Re: The survival time of chocolates on hospital wards: covert observational study
I thank Gajendragadkar and colleagues for their timely paper on this under-researched and neglected field.
I do, however, note that 36% of chocolates were lost to follow-up (!) With so many chocolates missing from the data, I am concerned that this may hide significant biases in the data. The authors diligently note that the investigating team was composed entirely of junior doctors. Given the significant numbers lost to follow up, I theorise that a) junior doctors may have been prone to under-recording of their own chocolate use and/or b) due to the hierarchical nature of the medical profession, junior doctors may have felt unable to record use of chocolate by their senior colleagues.
Furthermore and only anecdotally, with the advent of 'safari' ward rounds, I have noted that large numbers of doctors may arrive onto a ward within minutes of each other and eat large numbers of chocolates in a manner that may be difficult to capture in data with only a single observer.
I therefore sincerely hope that further research into this field uses novel 'blinding' methods for preventing bias, or at the very least a multi-disciplinary research team. Use of video-recording in this context, though not without its ethical problems, may assist future researchers.
Competing interests: I have attended to patients on wards with up to 5 boxes of chocolate present at any one time. I prefer Quality Street to all other brands of chocolate.