{"id":33831,"date":"2015-04-02T10:33:19","date_gmt":"2015-04-02T09:33:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=33831"},"modified":"2015-04-02T10:33:19","modified_gmt":"2015-04-02T09:33:19","slug":"the-bmj-today-lucentis-vs-avastin-fracking-and-delusional-infestation","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/04\/02\/the-bmj-today-lucentis-vs-avastin-fracking-and-delusional-infestation\/","title":{"rendered":"The BMJ Today: Lucentis vs Avastin, fracking, and delusional infestation"},"content":{"rendered":"

Good morning. Here\u2019s what is new on thebmj.com<\/a>\u00a0today.<\/p>\n

The BMJ<\/em> Investigation: Lucentis vs Avastin<\/strong>
\n\"avastatin\"<\/a>\u2022 Why have UK doctors had difficulty prescribing a cheap, safe, and effective drug (Avastin) and instead turned to a far more expensive one (Lucentis) for the treatment of wet age related macular degeneration?\u00a0An investigation by The BMJ’s<\/em> investigations editor Deborah Cohen reveals the behind the scenes efforts by industry<\/a> to “undermine and divert attention” from the evidence base.<\/p>\n

In a linked editorial, Jeffrey Aronson and Robin Ferner argue that<\/a> while the drug licensing system ostensibly constrains physician and patient choice in order to protect patients from harm, driving patients towards expensive formulations comes with a cost: \u201can opportunity cost that reduces the quality of care that can be delivered elsewhere in the NHS.\u201d<\/p>\n

For clinicians who wonder about the legality and other professional consequences of prescribing a drug \u201coff-label,\u201d David Lock, Queen\u2019s Counsel, has written a linked briefing of this and other \u201cfrequently asked questions<\/a>.\u201d<\/p>\n

BMJ Confidential<\/strong>
\n\"robin_stott1\"<\/a>\u2022 The BMJ<\/em> interviews Robin Stott, physician, medical director, and dean at Lewisham Hospital in London<\/a>. Stott recommends reading Tao Te Ching<\/em> by Chinese philosopher Lao Tzu; declares that Britain has never had a secretary for health; and says if he had \u00a31m, he would spend it on the groups \u201cwho work to put in place the social, environmental, and fiscal networks necessary for global good health.\u201d<\/p>\n

News<\/strong>
\n\u2022 Meanwhile, Medact\u2014one of the campaigning groups highlighted by Robin Stott\u2014calls for an immediate moratorium on fracking for shale gas<\/a>, characterizing the practice as \u201cinherently risky\u201d and in need of comprehensive assessment.<\/p>\n

Research<\/strong>
\n\"laminectomy_for_spinal_stenosis,\"<\/a>\u2022 In Research, we have dueling treatments for stenosis of the lumbar spine<\/a>. Norwegian researchers present the results of an observational study embedded in routine clinical practice that compared minimally invasive decompression versus open laminectomy. The primary outcome was change in Oswestry disability index score one year after surgery. An editorialist notes the importance of this study for its use of \u201cbig data,\u201d<\/a> but suggests the results would have been more meaningful if the trial had been designed to test potential superiority of alternatives to traditional laminectomy.<\/p>\n

Research News<\/strong>
\n\"apples\"<\/a>\u2022 Finally, an apple a day does not keep the doctor away, according to a study published in JAMA Internal Medicine<\/em> and reported in The BMJ<\/em>\u2019s selection of research news<\/a>. However daily apple consumption was associated with lower prescription medications.<\/p>\n

Practice<\/strong>
\n\u2022 Lepping and colleagues offer advice on how to approach delusional infestation<\/a>. \u201cDelusional infestation is a diagnosis of exclusion,\u201d they write, and urge clinicians that have exhausted other potential diagnoses to acknowledge patients\u2019 distress and be empathetic but not \u201creinforce the delusion.\u201d<\/p>\n

Peter Doshi<\/strong>\u00a0is an associate editor for <\/em>The BMJ.\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Good morning. Here\u2019s what is new on thebmj.com\u00a0today. The BMJ Investigation: Lucentis vs Avastin \u2022 Why have UK doctors had difficulty prescribing a cheap, safe, and effective drug (Avastin) and […]<\/p>\n

More…<\/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-33831","post","type-post","status-publish","format-standard","hentry","category-the-bmj-today"],"yoast_head":"\nThe BMJ Today: Lucentis vs Avastin, fracking, and delusional infestation - 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\/2015\/04\/02\/the-bmj-today-lucentis-vs-avastin-fracking-and-delusional-infestation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The BMJ Today: Lucentis vs Avastin, fracking, and delusional infestation - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Good morning. 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