The New England Journal of Medicine recently published research findings on prostate cancer screening. The results, from my reading at least, showed that screening was not terribly useful. So I was bewildered by subsequent media coverage that urged men to exercise “their right” to a prostate specific antigen blood test or PSA. A number of […]
Continue Reading →Making over the pharmaceutical industry
Or perhaps not so much a makeover, but a radical shift in how drug research is decided upon, performed and reported. The suggestions come from Sir Iain Chalmers, who is editor of the James Lind Library in Oxford, and Silvio Garattini, director of the Mario Negri Institute for Pharmacological Research in Milan. Writing in the […]
Continue Reading →Breast screening in the USA
Pleased to see that ripples from the UK have now reached the US.
Continue Reading →In praise of slow medicine
I have been inspired by Harry Eyres’s piece on Slow London in the FT over the weekend. So much of working in medicine feels like a sprint. Short and overbooked appointments, busy clinics, multiple bits of administrative work to be ticked, crossed, signed and dated; e-mails and correspondence to deal with, questions from patients and […]
Continue Reading →The nipple effect
“And so,” said my extremely pregnant friend while ordering lunch, “we’ve talked about it, and we’re going for nipple stimulation.” Nipples do not normally come up over coffee. I must have looked alarmed. No, no, my friend insisted, this was an evidence-based endeavour to bring on labour. She thought that I would approve. And what’s […]
Continue Reading →FAST, and furious
The FAST campaign wants you to call 999 if you can answer, about someone you’re with, “yes” to the question “Has their Face fallen on one side?”, “no” to “Can they raise both Arms and keep them there?”, or “yes” to “Is their Speech slurred?” The idea is to get people with strokes to hospital as quickly […]
Continue Reading →The dangers of databases
The Joseph Rowntree Reform Trust is today launching a report, “Database State”, which examines the rationale, security and consequences of 46 public sector databases. It is co-authored by Ross Anderson, professor of security engineering at Cambridge University, who is an outspoken critic of government databases. The results are startling. Two databases, the NHS Detailed Care […]
Continue Reading →In praise of wild swimming
Indoor swimming pools have many attractions. Heated and disinfected water, private changing space, and even the occasional Jacuzzi on the side. So why would anyone want to swim outdoors? Britain’s seas and rivers are often shockingly cold, and they are also inhabited by all […]
Continue Reading →Mid Staffordshire NHS Trust: a failure of policy
The investigation into the Mid Staffordshire NHS Trust makes for harrowing reading. The mortality rate at the hospital was found to be high in patients admitted as an emergency. The first data that showed an increase in the standardised mortality ratio was in 2005. The Healthcare Commission investigation was done during last year, 2008, and is reporting […]
Continue Reading →Rate my doctor
The concept of doctor-rating websites seems to be gathering political momentum; in fact, it’s already a reality. The NHS is being offered this data, apparently to ensure that “patient choice” is offered and “patient experience” is good. I think it’s an unproven and potentially hazardous waste of money. There’s a piece that I wrote for the BMJ here; […]
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