{"id":184,"date":"2007-04-10T11:26:44","date_gmt":"2007-04-10T10:26:44","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/04\/10\/bmj-7-apr-2007-vol-334\/"},"modified":"2007-04-10T11:26:44","modified_gmt":"2007-04-10T10:26:44","slug":"bmj-7-apr-2007-vol-334","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/10\/bmj-7-apr-2007-vol-334\/","title":{"rendered":"BMJ  7 Apr 2007"},"content":{"rendered":"<p>In England, we are lucky to have our screening programmes presided over by a sceptical Scot (Muir Gray) who is alert to the dangers of screening. Nevertheless, <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/334\/7596\/725\">argues Nicola Law here<\/a>, we are in the process of adopting a policy for opportunistic Chlamydia screening in young women based on evidence that is contradictory and frequently misrepresented.<!--more--><\/p>\n<p>As it happens, I had drafted a short piece on coeliac disease in primary care recently with a GP partner who did the first important case-finding study using an antibody assay. It\u2019s clear that we need a clinical prediction rule to save many patients duodenal biopsy, and <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/334\/7596\/729\">this study<\/a> shows that you can omit it in those with a high clinical probability and positive serology, and those with low clinical probability and negative serology. The Sheffield tissue transglutaminase assay doesn\u2019t perform nearly as well as our specially concocted Oxford endomysial antibody assay did 8 years ago (100% positive predictive value in all groups), but theirs is probably more typical of the run of available assays. Roger Jones\u2019 acompanying <a href=\"http:\/\/www.bmj.com\/cgi\/content\/extract\/334\/7596\/704\">editorial <\/a>in my view overstates both the extent to which coeliac disease is currently underdiagnosed in UK general practice, and the importance of detecting it in asymptomatic patients.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In England, we are lucky to have our screening programmes presided over by a sceptical Scot (Muir Gray) who is alert to the dangers of screening. Nevertheless, argues Nicola Law [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/10\/bmj-7-apr-2007-vol-334\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-184","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>BMJ 7 Apr 2007 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/10\/bmj-7-apr-2007-vol-334\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"BMJ 7 Apr 2007 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"In England, we are lucky to have our screening programmes presided over by a sceptical Scot (Muir Gray) who is alert to the dangers of screening. Nevertheless, argues Nicola Law [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/10\/bmj-7-apr-2007-vol-334\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2007-04-10T10:26:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/richard-lehman.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"540\" \/>\n\t<meta property=\"og:image:height\" content=\"350\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"BMJ 7 Apr 2007\",\"datePublished\":\"2007-04-10T10:26:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/\"},\"wordCount\":204,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/richard-lehman.jpg\",\"articleSection\":[\"Richard Lehman's weekly review of medical journals\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2007\\\/04\\\/10\\\/bmj-7-apr-2007-vol-334\\\/\",\"name\":\"BMJ 7 Apr 2007 - 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