A global health peril that demands global action. For only the fourth time in history, a health issue has reached the great political heights of the United Nations General Assembly. Following HIV, non-communicable diseases, and Ebola—antimicrobial resistance (AMR) has taken the grand stage, receiving a standing ovation in the form of a united political declaration which […]
Peter White et al: Releasing patient data from the PACE trial for chronic fatigue syndrome
The PACE trial was the largest clinical trial to date into Chronic Fatigue Syndrome (CFS), also sometimes referred to as Myalgic Encephalomyelitis (ME). This randomised controlled trial involved 641 UK patients suffering from CFS and compared the effectiveness of four treatments. It found that when added to specialist medical care (SMC), cognitive behaviour therapy, and […]
Simon McGrath: PACE trial shows why medicine needs patients to scrutinise studies about their health
Like all patients, what I want most from clinical research is treatments that work, not ones that merely look good on paper. As The BMJ has pointed out, patients are often faced with over-hyped treatments and an incomplete research base biased towards positive results. These biases arise partly because of “publish or perish” pressure on […]
William Cayley: What is your story?
Much has been written in recent years about “narrative medicine” or “narrative based medicine,” and there has even been discussion of how to integrate “narrative” and “evidence based” medicine in both journal articles and books. Most of this work (very helpfully) focuses on the narratives of patients: who they are as people, how their sufferings affect them, how […]
Matthias Wienold: Patient safety—when patients take centre stage
It is a rare moment for most physicians to engage with patients beyond the professional encounter. Some friends may become our patients, and sometimes patients can become friends—few physicians, however, take active roles in patient organisations or interact with patient representatives on an ongoing basis. Even fewer physicians take on a patient’s role when they […]
Richard Smith: Teaching children to make better health decisions
After 30 years of trying to teach clinicians, policymakers, journalists, and patients the basic concepts of deciding if claims about health interventions are valid, Andy Oxman, one of the originators of evidence based medicine, decided that it’s tough to teach adults new ways of thinking because of all the baggage in our heads. So he […]
Ian R Barker: Compassion fatigue—the neglected problem
Compassion fatigue—also known as vicarious traumatisation results in a gradual reduction in compassion over time. It is more common in those dealing with trauma or caring for close relatives (1). If often presents as hopelessness, decrease in experience of pleasure, constant stress and anxiety, and a pervasive negative attitude (2). Interestingly, it has been claimed […]
Nick Hopkinson: Saving the NHS—a lesson from Carthage
Cato the Elder is said to have concluded every speech he made in the Roman Senate, regardless of the topic, with “Delenda est Carthago”—Carthage must be destroyed. In answering the Editor of The BMJ’s call for ideas on how the medical profession can protest against the destruction of the NHS, a similar clarity and consistency […]
Health apps and how to evaluate them: Review of the PHE 2016 conference, part two
Embedded in the NHS Five Year Forward View is a sleek, bullet pointed ministerial promise: “an expanding set of NHS accredited health apps that patients will be able to use to organise and manage their own health and care.” Whatever your views might be on ministerial promises, it’s definitely true that digital technology is making […]
Using behavioural science and digital technology to “nudge”: Review of the PHE 2016 conference, part one
Being a GP at a public health conference is, I imagine, like being a proctologist at a plumbers’ convention: familiar subject matter, different perspective. I spend a lot of my clinical time advising people about smoking, alcohol, healthy eating, weight loss, mental health, contraception—all sorts of things that have at their core the vagaries of […]