{"id":31876,"date":"2014-07-02T10:26:43","date_gmt":"2014-07-02T09:26:43","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=31876"},"modified":"2014-07-03T10:08:23","modified_gmt":"2014-07-03T09:08:23","slug":"the-bmj-today-statins-and-uncertainty","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/07\/02\/the-bmj-today-statins-and-uncertainty\/","title":{"rendered":"The BMJ Today: Statins and uncertainty"},"content":{"rendered":"<p>And so the debate about the adverse effects of statins rumbles on.\u00a0Nigel Hawkes <a title=\"Hawkes\" href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4380\" target=\"_blank\">reported<\/a> from yesterday&#8217;s press briefing at the Science Media Centre\u00a0saying that the &#8216;Statins War&#8217; shows &#8216;no signs of a ceasefire&#8217;. Six\u00a0leading professors of cardiology and epidemiology present at the\u00a0meeting backed the NICE guidance on extending the use of statins,\u00a0expressing conviction that benefits of statins outweigh the risks.<!--more--><\/p>\n<p>But how,<a title=\"Ben Goldacre response\" href=\"\/\/www.bmj.com\/content\/348\/bmj.g3306\/rr\/759401\" target=\"_blank\"> argues<\/a> Ben Goldacre in a recent rapid response do patients (and\u00a0doctors for that matter) weigh up the risks and benefits of\u00a0preventative treatments such as statins when each patient is different\u00a0and each has different needs?<\/p>\n<p>Professor Peter Weissberg, Medical Director of the British Heart\u00a0Foundation (ref Hawkes- link above) has stated that &#8216;objective\u00a0evidence from RCTs is particularly important with a drug such as a\u00a0statin where we have to strike a balance between visible harm and\u00a0invisible benefit&#8217;. With these &#8216;invisible benefits&#8217; in mind, Ben\u00a0Goldacre highlights that with this new type of preventative treatment\u00a0medicine we may find ourselves becoming less like doctors and more\u00a0like being a life insurance sales team &#8216;offering occasional benefits,\u00a0many years from now, in exchange for small ongoing costs&#8217;.<\/p>\n<p>The theme of uncertainty continues with a recent clinical review on <a title=\"Allergic rhinitis\" href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4153\" target=\"_blank\">allergic rhinitis in children<\/a>. The authors provide clarity on the management\u00a0of this important condition with its potential to have major impact on\u00a0children&#8217;s quality of life, as well as being a risk factor for a child\u00a0developing asthma in later life. They set out the evidence for use of\u00a0nasal irrigation, second generation H1 antihistamines as well as\u00a0modern intranasal glucocorticoids and immunotherapy.<\/p>\n<p>And Margaret McCartney\u00a0<a title=\"Margaret McCartney\" href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4368\" target=\"_blank\">highlights<\/a> the difficulties faced in primary care in making\u00a0appropriate cancer referrals. She says that UK&#8217;s health secretary&#8217;s\u00a0suggestion to &#8216;name and shame&#8217; surgeries with low referral rates\u00a0represents &#8216;a failure to understand what GPs do&#8217;.<\/p>\n<p>Whether discussing the risks and benefits of statins, or spending time\u00a0making a diagnosis of cancer, the ultimate outcome for patient care is\u00a0that we present our patients with sufficient information in order to\u00a0support them to be able to make &#8216;their own truly informed decisions&#8217;.\u00a0(ref Goldacre -see link above).<\/p>\n<p><em><strong>Cath McDermott<\/strong> is education editor, The BMJ<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>And so the debate about the adverse effects of statins rumbles on.\u00a0Nigel Hawkes reported from yesterday&#8217;s press briefing at the Science Media Centre\u00a0saying that the &#8216;Statins War&#8217; shows &#8216;no signs [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/07\/02\/the-bmj-today-statins-and-uncertainty\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5750],"tags":[],"class_list":["post-31876","post","type-post","status-publish","format-standard","hentry","category-the-bmj-today"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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