Trial reportBMJ (Clinical research ed.)2019
Q fever-the superstition of avoiding the word "quiet" as a coping mechanism: randomised controlled non-inferiority trial.
Trial report in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- "Shh-don't say the Q-word" or do you?The British journal of oral & maxillofacial surgery · 2021Trial
- Elective arthroplasty on "high-risk" calendar dates: no evidence for worse outcomes in 43,000 procedures.Archives of orthopaedic and trauma surgery · 2026Article
- Friday Leukemia-a Structural Phenomenon.Deutsches Arzteblatt international · 2024Article
- A quiet place: The impact of the word "quiet" on clinical workload.World journal of otorhinolaryngology - head and neck surgery · 2023Article
- Debunking the myth of using "quiet" in clinical departments: an integrative overview of available literature.Annals of medicine and surgery (2012) · 2022Article
- Epidemiological Characteristics and Clinical Manifestations of Brucellosis and Q Fever Among Humans from Northeastern Inner Mongolia.Infection and drug resistance · 2022Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the validity of the superstition that utterance of the word "quiet" in a clinical setting increases workload.
designProspective randomised controlled non-inferiority study.
settingMicrobiology department of a large teaching hospital in Lancashire, UK.
participantsTwo members of the medical microbiology team carried out the duty work on any given week day and an on-call team member on any weekend day. 29 days were assigned in which staff were to say "Today will be a quiet day" and 32 days were assigned in which staff were to refrain from saying the word "quiet" in any context.
interventionsEach day was randomly allocated to either saying "Today will be a quiet day" (intervention group) or refraining from saying the word "quiet" (control group) in any context.
main outcome measuresThe primary outcome was mean overall workload: a composite of number of clinically related telephone calls, clinically significant results, or validated results processed by the duty medical microbiology team during a 24 hour period referred to collectively as "clinical episodes." A difference of 30 clinical episodes was considered as the margin of non-inferiority. Secondary outcomes included the individual components of the primary outcome.
resultsWorkload was measured each day over a 61 day period (1 May to 30 June 2019). A mean 139.0 clinical episodes occurred on control days compared with 144.9 on days when the experimental intervention was uttered, a difference of 5.9 (95% confidence interval-12.9 to 24.7). The upper bound was less than the specified margin of 30, providing evidence for non-inferiority. No evidence of a difference in workload was found between interventions with any of the four components, whether considering unadjusted or adjusted analyses, or looking at the subgroups of week days or weekends.
conclusionsThe study findings refute the long held superstition that utterance of the word "quiet" impacts on clinical workload, and therefore it should not be avoided. In the era of considerable staff shortages and increased work related stress, doctors should look to other methods to increase resilience and protect their wellbeing and mental health.
trial registrationLancashire Teaching Hospitals NHS Foundation Trust's research department SE-259.
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