The evidence base for current treatments has been built largely on aggregated results published in journal articles—articles that report trials initiated and sponsored by industry in order to get marketing approval for its products. At last we’re moving towards knowledge based on independent analyses of the original data about real participants in clinical trials, with […]
Jaana Ahlblad and Päivi Hietanen: Finnish baby boxes—could this joy be reproduced?
How can a cardboard box be a symbol of equality and express the importance of children? Easily, if it’s filled with soft cotton clothes for newborns and contains a towel, a hairbrush, a toothbrush, nail clippers, and bath thermometer for the baby, as well as outdoor gear and a sleeping bag, a […]
Richard Smith: The BMA and homosexuality
I was once responsible for Family Doctor Publications, which were a series of booklets owned by the BMA, had titles like You and Your Bowels, and sold in huge numbers in the 1950s because they were almost the only information on health available to the public. I was much amused that in the 50s the […]
Richard Lehman’s journal blog—24 June 2013
JAMA 19 June 2013 Vol 309 2449 If you give live attenuated measles, mumps and rubella vaccine to children with juvenile rheumatoid arthritis who are on immune suppressing treatment, are they going to make enough antibodies? Or might you risk a flare-up of their disease activity? A carefully conducted Dutch study finds that there is […]
Richard Smith: Health and social care: lots of activity, little value
My mother is a wonderful woman but has no short term memory and drinks too much alcohol. When she’s sober her language is complex and her sense of humour magnificent. “What a terrible world,” she says, watching the television news, “I’m glad I’m not in it.” In a way, she isn’t. She’s mildly disinhibited even […]
Paul Laffin: Is men’s health the forgotten inequality?
The discussion of health inequalities can sometimes appear ubiquitous at local, national, or European level. We all know the massive impact that socio-economic factors can have on a person’s health and that someone’s ethnicity can also play a significant role in determining health outcomes. But, by focusing on such contributory factors, are we ignoring the […]
Richard Lehman on the 7th International Shared Decision Making conference
The seventh International Shared Decision Making (ISDM) conference, sponsored by the BMJ, took place in Lima, Peru, over the last three days. It was organised by Victor Montori, a charismatic global proponent of patient centred care, who is a native of Lima and professor at the Mayo Clinic. The motto he chose was “pacientes @ […]
Penny Campling: Is the Francis Report part of the problem?
There seems to be a growing attitude that the Francis Report will not result in any great change. No doubt there will be a few worthy policies generated—although the amount of linked documentation is as likely to distract and irritate as it is to inspire more attentive caring. But any hope that it will be […]
Domhnall MacAuley: The US champions primary care
When the US starts to champion primary care, it is time to sit up. With its traditionally specialist focus, this may seem out of character, but as a result of the Patient Protection and Affordable Care Act, there is increasing focus on family medicine. In a perspectives article last year in the NEJM, Susan Okies […]
Mohit Sharma: Do we need tougher drug patent laws?
History has witnessed numerous drug patent wars, but in April 2013, the Indian Supreme Court did something which captured the attention of the international media. It denied a patent to the beta crystalline form of Imatinib mesylate, a life saving anticancer drug, to the Swiss pharmaceutical company Novartis. The verdict was noteworthy because this drug […]