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Stuart Buck: Sharing data from past clinical trials

30 Jan, 15 | by BMJ

Stuart_BuckThere was a time when academic and government researchers performed experiments that were clearly unethical—such as letting syphilis go untreated, or asking people to administer severe electric shocks to each other. Ethics review boards sprang up in an important effort to make sure that research on human subjects remained within the bounds of legality and ethics. But for all the good that ethics review boards do, today they often block undeniably valuable research from going forward. The re-analysis of clinical trial data is a recent case where specious ethics objections are used to stymie good research into the effectiveness of drugs given to patients. more…

Ohad Oren and Michal Oren on the “Cordon Sanitaire Hospital:” A vision being fulfilled

27 Jan, 15 | by BMJ

Credit: Herbert Bishko

Credit: Herbert Bishko


Seven years ago, we outlined our vision of a humanitarian hospital. As Israelis who had witnessed the suffering of the citizens of Gaza, we felt compelled to develop a model that would improve their overwhelming deficiencies in medical care. We envisioned a medical facility that would be dedicated to the care of wounded Palestinians at times of war. According to our model, deployable medical teams of all nationalities, would provide high quality emergency care in the framework of this hospital. We described our vision in a blog and published it in The BMJ. The responses were instantaneous. A pulmonologist, a surgeon, and a paediatrician were among the many who shared their enthusiasm and motivated us to “cross dividing lines and serve humanity.” One sensed a “glimmer of hope” in a relentlessly bloody conflict. Another believed that our dream was possible if “enough people take up the call.” One even wrote that our blog should be “circulated to Israeli and Palestinian leaders and to many more.” more…

Ferelith Gaze: Clarity and stability for the NHS in a time of political uncertainty

26 Jan, 15 | by BMJ

Ferelith_gazeWe are all prey to systemic amnesia, and in the final 100 days before the 2015 general election, we need to be mindful of the particular vulnerability of the NHS to political soul searching. After all, the NHS has, as the Institute for Government notes, been reorganised 20 times in 41 years.

Clearly, change is not new to the NHS, even while its foundations have remained strong. Throughout its extraordinary history the NHS has adapted to patient needs and medical advances, evolved and innovated. It is internationally renowned for its “world-leading … commitment to health and healthcare as a human right,” and ranks first among comparable countries for quality, access, and efficiency. more…

Doug Altman: Author overboard—arbitrary limits at journals

22 Jan, 15 | by BMJ

doug_altmanRecently I was bounced off the authorship of a letter to the editor. I had been one of four authors of a research paper published in a leading medical journal. Subsequently the journal received a critical letter from a reader, and I contributed to our joint response. After submitting our reply we learnt that the journal has an absolute rule that letters cannot have more than three authors, so (as the one who contributed least to the main paper) I had to be omitted. What is the point of such a limit? And how does it square with the ICMJE’s rules on authorship—“all who meet the four criteria should be identified as authors.” Well, it seems that that applies only if there aren’t too many of them. more…

Sarah Kessler interviews Atul Gawande

21 Jan, 15 | by BMJ

Sarah KesslerAtul Gawande, surgeon, author, and indie DJ (check his Twitter feed for mini playlists between the policy), just delivered the Reith Lectures for BBC Radio 4.

Broadcast to more than 50 million people worldwide, “The Future of Medicine” ranged across the UK, the United States, and India in a quest to navigate “the messy intersection of science and human fallibility.” more…

Charlotte McIntyre: How to survive your surgical ARCP

15 Jan, 15 | by BMJ

charlotte_mcintyreThe Annual Review of Competence Progression (ARCP) was introduced in 2007, as part of the implementation of Modernising Medical Careers (MMC), and can be an especially daunting time for surgeons in training. Particularly, if it is your first surgical ARCP, trying to ensure that you will meet all of the expected requirements can seem like a Sisyphean task. more…

Mike Smeeton: How to achieve a good death

12 Jan, 15 | by BMJ

Mike SmeetonTwo nurses from our Sue Ryder Nettlebed Hospice were interviewed recently by Paddy O’Connell for his Broadcasting House programme that airs on BBC Radio 4 every Sunday.

The reason for the interview, which you can listen to here, was to talk about a very topical conversation which has been taking place following Richard Smith’s blog in The BMJ. His blog which says that cancer is the best way to die has created a lot of conversation and a lot of media coverage.

In our experience, it’s not the condition that dictates whether someone has a “good death,” but how you die that is important. Focusing on the condition inhibits personalisation and informed choice for patients and their families. Instead, we work closely to find out what the most important elements of end of life care are for them. We think that a good death is all about coordinated, personalised, and compassionate care, where the dying person and their loved ones have coordinated access to the support services that they need and want 24/7. more…

Frank Chalmers: Channel swimming—the great leveller

17 Dec, 14 | by BMJ

Channel trafficAs soon as I opened The BMJ Christmas paper, Captain Webb’s legacy: the perils of swimming the English Channel, I knew I was in for something different. The Channel fare I’m used to consuming often begins with lazy questions, such as: “If you need a pee in the water, can you get on the boat”’

Answer: “No. You’d be disqualified, and if you’re swimming in billions of gallons of water, why would you want to?”

This paper was, interesting, informed, and authoritative, and the accompanying short film by Martin Freeth also brought memories flooding back of my own solo Channel swim in 2005. more…

Nancy Devlin, John Appleby, David Parkin: Why has the PROMs programme stalled?

3 Dec, 14 | by BMJ Group

In 2009, the English NHS introduced a world leading initiative in the pursuit of quality healthcare: the measurement of patients’ views about their own health became a routine part of the delivery of NHS funded services. In an initiative led by the Department of Health, robust and reliable condition specific and generic (EQ-5D) patient reported outcome measures (PROMs) are now completed by patients both before and after four elective surgical procedures. more…

Yogesh Jain and Raman Kataria: The pathology of a public health tragedy

3 Dec, 14 | by BMJ Group

yj_pic Lessons from the Bilaspur sterilization camp 

The recent deaths of 13 women in India operated on at a sterilization camp in Bilaspur, Chhattisgarh, has thrown up urgent questions on the delivery of these services. As doctors observing health systems for the poor from close quarters in Bilaspur for the last fifteen years, we are convinced this was a tragedy waiting to happen. It is a collective failure of our society as a whole to see the stark inequity that erodes the health system, which these poor women have had to pay for with their lives.


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