A recent article in The BMJ on the crisis in evidence based medicine (EBM) did a great job of both summarizing challenges that have developed over the past 20 years, and proposing some ways forward in delivering better evidence based care to our patients. Unfortunately, I think one piece of the evidence based puzzle is still […]
Category: US healthcare
The BMJ Today: Health challenges across the divide
Overdiagnosis and over-treatment of malaria is a major problem in South and central Asia, where malaria is a minority cause of febrile illness, and primary health centres often rely on clinical symptoms for a diagnosis. Researchers from London and Afghanistan conducted a patient randomised study in a primary care setting in two areas where malaria […]
Liz Allen: The economic case for medical research
Former US president Bill Clinton achieved a lot in the White House. He presided over the longest period of peacetime economic growth in American history, he signed the North American Free Trade Agreement, and he was the first Democrat since Franklin D Roosevelt to win re-election. Yet when asked last month to recall his greatest accomplishment, […]
The BMJ Today: Return of the Patient’s Journey and a history lesson from Richard Lehman
Two years ago, GP Michael Frank Harris discovered a right inguinal swelling while looking in his bathroom mirror. He writes about what happened next in the return of our Patient’s Journey series. Harris surprised his haematologist with an alternative diagnosis and together they took a leap of faith—deciding on treatment for stage I follicular lymphoma, […]
Richard Lehman’s journal review—16 June 2014
NEJM 12 June 2014 Vol 370 2265 Obstructive sleep apnoea is often a result of weight gain, and unfortunately, once it is established, losing weight does not reduce it. But losing weight has benefits of its own (he sighs wistfully), as this trial of weight reduction, continuous positive airways pressure, or both for OSA demonstrates. I […]
The BMJ Today: Is EBM broken? Then how about a nice cuppa
Is evidence based medicine broken? That’s the question that Greenhalgh et al are asking in this Analysis article. From inside The BMJ, with our attempts to shed light on unpublished data, it’s easy to become jaded about the whole medical-industrial complex, and say that yes, it is. But recently, while editing some videos collected as […]
The BMJ Today: The rising tide of obesity
Obesity rates are rising worldwide. According to the CDC, in the US, there has been a dramatic increase in obesity over the past 20 years. A similar phenomenon has been observed in other countries. Obesity related conditions (heart disease, stroke, diabetes, hypertension) are also increasing: around a third of adults in England now have prediabetes, and […]
David Kerr: Death in America
In the United States, even the grim reaper is not immune from political interference. Around two weeks ago, an episode of mass murder happened a few miles from where I live. On 23 May, 22 year old Elliot Rodger took his own life after killing six students, and wounding 13 others in the area known as […]
The BMJ Today: Lifestyle counselling and screening—great expectations and false hopes
The underlying concept of screening is that an early detection of risk factors or disease is beneficial for the clinical or public health outcome. Patients, physicians, and public health authorities have had high expectations for this concept. Unfortunately, some of the hopes for screening have turned out to be false hopes after critical, scientific assessment. Lifestyle medicine […]
Richard Lehman’s journal review—9 June 2014
NEJM 5 Jun 2014 Vol 370 2169 There is a story that when new antibiotics were arriving every few weeks in the late 1950s, drug companies had a hard time thinking up new names for them, all ending in mycin. So they started using a word generating machine, but stopped when it came up with […]