Do I need the drugs, doc? Heart failure drugs with preserved ejection fraction.

Evidence suggests heart failure patients with preserved ejection fraction could benefit from beta-blocker treatment, guidelines do not. Jack O’Sullivan   There is a well-established list of medications that work in heart failure with a reduced ejection fraction. However, it is unclear if these drugs are clinically effective in patients with heart failure with a preserved […]

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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 […]

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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 […]

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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 […]

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Why BRCA screening will harm (some) women

  ‘blindly pursuing early detection risks subjecting a third of diagnosed women to unnecessary harm.’ Jason Oke According to research led by the Barts Cancer Institute at Queen Mary University London, screening all British women over 30 years of age could result in 17,000 fewer ovarian and 64,000 breast cancers over a lifetime. Not only […]

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A Word About Evidence: 3. Manifesto

  A manifesto for Evidence-Based Medicine (EBM) was published in the BMJ earlier this year and presented at Evidence Live. Jeff Aronson has been thinking again about the word manifesto. The Indo-European root MAN meant a hand. The Latin word was manus, from which we get words such as maintain, manacle, manage, manège, manicure, manipulate, […]

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Seven ways to ensure faster removal of harmful medicines

  Harmful medicines sometimes stay on the market for longer than they should. When that happens, people are unnecessarily exposed to medicines that may adversely affect their health. Igho Onakpoya The benefit-harm balance of new medicines is often not fully known at the time marketing licences are granted. More information about harms often becomes apparent […]

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Rare adverse events in clinical trials: understanding the rule of three

  Investigators should report rare and very rare adverse events in clinical trials: Igho Onakpoya reports why it is important that all events are reported irrespective of their frequency.   Even though they may not give a signal in any single trial, a meta-analysis could reveal potentially important drug-adverse event associations that might require further […]

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