Author Archives: lowridan

About lowridan

www.evidence-bytes.com

Naming and shaming sites that make dubious health claims

Legal, decent, honest and truthful. It doesn’t sound too much to ask, but many traders
continue to use misleading advertising claims on their websites – and the list is dominated by health products.

If the UK Advertising Standards Authority (ASA) decides that an online ad does not comply with the UK Advertising Code, it will make repeated requests for the dubious claim to be
amended: if traders still fail to comply, then details of the claim and the ASA decision are published. Looking down the list, it is dominated by health products, including something I misread as psychic dentistry. Continue reading

From compliance to partnership: a different type of patient journey

The BMJ has called for a patient revolution, a “fundamental shift in the power structure in healthcare” in which patients improve healthcare, and not just for themselves. This is not just about engaging patients with specific decisions affecting their care, moving away from the idea of doctors’ orders or compliance, in which patients take the dose of medicine prescribed for them. It is about opening up the whole decision-making process to patients as partners. Continue reading

Dripping with melancholy: depression and historical heroes

In 2009, Alistair Campbell and Nigel Jones wrote A World Without: The Fantastic Five, asking what the world would be like if ‘five giants of history’ had been prevented by prejudice from making their enormous contributions. Winston Churchill, Florence Nightingale, Abraham Lincoln, Charles Darwin and Marie Curie: all brilliant, all shapers of the modern world, all lived with significant mental health problems. Lincoln’s law partner, William Herndon, said “His melancholy dripped from him as he walked”.

But could their illnesses actually have helped them in their work? Continue reading

Health internet searches: early warning of drug safety issues?

One common use of the internet is to search for health information. Could an analysis of search terms, and a little detective work, help provide early clues about drug side effects, before more traditional methods such as official reporting systems have kicked in? Continue reading

AllTrials not SomeTrials: no more invisible evidence

To assess the evidence, you need to know it is there.

Properly conducted clinical trials provide the best evidence for whether drugs work and are safe. But about half have never been published, and trials with positive results – where the drug concerned is shown to be safe and effective – are more likely to be published than negative ones. Patients can be harmed – for example if a treatment found to be harmful in an invisible trial is then given to patients in a new one – or medicines used ineffectively or wastefully, as a result. Researchers can’t plan research properly because they don’t know what has gone before. The problems with this situation have been well documented for years, but things may now be going to change.

Continue reading

NHS Choices: homeopathy is a ‘treatment’ without evidence

It’s official: homeopathy is a ‘treatment’ not a treatment.

The homeopathy entry on the NHS Choices website has been rewritten, following the media storm resulting from the revelation that the Department of Health censored accurate information about homeopathy after lobbying by the Prince’s Foundation.

The new entry starts by saying, “Homeopathy is a ‘treatment’ based on the use of highly diluted substances” and is bracingly frank in the evidence section: “There is no evidence for the idea that substances that can induce certain symptoms can also help to treat them. There is no evidence for the idea that diluting and shaking substances in water can turn those substances into medicines”. The evidence appears to have triumphed.

Is the speed with which this entry was rewritten a record?

Smoking bans may reduce risk of preterm births

Bans on smoking in public places are linked with reductions in preterm births, says a study from Belgium published in the BMJ, which introduced smoke-free bans in three steps. Each time a ban was bought in, the risk of babies being born before 37 weeks fell. There were no downward trends in the period before the bans – and other factors such as ‘flu epidemics did not seem to explain the differences either. So, good news for the public health benefits of smoking bans as premature birth is an important health risk factor.

NHS Choices: based on the evidence, except when it isn’t

Closer examination of the NHS Choices website, following the remarkable revelations about its article on homeopathy and the Department of Health’s insistence that homeopathic feathers are not ruffled, shows up something rather interesting. Continue reading

Homeopathy and the NHS

The Great Fight, Punch, Allopathy versus Homeopathy

The Great Fight, Punch magazine 1888, public domain via Wikimedia Commons

The long-running debate about the role of homeopathy in the NHS is hotting up again. In her evidence to the House of Commons Science and Technology Committee in January, Chief Medical Officer Professor Dame Sally Davies replied to a question about homeopathy with a ringingly clear statement: “..Why am I being wishy-washy? It’s rubbish”. Continue reading

Calling the midwife in early 20C Derbyshire

Mrs Blood, Dr Crook, Mrs Killer and Mrs Tipler – which would you choose to be your birth attendant?

These people all practised in Derbyshire early in the twentieth century. Dr Crook was a male GP, Frances Killer was a qualified, trained midwife, and Elizabeth Tipler was a ‘bona fide’ midwife – she had no training but was registered, and had some experience. Mrs Blood was one of a diminishing band of uncertified, untrained ‘handywomen’ who delivered babies and helped afterwards. Which had the best outcomes, for the mothers and babies they cared for? The answer is surprising and may also help explain why birth outcomes did not improve much at first after midwifery became a regulated profession in 1902. Continue reading