David Cameron is apparently about to announce that private companies – i.e., pharmaceutical companies – will be able to access NHS patient data. Over the last couple of years, I have had concerns that the opt-out system into electronic medical records is wrong, and should instead be an opt-in system. I’ve been concerned that the kind of […]
Continue Reading →What’s a conflict of interest when it comes to breast screening?
The medical press is carrying a lot about the latest international arguments about breast screening. The BMJ carried an excellent editorial ‘Mammography wars” highlighting the recent Canadian taskforce on the subject. This called for a halt to routine breast examination, and a starting age of 50 before starting screening mammography, which they recommended to be […]
Continue Reading →Dr Foster, association and causation
The headlines today have been driven by publication of the ‘Dr Foster’ (“the UK’s leading provider of comparative information on health and social care services”) annual hospital guide. The Guardian have reported it as have the Telegraph, who headline “Experts warn hospitals not to cut staff over weekend death risk.” They have presented their data as […]
Continue Reading →False hope and real living
The Quackometer has had some rather unpleasant emails following his criticism of the Burzynski clinic. The issue is that some people wanted to kindly raise money for a child with cancer to be treated there, when the evidence for the proffered interventions is questionable. Other people have examined the science very well. There is something […]
Continue Reading →Nuffield Health : adverts and evidence
This is an advert from this week’s BMJ. I am positively fuming about it. Nuffield Health are responsible for some non evidence based practices via their ‘health assessments‘. These currently consist of annual mammograms for women over 40, annual cervical smears, pelvic (ie vaginal) examination, urine analysis, ‘hydration levels’ and a chest xray ‘if […]
Continue Reading →General practitioners and sickness absence
Currently, it works like this. If you are ill and unable to work, you sign yourself off work for the first 7 days. This is self-certification. After this, you need a doctors’ line – the so-called Fit Note. This is a certificate from the doctor to say that you are currently unable to work due […]
Continue Reading →NICE, caesarian sections and the weekend press
In May 2011 NICE published draft guidance on caesarian sections which were not medically necessary. The guidance they have drafted is cut and pasted below. Over the weekend there was extensive coverage of the guidance. Here is the Daily Mail, Channel 4 News, The Sun, and the Independent; there was also a Press Association notice. It all […]
Continue Reading →Review of breast cancer screening evidence
Professor Susan Bewley challenged Prof Mike Richards on the evidence for her invite to breast screening, in the BMJ. He responded by saying a review was already underway, but it sounds like a weird review. He says that “An independent review of the research evidence (randomised controlled studies and observational studies) is being undertaken, led […]
Continue Reading →Are GPs failing new mothers with postnatal depression?
According to the Guardian, on the 1st October, we GPs are. I quote Ann Longfield, chief executive of 4Children, on a survey done of new mothers, which supposedly show most are offered antidepressants, not counselling : “Longfield said that the results of the report were shocking and showed that postnatal depression was not being taken seriously: “It […]
Continue Reading →GPs ‘failing cancer patients’
From the Guardian, and also making it’s way forth into the Daily Mail, the Mirror, Management in Practice, and Pulse , amongst others. The story is apparently that “GPs are failing to identify conditions such as osteoporosis, heart disease and bowel trouble that can affect patients’ lives for years after they have become free of tumours, claims […]
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