• Watch this space
Will future historians mark 2015 or 2016 as the beginning of a new era of drug and device regulation? Proposed legislation in the United States, popular for its promise to increase funding for the National Institutes of Health, easily passed in the House of Representatives last week. However, the 350 page bill, now heading to the Senate, has been called a Trojan horse by prominent critics who say it is promising to deliver new treatments only through weakening standards used in the drug approval process.
• Should doctors recommend homeopathy?
Billions are spent on homeopathy, but The BMJ asks: should doctors partake? In a head to head debate, Edzard Ernst says “No.” With no plausible physiological basis for their purported effects and a recent Australian evidence review implying the remedies are nothing more than high priced placebos, doctors recommending homeopathy “seems unreasonable, even unethical.” But Peter Fisher argues otherwise, pointing out flaws in the Australian study and highlighting other evidence that indicates benefit. He says doctors “should put aside [their] bias based on the alleged implausibility of homeopathy,” and pay attention to the evidence.
• Avoiding death in hospital
Overall, admitted patients have around a 10th of 1% chance of dying an avoidable death in a UK hospital, reports an editorial. Yet still we know that in some hospitals, the odds are far worse than in others. Unfortunately, figuring out some kind of early warning system to detect—and correct—the outliers is proving difficult. This linked editorial discusses a research study that found no clear association between death rates reported by hospitals and the number of deaths that should have been avoided, raising questions about the continued use of such “standardised mortality ratio” metrics around the world.
Peter Doshi, associate editor, The BMJ.