EBM students, if you haven’t already seen this paper then it’s a must-read: Why Did the Randomized Clinical Trial Become the Primary Focus of My Career? Carl Heneghan The late David Sackett, the first Director of CEBM, undertook, wrote about and researched the methods of randomized controlled trials for most of his career. Why? […]
Latest articles
UK bans transvaginal mesh: here’s 5 reasons why
The problems with transvaginal mesh are longstanding and have gone on far too long Carl Heneghan This week the UK put a temporary ban on surgical mesh for stress urinary incontinence. Julia Cumberlege, who chaired the review, said: “I have been appalled at the seriousness and scale of the tragic stories we have […]
NHS Health Check appears neither equitable nor cost-effective
NHS health checks may be missing the point when it comes to offering the optimal interventions and preventing cardiovascular disease. Carl Heneghan Since 2009 the NHS Health Check programme in England has added considerably to GP workload and has proved to be controversial given the uncertainty about whether it adds value. A Cochrane review found […]
A Word About Evidence: 8. Data—usage and who owns them
In the second of two blogs, Jeff Aronson considers how the word “data” is used in bioscience publications and discusses who owns data and collections of data. Usage Whether we can use etymology or grammar to settle the question of the singularity or plurality of “data” (it appears to be both), we can determine […]
A Word About Evidence: 7. Data—etymology and grammar
In the first of two blogs, Jeff Aronson considers the etymology of the word “data” and grammatical aspects of its usages, with the intention of discussing who owns data and collections of data. I was recently verbally accosted (the word is not too strong) by a professor of computing science who demanded to know […]
Paracetamol for patent ductus arteriosus
A recent review suggests paracetamol may be as effective as ibuprofen for the closure of patent ductus arteriosus. But there is much more to come with 19 more trials due to report. Carl Heneghan In preterm newborns, the mainstay of treatment for patent ductus arteriosus have been ibuprofen or surgery; however, case reports have […]
NOACs: good for some perhaps, but not for all
‘More than ten years of use, there remains uncertainty as to which populations are most likely to benefit from NOACs.’ Kamal Mahtani Over the last ten years, prescribing of non-vitamin K oral anticoagulants (NOACs) has increased substantially. In the UK, an estimated 58% increase has been quoted with a nine-fold increase in anticoagulant costs. […]
Should you treat resolved Atrial Fibrillation?
Do patients with resolved AF have a higher risk of strokes, asks Jack O’Sullivan Patients with Atrial Fibrillation (AF) are five times more likely to have a stroke than patients without AF. AF can be reversed (sinus rhythm restored) via catheter ablation or cardioversion (either electrical or chemical). Patients can also spontaneously revert to sinus […]
Overestimation of cardiovascular risk and what to do about it
A New Zealand study sets new standards for predicting cardiovascular risk and questions the validity of pre-existing risk equations Carl Heneghan Prevention of cardiovascular disease relies on identifying those most at risk. Most cohorts of patients were established many years ago with patients at higher risk. A recent prospective cohort study done in New Zealand representing primary care […]
Diagnosing childhood coeliac disease without biopsy
Can a diagnosis of coeliac disease in children be made without doing a biopsy? Annette Pluddemann Current NICE guidelines recommend that in children referred with a positive serological test result, further investigations to rule in or rule out coeliac disease may use combinations of IgA EMA serological testing, HLA genetic testing and endoscopic biopsy. […]