NEJM 6 Dec 2012 Vol 367 This is the time of year when, as a GP who is still let loose on patients, I have to undergo my annual appraisal. I shall try to demonstrate that knowledge keeps entering my brain at a rate roughly sufficient to replace the increasing amount that leaks out. […]
JAMA 28 Nov 2012 Vol 308 2097 Heart failure is a common process of dying which mostly affects people over the age of 75. Living with heart failure can be burdensome and unpredictable, and dying from heart failure can be awful, unless you are lucky enough to die suddenly. I thought I’d get those sentences […]
JAMA 21 Nov 2012 Vol 308 OPERA is the quintessential Italian art-form: devised as a return to the classical past, it is a brilliant transitory display of music, costume, and painted stage sets; an escape to a heightened form of existence and emotion. Palpitations are to be found everywhere: in fact the aria Di tanti […]
JAMA 14 Nov 2012 Vol 308 1916 Last week we learned that male doctors who were randomised to take a daily multivitamin preparation had cardiovascular events and died from them at exactly the same rate as those who took placebo for a median of 11.2 years. This week we learn that they also died of […]
JAMA 7 Nov 2012 Vol 308 1747 Big trials: don’t you love ‘em? James Penston doesn’t, arguing in his book stats.con (2010) that we have been duped into adopting interventions with small but statistically significant effect sizes that merely prove that most people receiving the treatments derive no benefit from them. And this is true: […]
NEJM 1 Nov 2012 Vol 367 1677 Cancer screening campaigns—getting past uninformative persuasion is a topical subject on both sides of the Atlantic. Nobody writes better about it than Steven Woloshin and Lisa Schwarz, and in this Perspective piece they join forces with two colleagues to point the way forward. All past and many present […]
JAMA 24-31 Oct 2012 Vol 308 1660 Medicine is full of surprises, but sometimes things are just the way you thought they were. Back in 1973, I was taught that the causes of peripheral arterial disease in men were smoking, diabetes, hypertension and high cholesterol. Then in 1986, the Health Professionals Follow-up Study recruited 44 […]
JAMA 17 Oct 2012 Vol 308 1545 “Between 1988 and 2010, favorable trends in lipid levels have occurred among adults in the United States.” That may seem pretty amazing, but there is a lot we don’t understand about these things. Remember that cardiovascular disease is also falling steeply, even as the population gets more obese. […]
JAMA 10 Oct 2012 Vol 308 1433 A Viewpoint piece by three Dutch radiologists explores the possible added benefits that could arise if developed countries introduced lung cancer screening using computed tomography (CT) in high risk groups. You will remember that the National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer–specific mortality of […]
JAMA 3 Oct 2012 Vol 308 1333 Can vitamin D prevent the common cold? The answer is almost certainly yes, depending on baseline levels. If you run a trial in a place where the sun shines, good dairy products are abundant, and the ocean teems with oily fish, you might get a negative result. Such […]