Knowledge saves lives after natural disasters
Published Guardian online, Carl Heneghan, 26/09/2011
Comment: Dr Carl Heneghan, director of the Centre for Evidence-Based Medicine and a clinical reader in the Department of Primary Health Care Sciences at the University of Oxford, writes: ‘Where were you when the tsunami hit in December 2004? ... Have you ever considered how rescue workers and medics on the ground make the right decisions under such extreme circumstances? To improve their decision-making, the Centre for Evidence-Based Medicine at the University of Oxford organised the first conference on Evidence Aid, held in Oxford on Monday ... Evidence Aid was born after the 2004 tsunami. Its aim is to provide summaries of Cochrane reviews of health research in one place and in a timely fashion for those involved in disaster management ... Yet the evidence to support informed choices in disasters is scarce. Evidence is lacking not only for many health decisions, but also for simple interventions such as what are the best shelters, what is the best way to ensure security, and how best to support displaced people, and many more.’
Medical Device recalls
Today we published in BMJ open an article on Medical-device recalls in the UK and the device-regulation process.
Our conclusion is the number of medical devices subject to recalls or warnings in the UK has risen dramatically. A whopping 1,220% increase.
A substantial number of these devices may have caused serious adverse effects in patients and contributed to healthcare costs. Also significant problems exist in the UK with a lack of access to transparent data and a registry of the highest-risk devices.
The articles worth a read to see the sort of problems we faced in trying to access clnical data on recalled devices. There is also a linked anlysis we wrote in the BMJ
This is what the independent made of the story, "patients lives are put at risk by faulty medical implants."
If you want to know more then look out for tonight's episode of Dispatches on channel 4.
The inadequate evidence base for monitoring in chronic diseases
We often undertake projects with folk who visit the department, and for this systematic review, Ivan Moschetti visiting from Italy and Daniel Brandt from Canada did a great job, undertaking the majority of the spade-work.
Our conclusion is pretty straightforward: ‘Many guidelines for cardiovascular disease do not report clearly what to monitor and what to do if a change is detected. If no evidence is available to support a specific monitoring schedule, this should be explicit in the guideline, with a description of the new research that would fill the gap’.
A lot of money is spent on monitoring in chronic diseases, and based on what we found a considerable amount of it is wasted. Read more