The prevalence of LVNC is higher than expected for a rare disease in all population cohorts. There are at least three major factors which appear to strongly influence the high prevalence of LVNC including the type of imaging modality used, the characteristics of the cohort [...]
We used multilevel modelling to examine variation at hospital of treatment, Local Health District of the hospital, and patient’s area of residence. Most variation was at the hospital level. We conclude that investigations into the causes of low-value care and initiatives to reduce low-value care [...]
When men say “no” to treatment for prostate cancer, they don’t walk away feeling unburdened and free of concern. They’ve made a difficult decision and, as the diagnosis stays with them, they live with complex consequences.
Men who choose not to have recommended treatment for prostate cancer may avoid treatment-associated harms like incontinence and impotence, however our findings showed that the impact of the diagnosis itself is immense and far-reaching. A high priority for improving clinical practice is to ensure men [...]
The Royal College of General Practitioner's response to the BMJ Evidence-Based Medicine paper on definitions of disease (April 2019 - see publications page)
Did you know the definition of high blood pressure (hypertension) in the United States was recently greatly expanded? Overnight, tens of millions of people were reclassified, leaving one in every two adults with a diagnosis of hypertension. The move has been welcomed by some but [...]
Expanding disease definitions are causing more and more previously healthy people to be labelled as diseased, contributing to the problem of overdiagnosis and related overtreatment. Often the specialist guideline panels which expand definitions have close tis to industry and do not investigate the harms of [...]
Over 1/3 of deprescribing patient education materials (PEMs) present potential benefits and harms of deprescribing indicating most of the freely available materials are not balanced. Most PEMs are pitched above average reading levels making them inaccessible for low health literacy populations.
Medical researchers are calling for restraint on the use of aggressive life-saving treatments for frail elderly patients at the end of their lives, saying the focus should instead be placed on making patients' last days comfortable and dignified
A man walks up to a stranger with a loaded gun, points it at his head, and pulls the trigger. All of us can recognise that this is morally wrong, whether we pay attention to the consequences (the stranger dies), duties (we ought not kill [...]
