TVT: seventeen year follow up and the shrinking denominator effect

  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 – […]

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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 […]

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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 […]

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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 […]

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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. […]

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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 […]

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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 […]

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