This is what is meant when referring to ABSENCE OF EVIDENCE IS NOT EVIDENCE OF ABSENCE. Rafael Perera In science, it is difficult to show that something is so – to prove something. Instead, we deal with hypotheses and theories. We gather evidence and compare our hypotheses to the data collected to decide which […]
Latest articles
Crystalloids or saline?
Use of resuscitation fluids has largely been based on physiological principles rather than evidence. Carl Heneghan The debate over when to use crystalloids versus saline in unwell adults shows there has been considerable uncertainty about what to do in practice. Use of resuscitation fluids has largely been based on physiological principles rather than evidence. […]
Should asthma patients increase their steroid inhalers during an attack?
EBM Practice Spotlight highlights new evidence that challenges current clinical practice Kamal Mahtani Asthma is a long-term condition affecting more than 300 million people (adults and children) worldwide. In the UK, it affects about 1 in every 10 people. When asthma management is effective, patients should be able to continue their normal activities of […]
Why I am confused about lung cancer screening
Should findings from a single trial inform decision making about lung cancer screening? Carl Heneghan, Editor in Chief A recent cost-effective analysis of low-dose computed tomography for lung cancer screening targeted in those at highest risk of lung cancer suggests only modest benefits. The conclusion is based on a cost-effectiveness analysis of risk-targeted screening […]
Evidence Watch: Implantable defibrillators might not affect death
Results of a recent review show a significant reduction in mortality with ICD. The effect, however, was weakened by the inclusion of the largest recent trial. Carl Heneghan, Editor in Chief One essential element of determining if a trial is sufficiently robust enough to believe the results is that the control group received standard […]
Prostate cancer now kills more people than breast cancer: cause for alarm?
‘As epidemiologists, we are not alarmed by the apparent ‘increase’ in deaths from prostate cancer,’ here’s why Jason Oke For the first time in the UK, the number of deaths from prostate cancer has exceeded the numbers of deaths from breast cancer. According to figures from the UK’s Office for National Statistics (ONS), more […]
Evidence Watch: uncertainties with the evidence for influenza vaccination
This week’s Evidence Watch highlights serious uncertainties with the current evidence-base for influenza vaccination Carl Heneghan, Editor in Chief A systematic review of vaccines in the elderly [1] highlights the difference vaccination makes in a single season (lowers risk of influenza from 6% to 2.4%); but adds caution, in that we have very little […]
Evidence Watch: Carl Heneghan’s view on evidence that impacts practice
This week’s Evidence Watch highlights preoperative physio, the risk of heart disease in relation to the number of cigarettes smoked per day, use of antipsychotics in hospital and risk of pneumonia, the effect of exercise across 17 countries and the impact of having a large preterm baby. Carl Heneghan, Editor in Chief Does a single […]
Evidence Watch: Carl Heneghan’s selection of evidence that impacts on practice
This week’s Evidence Watch highlights the risk of pre-eclampsia with metformin, the role of repeated influenza vaccination, de-prescribing medications and assessing harms in the elderly at the time of elective surgery. Carl Heneghan, Editor in Chief A meta-analysis evaluating the risk of pre-eclampsia in women taking metformin before, or during pregnancy found that there […]
Centrally-acting drugs for obesity cause more harm than good
Centrally acting medicines increase the chance of losing at least 5% of body weight, but their use increases the risks of serious of harms Igho Onakpoya Are the benefits and harms of currently available centrally-acting weight loss drugs (medicines that act on the brain) different from those withdrawn from the market at the time of […]