In my opinion a recent Panorama programme, “Britain’s Secret Health Tourists,” didn’t do justice to a complex issue. With a Department of Health consultation looming on the issue, it’s important doctors understand why. I’ve attempted to summarise the evidence on this issue elsewhere, so here I’ll stick to the key points that I think Panorama […]
Muir Gray: Defining the scope of systems of care
Read the first in this series of blogs about designing and planning population based systems of care here. Step 1: Defining the scope The focus of a system may be: A symptom such as breathlessness. A condition such as inflammatory arthritis or multiple sclerosis. A sub group of the population such as frail elderly people, […]
Richard Smith: Stratified, personalised, or precision medicine
Doctors know that many of the patients they treat with drugs will not benefit. Many patients know that too, which may be why some don’t take their drugs. The simple concept behind stratified medicine is that we become smarter at identifying the patients who will benefit. What has long been an aspiration is slowly becoming […]
Richard Lehman’s journal review—15 October 2012
JAMA 10 Oct 2012 Vol 308 1433 A Viewpoint piece by three Dutch radiologists explores the possible added benefits that could arise if developed countries introduced lung cancer screening using computed tomography (CT) in high risk groups. You will remember that the National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer–specific mortality of […]
Andrew Burd on toxic beauty treatments
A recent report in the South China Morning Post described three ladies who developed septic shock and needed ICU admission after receiving “beauty” treatments in a local clinic. More details are available on the government website. It is apparent that the ladies were all receiving treatments with intravenous infusions. Intravenous infusions sound “invasive” to me, […]
Pritpal S Tamber: Why TEDMED might be the only health conference worth going to
“We cannot solve our problems with the same thinking we used when we created them”—Albert Einstein Healthcare is broken, nowhere more so than in the US where they spend 18% of GDP on it and achieve only the 37th best (sic) outcomes in the world. How healthcare got here is a sad tale of self-interest […]
David Payne: Innovation and scholarly publishing
At a conference I attended in Washington DC last week we discussed innovation in scholarly publishing. One activity was to fast forward to 2022 and imagine what would have changed in the industry. Would print be dead, replaced by tablet and other mobile apps? Will journals still exist in their current form? Might authors bypass […]
Kate Guthrie: Where is Jeremy Hunt’s evidence on abortion?
It may have been a throw away comment as part of a wider interview but the new Health Secretary Jeremy Hunt has reiterated his belief in a reduction of the abortion time limit to 12 weeks. This, he says, is his personal view based on evidence. So what is the evidence? Scientific opinion is that […]
Anita Jain: Evidence based medicine and shared decision making in Delhi
A child with rickets who has received varied, sporadic treatment over two years presents with the inability to walk and a short stature. A 55 year old widow diagnosed with hypertension meticulously preserves prescriptions from follow-up visits to the clinic, fully aware that she will purchase these medicines only when she has a good harvest. […]
Desmond O’Neill: Anthropology, ageing, and medicine
The Meeting Room of the Royal Irish Academy is one of the hidden gems of academic architecture in Dublin, a city belatedly recognising the richness of its Victorian heritage (1). Behind a discreet red-brick façade on a busy street in central Dublin, the prelude to the experience is by way of a hushed procession through […]