November was an interesting month, with many new papers published: five of which reached this month’s Top 10 Most Read list. In the top spot is Watkins et al, with a time trend analysis looking at the effects of health and social care spending constraints on mortality in England. They found that spending constraints, especially public expenditure on healthcare, are associated with a substantial mortality gap.

In at number five, a diagnostic accuracy study looks at physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis. A mixed methods paper by Alberti et al looks to ascertain comments from trainees about their career choices at number seven, finding that negative comments towards general practice as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training.

Roberts and colleagues, reaching number nine this month, perform a systematic review of economic evaluations, to assess the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes in high risk individuals. Finally, in at number ten, Earl et al examine whether chronic fatigue syndrome is associated with altered circulating vitamin D metabolites.

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.