Bristol fails to ignite Goodman, Neville W
BMJ,
07/2001, Volume:
323, Issue:
7306
Journal Article
Peer reviewed
In marked contrast to his inflammatory response to the report on pathology services at Alder Hey Hospital in Liverpool earlier this year, health secretary Alan Milburn was sombre, thoughtful, and ...placatory in his address to the House of Commons. From reportage of the earlier General Medical Council hearing, Davies and Shields (Journal of Evaluation in Clinical Practice 1999;5:335-42) documented what most doctors suspected: the media were sceptical and hostile to doctors, and "fairness, balance or even the veracity of the reporting is immaterial."
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Addressing the issue Goodman, Neville W
BMJ,
01/2001, Volume:
322, Issue:
7279
Journal Article
Peer reviewed
In the retrieved issues of bmj.com, the verb address was used for its precise meanings just twice in 92 uses: once for addressing a conference and once for a consideration of Mr or Dr being the ...correct way to address a surgeon. Given the popularity of the golf course as a place of recreation for doctors, perhaps it is surprising it was never used for its other precise meaning.
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Abstract Objective: To determine how many patients were deprived of treatment by being given placebo as comparator in trials of ondansetron for postoperative nausea and vomiting. Design: Review of ...published trials of ondansetron during 1991 to July 1994. Setting: Medline search in a university department of anaesthesia. Subjects: 8806 patients who had been included in 18 indexed placebo controlled trials of ondansetron as prophylaxis against or treatment of postoperative nausea and vomiting. Results: Five studies (1236 patients) had been published by July 1992. All were placebo controlled trials. By July 1994, 8806 patients had been included in 18 indexed placebo controlled studies of prophylaxis or treatment. Only 462 patients had been in studies that compared ondansetron with other drugs, and there were no indexed comparative trials of treatment of nausea and vomiting. Roughly 2180 patients had been given placebo as prophylaxis and 440 had been given placebo when already experiencing postoperative nausea or vomiting. Conclusions: Around 2620 patients in the reviewed studies were denied existing drugs, which, though not completely effective or without side effects, do bring some relief from postoperative nausea and vomiting. Drug regulatory bodies should collaborate with drug companies to ensure better comparison of new with established drugs. This would avoid placebos being given to more than the fewest patients necessary to confirm effect and would allow doctors to be informed more quickly about relative efficacies.
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Bristol fails to ignite Goodman, Neville W
BMJ. British medical journal (International ed.),
07/2001, Volume:
323, Issue:
7306
Journal Article
Peer reviewed
Interest trickled on into the weekend. Mary Riddell, in the Observer, was one of the few columnists to put the affair and the report into the context of the understaffed, under-- resourced NHS. The ...report dismissed lack of resources as a special factor at Bristol, but its recommendations for schemes of assessment and validation of hospitals and medical practice are more stringent than those already under discussion. These schemes will cost money, as well as taking clinicians out of their clinics.
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