A Word About Evidence: 3. Manifesto

  A manifesto for Evidence-Based Medicine (EBM) was published in the BMJ earlier this year and presented at Evidence Live. Jeff Aronson has been thinking again about the word manifesto. The Indo-European root MAN meant a hand. The Latin word was manus, from which we get words such as maintain, manacle, manage, manège, manicure, manipulate, […]

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Self-management of asthma – is there an app or pulse oximeter for that?

  While the app technology is developing at a fast pace, it seems the evidence is not keeping up to say how asthma patients might use these devices.  Annette Pluddemann 334 million people globally have asthma with 1 in 7 of the world’s children experiencing asthma symptoms that require lifelong management. Pulse oximeters are marketed […]

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Seven ways to ensure faster removal of harmful medicines

  Harmful medicines sometimes stay on the market for longer than they should. When that happens, people are unnecessarily exposed to medicines that may adversely affect their health. Igho Onakpoya The benefit-harm balance of new medicines is often not fully known at the time marketing licences are granted. More information about harms often becomes apparent […]

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Five reasons why diagnostic studies fail

  The number of studies assessing the diagnostic accuracy of tests is growing rapidly, but many studies fail to impact on practice due to five fundamental flaws in their methods. Jack O’Sullivan Diagnostic accuracy studies aim to determine how good a new test is at diagnosing a disease compared with a current test. To do this, […]

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Oxygen in heart attack: has practice caught up with the evidence?

  Use of oxygen in heart attack patients has remained uncertain for over 40 years, but clinical practice has only recently caught up with the evidence. Carl Heneghan My Oxford Handbook of Acute Medicine – getting rather old now, like me – states to give oxygen in the initial management of myocardial infarction. Oxygen was routine […]

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Rare adverse events in clinical trials: understanding the rule of three

  Investigators should report rare and very rare adverse events in clinical trials: Igho Onakpoya reports why it is important that all events are reported irrespective of their frequency.   Even though they may not give a signal in any single trial, a meta-analysis could reveal potentially important drug-adverse event associations that might require further […]

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Why do rates of knee arthroscopy differ?

  A recent trial of keyhole knee surgery for partial meniscectomy showed surgical intervention was ineffective. Surgery rates have varied markedly over time and across the UK, suggesting there is a lot of overtreatment.  Carl Heneghan Published in the Annals of Rheumatic Diseases the randomised trial reported arthroscopic partial meniscectomy was no more effective than […]

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Is it the end for type 2 diabetes monitoring?

  More intense monitoring makes no difference to outcomes in type 2 diabetes and costs a lot more, but not everyone agrees on what should be done in practice. Carl Heneghan,  Ben Goldacre Glucose self-monitoring with automated feedback messaging in type 2 diabetics not taking insulin makes no difference to patient outcomes and costs a lot […]

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EBM Library – Systematic reviews in policymaking: part 1

  The EBM library signposts some essential reading for the practice of Evidence-Based Medicine. In this part of the library, we highlight papers that reflect the role of systematic reviews in policymaking. Kamal R. Mahtani One of the purposes of conducting systematic reviews is to provide accessible evidence to inform clinical decisions. In healthcare, they […]

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