the data, and how it relates to Simpson's paradox inside.  For the video version of this post, click here.

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Two Pressors, both Alike in Dignity? Vasopressin versus Norepinephrine and Renal Failure in Sepsis by Perry Wilson

A randomized trial appearing in JAMA found no difference in the rates of renal failure when patients with sepsis were given norepinephrine versus vasopressin. But some signal of a vasopressin benefit emerged.  For the video version of this post, click here.

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One Simple Trick to Get Kids to Eat Their Veggies: A Randomized Trial by Methods Man


Kids these days are supposed to be much more sophisticated than when we were growing up. My kids can use Iphones, play shows on Netflix.  I caught my six-year old looking for shoes on the other day. So the fact that some colorful cartoon vegetables could meaningfully change elementary school kids eating habits seemed unlikely to me at first.  Nevertheless, that's what a study appearing in the journal Pediatrics suggests.  And these effects were far from subtle. For the video version of this post, click here.

Here's what you need to know.  Ten urban elementary schools participated in this study. These were schools with a largely minority population and where the large majority of students participated in the school lunch program.  They all had a regular lunch line as well as a salad bar. The researchers randomized these ten schools into 3 intervention groups and one control.  The intervention involved… well… this:


Colorful, smiling, anthropomorphic vegetables. With muscles. One group of schools got these happy little fellows, one group got a video playing some edutainment about healthy eating, and one group got the deluxe package of both. Check out SuperSprowtz for more adorableness.

It seems a bit hokey, but here's the thing.  This worked.  Surprisingly well.  Researchers examined two main outcomes – the number of kids visiting the salad bar, and the percent of kids who ended up buying vegetables from anywhere in the cafeteria.

Here are some numbers: In schools with the vinyl banners, the percent of kids who visited the salad bar increased from 12.6 to 24%. In schools that got the banners as well as the TV spots, the rate went from 10 to 35%. These were pretty impressive numbers.

The main issue here is that the interventions only occurred over a six-week period.  That means that some of this effect could be due to novelty. As the great ad man Don Draper once said, "Even though success is a reality, its effects are temporary".

And it should be noted that there are groups out there who are opposed to marketing to children in all its forms. To some extent, I get that – kids minds are manipulated by cleverly-designed ads all the time.  But could this be a case of the ends justifying the means?

I mean, if it would get my kids to eat their vegetables, I might dress up like Brian the Brawny Broccoli myself.


Do Smarter Babies Walk Earlier? by Methods Man


Do you remember when your little baby took her first step? How about when she sat without support?  How about standing with assistance? Yes, for many of us these "milestones" are not exactly burned in our brain, but a new study from the journal Pediatrics suggests that some of these milestones may be really important – not just for baby journals, but for childhood development. For the video version of this post, click here.

Here’s the deal. We've known for a long time that kids with severe developmental disabilities in childhood seem to meet some gross motor milestones later than expected. But that's looking at an extreme case. The question these researchers had was whether delayed gross motor development would associate with later childhood development in kids without developmental delay.

To answer this question, they turned to the Upstate KIDS study, a prospective cohort study of over 6000 babies born in the New York area.  The study focuses only on 501 of the children though – a subset who agreed to a follow-up examination at 4 years.  So, if you’re keeping score, we’re already looking at a group that is not representative of the population at large.

Based on logs the mothers kept, the researchers looked at when the child achieved certain gross motor milestones like walking. They looked at 6 milestones in all, and compared them to the total developmental score at four years of age. The findings were… subtle.

After adjustment for factors like maternal age, prematurity, and others, there was a statistically significant association between one of the six milestones - later standing-with-assistance and total developmental score. That total score is driven by 5 subcomponents, and when those were analyzed individually, later standing with assistance was associated with worse adaptive and cognitive development.

Similar results were seen in the subset of kids with no developmental disability – the subset, which, speaking editorially here, really should have formed the primary analysis of this study.

So… ok… should we panic if our kids aren't standing and walking like a bunch of little Rory Calhoun's? I'm not ready for that yet. For one, the authors don't appear to have accounted for the multiple comparisons evaluated here – so the marginally statistically significant result has a pretty high risk of being a false-positive. Second, it's not immediately obvious what you would do with a kid who stands with assistance 2.1 months later than the average. Stand them up more? Send them to a neurologist?

In the end, we’d end up giving moms and dads just one more metric to worry about in a world obsessed with measuring kids' performance at every turn. Or every step.