A couple of quotes from this weeks’ BMJ. “Harpal Kumar, chief executive of Cancer Research UK, called on the next government to add the test to the existing national bowel screening programme as one of its first priorities. “I think it is a no brainer,” he said. “This is the most important development in cancer […]
Continue Reading →Bowel cancer screening and noise to signal ratio
What a lot of media noise about a study just out in the Lancet on one-off bowel cancer screening using sigmoidoscopy, a test to examine the lower part of the bowel – usually in outpatients, with no sedation. It’s a well designed, large study, true. But no wonder about the fuss, given the press release […]
Continue Reading →The myth of the body MOT
continues. In yesterdays’ Daily Telegraph there is an enthusiastic large feature on how to spend 2,300 UK pounds upwards on having a what is billed as a full body check up. It’s depressing reading: scant attention is paid to the fact that this – including electrodes to the scalp to check ‘brain functions’ …’ a […]
Continue Reading →why the NHS isn’t so bad…
This article from the NYTimes is an illuminating discourse into what US psychiatry is like. The author describes himself as a psychopharmacologist and clearly is used to treating symptoms with medication. For all the faults of the NHS, this kind of approach in psychiatry is rare. No wonder healthcare costs so much in the States. […]
Continue Reading →The ongoing unethical non-publication of clinical trials
See here :http://www.trialsjournal.com/content/11/1/43 . An examination of trials of medication for stroke which were completed but never published. This problem, the non-publication of trial data, does not seem to go away. I quote: “Well designed clinical trials should be published because their results can benefit patients, justifying the risk to trial participants from experimental treatments. We […]
Continue Reading →The first false positives….
False positives are one of the many banes of screening programmes. In the US, advertising for people to come to private clinics for expensive CT scans, to screen people for lung cancer is common and, of course, legal. Here in the UK, several private companies advertise their services despite COMARE saying that “we have strongly […]
Continue Reading →Dressings, not drugs
Drugs have quite rightly be subject to a lot of angst from cost-effectiveness viewpoints. The NHS is skint. Generics are cheaper than branded: some branded drugs are not well evidence based, as are some generics, and some doctors are not very good at prescribing cost effectively. I confess to being far more aware of the […]
Continue Reading →Swine flu in the UK – how reliable are the numbers?
So how exactly do we know that there are – as the Health Protection Agency says -around 55,000 new cases of H1N1 “swine” flu each week – especially now that we are no longer swabbing patients before prescribing for it? Extrapolation. The HPA does give a range, between 30,000 and 85,000 cases. There are […]
Continue Reading →Who’d be a guinea pig? : column
To be a “guinea pig” in a clinical trial is not an experience people volunteer for lightly. We need only think of the dramatic side-effects of the so-called Elephant Man drug trial at Northwick Park in 2006 to be reminded that volunteers can end up worse off. In that case, there was financial reward for […]
Continue Reading →The increasing advice about swine flu
To have a baby or not? The National Childbirth Trust, a hardworking parenting charity, have been criticised for offering advice (now withdrawn) that women may wish to delay pregnancy until the swine flu pandemic is over. Various other agencies, including the Royal College of General Practitioners and the Department of Health, were quick to respond by saying […]
Continue Reading →