eLetters

56 e-Letters

  • Do not discard your mercury sphygmomanometers, yet.
    Yehia Y. Mishriki

    It would not be surprising to find that the "error" rate in blood pressure determinations with the "old fashioned" sphygmomanometer was due, in part, to a faulty technique by the individuals taking the blood pressures. Remarkably, little or no time is spent in teaching medical students the proper technique for blood pressure determination including the appropriate cuff size to use, the various audible phases, etc. One ca...

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  • Qualitative reasoning by elimination
    Huw Llewelyn

    Dear Editor,

    Bayes theorem can only be applied properly when considering a single diagnosis or its absence e.g. the presence or absence of asymptomatic diabetes mellitus, hypothyroidism, hyperlipidaemia, cervical cancer, breast cancer, etc. These asymptomatic situations are very important in the clinical setting and also in the community. It is in these situations that the reasoning described in this paper can be...

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  • What is 'transparent' EBM?
    Huw Llewelyn

    Dear Editor,

    Different individuals have adapted and adopted the principles of EBM to different degrees and in vastly different ways [1]. There is yet another approach to EBM, which goes back a long way in terms of verbal justification on ward rounds but which has not been put in writing and taught in that way until recently [2]. It involves specifying the 'evidence' obtained from the patient that was used for ea...

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  • Editor's reply to "Conflicts of Interest"
    Richard Saitz

    I agree with Dr. Tomedi's assertion that one might question the credibility of a commentary written by someone who has received pharmaceutical industry support, or for a number of other reasons. It is for this reason that BMJ Group policies ask authors to acknowledge and openly state any competing interests (1), and as a result of this policy, Dr. Tomedi could become aware of them and consider them in reading the commenta...

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  • 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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