JAMA 2 Mar 2011 Vol 305 913 A friend recently began a piece on outcomes research with Bishop Joseph Butler’s maxim, “Every thing is what it is, and not some other thing.” If a trial like SOLVD is designed to measure the effect of a particular ACE inhibitor on survival in people with symptomatic left […]
JAMA 23 Feb 2011 Vol 305 783 The highly prevalent custom of poisoning the osteoclasts of old ladies with bisphosphonates for years on end seems surprisingly harmless. This case-control study confirms that there is a tiny increase in the risk of subtrochanteric fracture after five years, heavily outweighed by the protective effects of these drugs […]
JAMA 9 Feb 2011 Vol 305 569 If I were a woman, the things I would most fear from breast cancer surgery would be arm lymphoedema and recurrence of the cancer. Does one have to be balanced against the other? Common sense would suggest that the more axillary lymph nodes you dissect, the less likely […]
JAMA 2 Feb 2011 Vol 305 487 Most of us have never come near a vial of bevacizumab, though we’ve read plenty about it, especially over recent years in the context of eye disease involving vascular proliferation. This monoclonal antibody targeting vascular endothelial growth factor A was initially developed as a treatment for solid cancers […]
JAMA 26 Jan 2011 Vol 305 391 Stroke medicine grew up in the 1990s: like heart failure medicine, it shone welcome light on a large and neglected group of patients with organ damage who had been written off as unsalvageable. This was a Very Good Thing in itself, but its proponents then went on to […]
JAMA 19 Jan 2011 Vol 305 261 I’m of an age when the words cognitive decline in the title of a paper make me rush to read it – the exception being a self-assessment study in the BMJ a couple of years ago, which was just too scary. This paper isn’t scary; in fact it […]
JAMA 12 Jan 2011 Vol 305 151 “Behavioral Therapy With or Without Biofeedback and Pelvic Floor Electrical Stimulation for Persistent Postprostatectomy Incontinence: A Randomized Controlled Trial.” As so often with titles like this, you have to explore the text before you can tell what the study is really about. In the UK, “behavioural therapy” usually […]
JAMA 5 Jan 2011 Vol 305 43 Implantable cardioverter-defibrillators are a good intervention for those who have bad systolic heart failure with a risk of ventricular arrhythmia, and would rather die slowly than suddenly. The “utility” of the device is that it can have a statistically significant effect on mortality in younger, properly selected patients; […]
JAMA 22-29 Dec 2010 Vol 304 2732 “Professionalism may not be sufficient to drive the profound and far-reaching changes needed in the care system, but without it, the health care enterprise is lost.” Britons, take heed! This “special communication” was written by a social scientist and five doctors to inform the debate about American health […]
JAMA 15 Dec 2010 Vol 304 2595 New England is a wonderful place: from its little towns a nation was born, full of the idiosyncracies of seventeenth century Britain. The cadences of the 1611 Bible can still be heard in the speeches of President Obama, and even on hoardings advertising health products; miles, pints, and […]