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 […]
Latest articles
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 […]
EBM Roundup – Devices and Facebook vaccines
In the second of our EBM round-ups, Carl Heneghan, Helen Macdonald and Duncan Jarvies are joined by Deborah Cohen, investigative journalist and scourge of device manufacturers. We’re giving our verdict on the sensitivity and specificity of ketone testing for hyperemesis, and the advice to drinking more water to prevent recurrent UTIs in women. Deb […]
Finding practice-changing research evidence
How do we find the evidence that might be of interest to individual health professionals? Jon Brassey We’re all aware of the explosion of medical knowledge: “Seventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up?” sums up the problem in the title alone, while the NEJM reports “In 1950, […]
Updated EU Medical Device Regulations: do they make a difference?
I’ve taken a look at the new EU medical device regulation including the clinical evidence required, the postmarketing data needed and the proposed device database and how it might be interpreted. Carl Heneghan The International Consortium of Investigative Journalist (ICIJ) has published the “Implant Files.” Their global investigation, which I’ve been a part of, […]
Harms in Healthcare: Primodos, Vaginal Mesh and Sodium Valproate
The UK Government is holding a review after patient-led campaigns on 3 NHS treatments: the hormone pregnancy test Primodos used up until 1978; the anti-epileptic drug sodium valproate and its use in pregnancy and the use of vaginal mesh. Carl Heneghan Next week I’ve been asked to present evidence to the Independent Medicines & Medical […]