The shrinking denominator enhances the effect size and misleads the reader into thinking the effect is better than it actually is. Carl Heneghan I am at the Ideal Conference, at a workshop talking about clinical trial reporting and recent surgical scandals. I chose the 17 years follow-up of the Tension-free Vaginal Tape – often quoted – […]
Category: Carl Heneghan
First do no harm: surgical mesh
Last week, I learnt with great sadness of the death of Eileen Baxter, who died in an Edinburgh hospital in August. Mrs Baxter’s cause of death was multiple organ failure. Sacrocolpopexy mesh repair is named as an underlying cause on her death certificate, meaning the mesh triggered the chain of events leading to her […]
Bronchial Thermoplasty – evidence does not back up NICE approval
We’ve been here before with devices, the studies are small, biased, there is lots of uncertainty about who, if anyone, benefits from this treatment and the adverse events including admissions are higher. Carl Heneghan Bronchial Thermoplasty is all over the news today: The BBC reports that the New asthma treatment is set for wider […]
Medicine: more precise, more effective, more overdiagnosis
I’m at the 6th preventing overdiagnosis conference chairing a session on Overdiagnosis 2.0 (Technology) by Henrik Vogt, Claus Ekstrøm & Johnny Kung. So I thought I’d share some insights. Carl Heneghan at Preventing Overdiagnosis Henrik Vogt from the GP research unit at Trondheim talked about the impact of new technology ‘that is heavily geared to […]
Do Calcium and Vitamin D supplements cause cancer?
In a recent trial calcium and vitamin D treatment elevated the risk of precancerous polyps nearly fourfold – but does this result matter? Carl Heneghan If you weren’t observing carefully, you likely missed this study, I did. A recent randomised trial participants with one or more adenomas received daily calcium, vitamin D3, both or […]
David Sackett’s four worries about observational evidence
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? […]
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 […]
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 […]
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 […]