Essentialist or consequentialist? Patrick Bossuyt (University of Amsterdam) introduced this concept at the “Evidence Live” conference. Thinking about diagnostic testing he suggested that, rather than focus on the nuts and bolts of a diagnostic test (sensitivity, specificity etc), we might also consider the downstream effects. We know there are benefits to accurate diagnostic testing, but […]
David Shearman: The climate “tide” is still rising
Time and tide wait for no man published in the BMJ 10 years ago detailed a vital role for the medical profession in addressing climate change and was used in Australia to form Doctors for the Environment Australia (DEA) in 2001. The article could be reprinted today with updated references as the current report card—except […]
Pritpal S Tamber: Innovation, lazy commentators, and data Darwinism
One of the most common questions I have had since becoming the clinical editor of TEDMED is what’s the “next big thing.” When I started the role I actually tried to answer but as time has gone on I have resisted—and felt more and more disappointed with the people asking the question. My disappointment has […]
Richard Lehman’s journal review—25 March 2013
JAMA 20 Mar 2013 Vol 309 1125 Is aliskiren a good drug for heart failure? Despite the negative result of this Novartis-funded trial (ASTRONAUT), I think the answer is probably yes. First of all, let me remind you that aliskiren is a direct renin blocker. In other words, it acts right at the start of […]
Charles Ssonko: Familiar enemies in conflict and tuberculosis
Amid the justified excitement surrounding the development of the first new drugs to treat tuberculosis (TB) in over 50 years it is worth remembering on World TB Day that in countries affected by conflict and instability the biggest challenges remain lack of access to diagnosis and treatment. Working as a doctor treating TB and HIV […]
David Kerr: The social media medical highway
Should doctors avoid fame or notoriety? More than 10 years ago I achieved a modest mixture of both after being asked to leave a public house one Sunday evening for no other reason than being a member of “a group of men.” In the immediate aftermath of the event whilst shopping in the local supermarket, […]
Readers’ editor blog: Our Indian readers, and why there’s more of them
At the beginning of 2013 bmj.com’s most accessed article in India typically received between 100 and 200 views. In three months the figure has more than doubled. In the first full week of January there were 9,784 visits to bmj.com from India. The figure has been rising since. Last week there were 12,121. In November 2012 […]
Richard Smith: 14 years at the helm of NICE
“You’ll do, but you’re not my first choice,” said Frank Dobson then Secretary of State for Health when he appointed Mike Rawlins as the first chairman of the National Institute for Clinical Excellence (NICE) in 1999. Later the blunt speaking Dobson was asked whether NICE would work: “Probably not—but it’s worth a bloody good try.” […]
Domhnall MacAuley: The future of general practice….is private
What will happen in general practice…now that we have so many part time portfolio doctors, practices where the focus is on performance related income, increasing delegation to practice nurses and nurse practitioners, and patients often seen by someone who has little knowledge of their past medical history? Out of hours care, for at least 8 […]
Richard Smith: Nestlé—a force for good or ill?
Nestlé, one of the world’s largest food companies, sells 1.2 billion products a day. This gives it huge potential for good or ill in a world where a billion people are undernourished, more than 2 billion are deficient in micronutrients (iron, iodine, zinc, and vitamin A), and 1.6 billion are overweight. So which is it, […]