The release of NICE guidelines allows MESH to be used in the NHS once again; the guidance, however, has proved controversial: MPs and campaigners have warned NICE guidance neglects the serious risks associated with the use of mesh in surgery. They also fear the evidence is untrustworthy, biased and too low quality to inform […]
Year: 2019
BMJ EBM Verdict Tracker
The EBM Verdict tracker is updated monthly to select the research evidence that can matter to clinical practice: EBM Verdict articles are published in BMJ EBM. EBM Verdict Evidence that helps you come to a definitive conclusion and can be implemented into clinical practice. Introducing the EBM Verdict: research evidence relevant to clinical practice […]
Assessing bias in studies of harms: a case study of Primodos and congenital malformations
In a recent systematic review, we assessed the use of Primodos, an oral hormone pregnancy test (HPT) marketed between 1958 and 1978, and the associated risk of congenital malformations. This post discusses the assessment of quality in assessing associations of harms. Carl Heneghan We found oral HPTs in pregnancy was associated with an increased […]
Bard withdraws its surgical urogynaecological mesh: what next?
Bard has stopped production and distribution of their urogynaecological mesh products – all 20 of them (see here MDA 2019 014). The question now is what’s needed next. Carl Heneghan The medical device alert by C.R. Bard, on the 7th March, removed all surgical mesh for stress urinary incontinence (SUI) and pelvic organ prolapse […]
Gender-affirming hormone in children and adolescents
Gender dysphoria occurs when a person experiences discomfort or distress because of a mismatch between their biological sex and gender identity. Gender dysphoria can arise in childhood and adolescent which raises many questions about how best to handle the condition. This post sets out some of the current evidence for gender-affirming hormones in adolescents […]
Understanding Lung Cancer Screening
Understanding screening is difficult. Responses to screen, or not to screen individuals, is often an emotional topic. This blog sets out evidence that might inform such screening decisions. If I get something wrong, or there is something you’d like to discuss then email me, send a message via twitter – I’ll add or correct the post […]
Pregabalin in neuropathic pain
Pregabalin has some beneficial effects in the management of neuropathic pain. However, there is an increased risk of adverse events and discontinuation because of adverse events. Igho Onakpoya In our recent systematic review [1], we searched for evidence from human trials that compared pregabalin with dummies in patients with neuropathic pain. We included studies of neuropathic […]
The influence of medical marketing
Marketing and advertising in medicine are on the rise and affecting all aspects of healthcare: $30 billion a year is currently spent on medical marketing in the US. Carl Heneghan A recent study by Lisa Schwartz and Steve Woloshin in JAMA assessed medical marketing in America over a twenty year period. Using consumer advertising data they […]
Surrogates and missing data in cancer trials
Most surrogate outcomes in cancer studies have little – if any – connection with overall survival, which is affecting patient care and leading to the approval of treatments that don’t work. Carl Heneghan Surrogate markers are often used in an attempt to predict the real outcome of interest such as death. Because they are […]