NEJM 20 Feb 2014 Vol 370 699 This week, the NEJM is big on bevacizumab. Amongst the crowd of mabs, this is one of the best known: Avastin is a humanized monoclonal antibody directed against vascular endothelial growth factor-A which has been on the market since 2004. It has had its ups and downs, and […]
General practice represents a paradox. On the one hand, it is widely and rightly viewed around the world as a model of primary care to be studied and emulated. On the other hand, it is based on small, independently minded units, unable to operate on the scale needed to meet changing population needs. GPs in […]
In the past 50 years mental healthcare has been transformed in ways few could imagine in 1964. Fifty years ago Broadmoor Hospital had nearly 1000 patients who stayed an average of 20 years each at what is arguably the world’s most famous high secure hospital for mentally disordered offenders. Today it has some 195 patients […]
One of the pleasures of academic medicine, and a salve for the gentle disorganisation of Irish medical schools, is the initiative, enthusiasm, and broad ranging interests of the medical students and trainees. A recent taste of this was a play on anorexia from the Edinburgh Fringe Festival hosted by medical students at Trinity College Dublin. […]
Political parties often pitch intensively against a few individuals for maximum media bites. There is, however, no real discussion of the issues which affect the lives of scores of Indians. “Development” has recently become the buzzword of political parties. If development means economic and social transformation, then health should be seen as an essential component. Our country’s future will […]
In a couple of months India will hold parliamentary elections to determine its next central government. This administration, due to hold office from June, will also have responsibility for drafting India’s 13th five year plan, which is key to its direction of development from 2017. Prime Minister Manmohan Singh has said that he will not […]
New draft guidance issued by the National Institute for Health and Care Excellence (NICE) for public consultation recommends that the threshold for starting treatment to prevent cardiovascular disease should be halved from a 20% risk of developing cardiovascular disease over 10 years to a 10% risk. The guideline is being updated to allow for a consideration […]
Perhaps 20, possibly 25 or even 30, years ago I had breakfast (or was it lunch?) with Geoffrey Marsh, a GP from Teesside, and he told me that all GPs should have 3000 patients. I think he was right, but since that time average list sizes have steadily shrunk until they are now under 1600. […]
There was more than a little bit of déja vu about the government’s response to the Keogh review of cosmetic surgery when it finally saw the light of day, early last Thursday.[1] A bunch of us were led into a Department of Health underground room and given the embargoed report … I can recall receiving […]
NEJM 599 Most weeks I quote you the conclusion of some pharma-funded trial which overstates the benefit of an intervention. But in reality clinical trials of any kind can be a form of marketing: doing them is difficult work, there are reputations and ideas at stake, and the temptation to overstate results is always there for career academics as […]