NEJM 29 Aug-12 Sep 2013 Vol 369 799 When comparing a new fixed-dose anticoagulant with conventional warfarin based anticoagulation, what do you look for? Thrombotic events, death, major bleeding? Yes, certainly. But what makes the comparison meaningful? That depends largely on how well the warfarin group were kept within the target INR range. In the […]
Edward Davies hits the nail on the head: “The fear of both patient and doctor can sometimes override the best knowledge, research, and information known to man.” I do not think, however, that it is just fear of getting sued that drives us physicians towards over-testing and overdiagnosis. Rather, it is existential fear of uncertainty, […]
One of the many takeaways from this week’s excellent Preventing Overdiagnosis Conference is that it’s hard for doctors to tell their patients that too much care is bad. For so long, the rhetoric has been about the danger of too little care. Newspapers brim with stories of death from missed diagnosis and lack of access […]
Akerman—a £12.3m community healthcare building designed by the architectual practice Henley Halebrown Rorrison—opened last year as part of the regeneration of Myatts Field North in the south London borough of Lambeth. Sandwiched between homes and a local park, the bold white building stretches for 80m and, according to its architects, was designed to mimic the flat […]
“Doc, how’s my blood pressure? What about my cholesterol? How about my weight?” “There’s room for improvement,” I say. “How much do you exercise? How many fruits and vegetables do you eat?” “Oh, I’m too busy right now for exercise—and I have to eat what I can get when I’m on the road. But I […]
Evidence based medicine is first and foremost at the Preventing Overdiagnosis Conference in Dartmouth this week. The importance of data, research, and careful analysis has been repeatedly hammered home, with talks catchily entitled such as, “Does inclusion of total cholesterol in mortality risk algorithims lead to overestimation of risk?” “Ten years prospective data from the […]
Recently the resignation of Yu Ying, a Chinese female doctor from a famous public hospital has provoked heated discussions among the Chinese netizens. Yu Ying was an emergency care physician at the Peking Union Medical College Hospital before her resignation. She has a Weibo, the Chinese equivalent of Twitter, with the name, […]
Progress. The march towards giving patients online access to their medical records is accelerating. The Society of Participatory Medicine has put out the bunting in welcome to the announcement by the OpenNotes initiative that 1.8 million more US patients can see and share full versions of their doctor’s notes; and that big US providers, including […]
The piece that follows is my foreword to a new and fascinating book by Peter Gøtzsche, the head of the Nordic Cochrane Centre, entitled Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. I hope that this piece might prompt you to read the book. I was not paid for my foreword and […]
I would cautiously suggest that these days “death and dying” is no longer the taboo subject it used to be. People are aware of their mortality and seem to be giving some thought to their inevitable death. I have spent my adult life working as a nurse. Presently I do agency work. This means that […]