8 e-Letters

published between 2005 and 2008

  • 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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  • Pain
    peggy lreager
    Dear Editor,

    I ran across your site concerning glucomine and sulphate knee cream. I took a cruise to Mexico and bought some cream there with glucomine and sulphate for 6.00. I am 65 and I have rheumatoid-osteoarthritis and am in pain

    That cream worked for me but I cant find it anywhere here. Can you help me find it please?

    Thank you,


  • What is evidence-based medicine?. A note from a developing country
    Luis Huicho

    Dear Editor,

    I read with optimism the note from Dr. Glasziou. It is encouraging to know that systematic reviews on diagnostic tests are being considered as part of national Cochrane movements. We badly need them. We have been involved in this task ever since 1995 and published two systematic reviews [1,2]. Quality of primary studies and methodological problems need to be studied and new tools need to be developed....

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