Last week, The BMJ published a series of articles that investigated how the safety and effectiveness of the new oral anticoagulant, dabigatran, had been studied, licensed, and subsequently marketed. An investigation found that the drug company Boehringer Ingelheim withheld important analyses from the regulators, which showed that monitoring drug plasma concentrations and adjusting the dose could […]
Saurabh Jha: How a fine-tooth comb is entangling Obamacare
The Affordable Care Act (ACA), which recently survived a major scare in the Supreme Court over the constitutionality of the individual mandate, has just met another potential nemesis. Halbig vs. Burwell is the latest lawsuit afflicting the ACA. The suit has been filed by Jacqueline Halbig, former health policy advisor to the Department of Health and […]
Mary Rance: Loneliness—it’s time to stop talking and start doing
Extreme loneliness in older people in the UK is a topic that always ignites debate. Partly because the problem is only getting worse as the population ages and, I suspect, partly because for many of us it resonates deeply as a fear we hold about the process of getting older. The impact of chronic loneliness […]
The BMJ Today: Improving vaccination rates
In the United States, the Centers for Disease Control and Prevention (CDC) held a press conference to discuss a recent survey, which found that rates of HPV vaccine coverage did not reach the 80% target. This in itself is not a surprise given the vaccination levels of previous years. But at the press conference, The […]
David Zigmond: Depression needs more than formulaic treatment
An eminent academic psychologist, Professor David Clark, recently broadcast on the BBC’s Today programme (1 July) authoritative hope to the many sufferers of depression. He informed us how current scientifically formulated, measured, and monitored cognitive behaviour therapy (CBT) is positively transforming the efficiency and economy of care. To me, this picture is a misleading exaggeration. I […]
Karen Sumpter: Can MRI help make inaccurate prostate cancer diagnosis a thing of the past?
Prostate cancer is the most common cancer in men; in the UK, it kills over 10 000 men every year, and currently there are over a quarter of a million men living with—and after—the disease. If diagnosed early enough, prostate cancer can often be successfully treated. However, the diagnostic process is far from perfect, and […]
The BMJ Today: Bleeding anticoagulants and guerrilla warfare
Can we better quantify the risk of upper gastrointestinal and intracranial bleeding among patients who are taking long term oral anticoagulants for venous thromboembolism, systemic embolism, or stroke prevention? This information would help inform treatment, further investigation, or monitoring. A research paper published yesterday on thebmj.com describes the newly devised “QBleed algorithms.” The researchers, from […]
Neal Maskrey: Feeling the force of the QOF
It’s the season for graduation ceremonies. Proud parents and partners, relieved graduates, and a lump in everyone’s throat as that enormous rite of passage is eased by impressive ceremony, thoughtful words, cheap university wine in plastic glasses, and finally by long, late, cheerful family lunches. My generation began their medical careers in a different world, […]
Richard Lehman’s journal review—28 July 2014
NEJM 24 July 2014 Vol 371 371 Long ago I had a patient who kept having odd things happen to her. She infarcted part of her cerebellum, and then did the same to two fingers on her right hand. She was full of pains, her kidneys were failing, and her erythrocyte sedimentation rate (ESR) stayed […]
The BMJ Today: Dabigatran—the impact of The BMJ’s investigation
“The results of this investigation are somewhat shocking to me, but, reviewing the information, not entirely surprising.” That was the verdict of David Haines, section head of the Heart Rhythm Center at Beaumont Health System in the United States, on The BMJ’s investigation into dabigatran, the first of the new oral anticoagulants licensed to prevent […]