JAMA 7 Mar 2012 Vol 307 915 “Almost 2 and a half million people in the United States die every year, making death the most common health event in the United States” says Mary Tinetti in a Viewpoint piece called The Retreat from Advanced Care Planning. It’s a strange and somewhat disturbing choice of words, […]
NEJM 1 Mar 2012 Vol 366 777 There is no JAMA this week, and the best things in the New England Journal come right at the start. Whether you are a British GP contemplating another set of humiliating idiotic directives and the imminent destruction of the NHS, or an American physician wondering how your crazy […]
JAMA 22 Feb 2012 Vol 307 813 When an Italian team of physicists reported that they had detected neutrinos travelling faster than light, the televisual physicist Jim Al-Khalili promised to eat his boxer shorts if it proved to be true. It turns out to have been a measurement error due to faulty wiring. Unbelievable results […]
JAMA 15 Feb 2012 Vol 306 669 This week’s star Viewpoint piece is about The Unintended Consequences of Conflict of Interest Disclosure. It seems to me that twenty-first century medicine operates on roughly the same principle as the court of the Grand Vizier of the Ottoman Empire – prestige is judged by the number of […]
JAMA 8 Feb 2012 Vol 307 565 There are signs that JAMA is gradually improving under its new editor, although moving its perspective pieces to the beginning of the journal doesn’t really count as progress. The BMJ has also tinkered with its order of contents, almost as if to hide the fact that they are […]
JAMA 1 Feb 2012 Vol 307 467 We of a physicianly disposition may not like to admit it, but throughout history surgeons have been well ahead of physicians at looking critically at their outcomes. For example, rates of re-operation have appeared in case series reports for well over a hundred years, so this paper on […]
JAMA 25 Jan 2012 Vol 307 373 Here’s the kind of study that’s all too rare in the medical literature: an important interventional trial that is not funded by pharma. The question is whether giving a proton pump inhibitor can improve outcomes in poorly controlled childhood asthma: a reasonable hypothesis to test, since a high […]
JAMA 18 Jan 2012 Vol 307 265 Cangrelor is one of a number of reversible thienopyridine platelet inhibitors competing to replace clopidogrel. This could be an enormous market, but the BRIDGE study, funded by The Medicines Company, begins with a small niche: patients who discontinue antiplatelet treatment before elective coronary artery bypass grafting. The problem […]
JAMA 11 Jan 2012 Vol 307 157 There’s a general feeling among cardiologists that low potasssium is a bad thing, but this interesting observational study of 38 689 patients with acute myocardial infarction shows that a high potassium can be even worse. On admission with AMI, potassium levels are normally distributed (figure 1): mortality in […]
JAMA 4 Jan 2012 Vol 307 37 The gradual makeover of JAMA takes a further step with the introduction of a series of Viewpoints in the opening section. Quite nice, and very like the NEJM: it’s good to see some of America’s liveliest minds at work here thinking about medicine in general and their chaotic […]