Staying with astrophysics (qv), let’s think about dark matter and light years. As the Wikipedia entry states, “Dark matter is a hypothetical kind of matter that cannot be seen with telescopes but would account for most of the matter in the universe.” The subtitle of an article in Science in 1984 was, “It fills the […]
Ferelith Gaze: The NHS is a duty to uphold, not just a function to devolve
The government is heralding the Cities and Local Government Devolution Bill—currently making its way through parliament, with broad cross party support for its intentions—as reversing 150 years of centralisation. The bill opens up a number of exciting opportunities. Local partners—from Manchester to Cornwall, from Dorset to Hertfordshire—are making headway in their plans, with strategically aligned […]
Lyndal Trevena: Bringing evidence based practice and shared decision making together
As I write this blog, research teams from the four corners of the globe are travelling to Sydney for the first joint conference of the International Shared Decision Making (ISDM) group and the International Society for Evidence Based Health Care (ISEHC). There are over 300 delegates from more than 25 countries and a large contingent […]
Michael Devlin: Duty of candour—make apologising easy
Seven months ago a statutory duty of candour was introduced for hospitals in England, and four months later it was extended to all healthcare bodies registered with CQC. Are we likely to have seen a remarkable improvement in patient safety as a result? I suspect not, although to be scrupulously fair it will probably take […]
David Kerr: The for profit company will see you now
When you hear hoof beats, think of horses not zebras, is the aphorism coined in the 1940s by Theodore Woodward to explain that common conditions occur commonly and rare ones rarely. Most physicians involved directly in patient care will have seen the occasional “zebra” blood test result that is so unexpected when taken into clinical […]
Jack O’Sullivan: Managing overdiagnosis
“Hardly more effective than a coin toss.” The damming words from the discoverer of prostate specific antigen (PSA) poignantly reflect the controversies of prostate cancer screening. In fact, Richard J Albin’s principle criticism—”(PSA testing) can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t“—highlights […]
The BMJ Today: A new era of drug and device regulation, homeopathy, and avoiding death in hospital
• Watch this space Will future historians mark 2015 or 2016 as the beginning of a new era of drug and device regulation? Proposed legislation in the United States, popular for its promise to increase funding for the National Institutes of Health, easily passed in the House of Representatives last week. However, the 350 page […]
David Moher and Rustam Al-Shahi Salman: How can research be improved and waste reduced?
We shudder to think about the amount of paper and computer screen pixels used to report on the very sad state of biomedical research. This journal and others have been vocal on the subject and have published many relevant articles on a variety of topics related to the theme. In […]
Andrew Moscrop: Would it be a good idea to charge for missed appointments at the doctors surgery?
The studio audience of BBC Question Time applauded and health secretary Jeremy Hunt appeared to wriggle with delight when a member of the public asked whether patients should be charged if they miss their appointment in general practice. “I don’t actually have a problem in principle with the idea of charging people for missed appointments,” […]
The BMJ Today: The paperless NHS
• Finally, the NHS goes digital. Or does it? There have been many predictions of the death of paper in the NHS, but are they exaggerated? The NHS is in fact 20 years behind the private sector in its use of technology, and a long way behind many of its doctors and patients. And although there […]