eLetters

52 e-Letters

  • Conflicts of interest
    Angelo Tomedi

    Dear editor,

    The important influence of pharmaceutical manufacturers on the medical literature, and the positive "spin" placed on results and conclusions, has been well documented. Given this pervasive problem, readers may question the credibility of the commentary of an EBM reviewer who has "received consulting fees from MSD, Schering, Novartis and GSK and received honoraria from Altana, Astra Zeneca, Boehringer Inglehi...

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  • Is Rosiglitazone a safe drug?
    Chris Williams

    Dear Editor,

    I was surprised to see the assertion by Philip Home that rosiglitazone is a "particularly safe drug." Given its withdrawal from public use (the current prescribing ban recommended by MHRA in the UK, the European Medicines Agency and the FDA in the United States) due to concerns over increased cardiovascular risks, it would seem that our health authorities see it as anything but a safe drug.

  • Re:This commentary could be more helpful to me: Editors Note...
    Richard Saitz

    We are making some changes going forward to the Commentaries such that they are more structured and contain key features related to critical appraisal of the evidence: http://ebm.bmj.com/content/15/4/103.full. Some of what Dr. Bossano refers to (e.g. the use of absolute versus relative risks will be addressed by such changes.

    Thanks

    Richard Saitz, Editor.

    Conflict of Interest:

    ...
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  • This commentary could be more helpful to me:
    Davud Bossano
    Dear Editor

    It's quite a while since I read EBM but I received an eTOC today and was pleased to discover I could read it via my NHS Athens login. I couple of abstracts caught my including this one, because as a GP, LUTS and concern about PSA are relatively commonly seen. The commentary seemed to have a lot of detail about prostate disease, which was interesting but perhaps not entirely relevant to the paper it was comm...

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  • Caution Warranted
    John B Waits

    This is indeed an important finding on several levels, yet it remains difficult in translating this into clinical practice. I have found myself even more ambivalent about suggesting SMBG to patients reasonably well-controlled on oral anti-diabetes medications.

    In an effort to translate these findings, I propose the following practical suggestions.

    1. For patients struggling to comply with health care...

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  • Improving the uptake of MMR vaccine
    Mary Hardy

    Re: editorial BMJ 5th April 2008 Volume 336 pages 729-30: Improving uptake of MMR vaccine - Recognising and targeting between population groups are the priorities

    Dear Editor,

    In the editorial on improving uptake of MMR vaccine, no mention was made of the parents who decline MMR vaccination on ethical grounds. The rubella vaccine component of MMR is derived from an aborted human fetal cell line. The Takah...

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  • Sometimes small things can make a big difference: Dionne et al. respond to Evans and Hadler
    Clermont E. Dionne

    Dear Editor,

    We agree with doctors Evans and Hadler that our clinical decision rule[1] should be validated in another setting and that it should be shown to cause more good than harm before it could be widely used. Our study was a first step in the process of developing a predictive tool for the occupational outcome of back pain. In a next phase of development, not only should the rule be validated in a new group of...

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  • Paediatricians as specialists
    Céline Lemay

    Dear Editor,

    Looking at the effectiveness of actions for well-child care makes us forget that paediatricians are specialists and not primary care givers in our health care system. Specialists are the best professionals to deal with pathology and complex problematic health situations for children. I think that well child should be followed by a family doctor, having time to do prevention by education and screening....

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  • ... but they also present an opportunity to learn more
    Paul Glasziou

    When RCTs are consistent across a variety of populations and settings, we should feel more secure about the applicability of the intervention. If it works in low risk and high risk, young and old, East and West, it will probably work in my patient. However, as Puliyel and Sreenivas point out, RCTs don't always agree, and sometimes diverge widely. When that happens, we would like to know why. It could be any of the PI...

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  • Meta-analysis can be statistically misleading
    Jacob M. Puliyel

    Dear Editor,

    In response to the Editor's invitation calling for short items on EBM related issues, we would like you to consider this statistical problem for possible publication.

    The double-blind Randomised Controlled Trial (RCT) is the basis of good evidence based medicine because it eliminates problems of bias and confounding. However systematic reviews show different RCTs arriving at diametrically op...

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