Blog entry written on: Assessing the magnitude of reporting bias in trials of homeopathy: a cross-sectional study and meta-analysis, (bmjebm-2021-111846) Authors: Gerald Gartlehner, Robert Emprechtinger, Marlene Hackl, Franziska L Jutz, Jacob E Gartlehner, Julian N Nonninger, Irma Klerings and Andreea Iulia Dobrescu Undeterred by allegations that homeopathy is a pseudoscience that lacks-approval by regulatory agencies […]
Bard withdraws its surgical urogynaecological mesh: what next?
Bard has stopped production and distribution of their urogynaecological mesh products – all 20 of them (see here MDA 2019 014). The question now is what’s needed next. Carl Heneghan The medical device alert by C.R. Bard, on the 7th March, removed all surgical mesh for stress urinary incontinence (SUI) and pelvic organ prolapse […]
Understanding Lung Cancer Screening
Understanding screening is difficult. Responses to screen, or not to screen individuals, is often an emotional topic. This blog sets out evidence that might inform such screening decisions. If I get something wrong, or there is something you’d like to discuss then email me, send a message via twitter – I’ll add or correct the post […]
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 – […]
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 […]
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 […]