Important paper in JAMA: ovarian cancer screening using transvaginal ultrasound and serum Ca-125 testing does not reduce mortality from ovarian cancer. Worse, there “Diagnostic evaluation following a false-positive screening test result was associated with complications”. The harms of this ineffective intervention: “Of 3285 women with false-positive results, 1080 underwent surgery (32.9% for oophorectomy) as part […]
Continue Reading →FEAST clinical trial
You can do high quality research work in rural Uganda – randomised controlled trials save lives. This video is wonderful http://www.youtube.com/watch?v=hK9VUkL-DqU
Continue Reading →Early trial results and sex revolution overselling
I’m trying to get hold of the press release or poster or whatever it was from the American Society of Reproductive Medicine that triggered this Guardian article, here: ‘Contraceptive gel could offer alternative to pill’. It’s an opinion piece which says ‘As with the pill, though, these are hormone-based treatments that can have unpredictable consequences […]
Continue Reading →The origin of PMT
I’ve had some truly fascinating emails in response to this column on PMT. I had forgotten completely about this BMJ paper, from 1953, which you can view for free if you register. The first author is Katharina Dalton, who is famous for advocating progesterone to ‘treat’ PMT, and which is now recognised as being non […]
Continue Reading →Waky up time: pathology isn’t black and white
..and if I remember much from histology, it often comes in shades of pink. The NYT today has an interesting article; shock horror – cancer that might not be. It focuses on the DCIS phenonema – if you have been reading for a while you’ll know that ductal carcinoma in situ is a ‘cancer’ that […]
Continue Reading →Statins: benefit (again) overstated?
Regular readers will know my ongoing concerns about statins: these drugs now make up one of the most frequently prescribed medications, and especially to well people. The benefits for people who have had a heart attack or stroke are one thing, but the potential benefit to people who are scored at being as high risk […]
Continue Reading →what’s a mistake?
Diagnosis is an odd thing: occasionally it is easy and satisfying (at least to the doctor). More often it is elusive, taking time, tests, and possibly time again to become clear. I’m not even sure if I do make a definite, cast-iron diagnosis that often. Another way of looking at symptoms, and which seldom appear […]
Continue Reading →Private “NHS” provision, continued
Previous post on Clinicenta here: This week the medical newspaper Pulse reports multiple ongoing concerns . I note that one of the major problems is felt to be staff inexperience. Of course, if recruiting on the basis of cost is a factor then this is going to be, too: and when you are in a […]
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 […]
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