The BMJ Pub Date : 2024-11-11 DOI: 10.1136/bmj.q2403

Sally Howard

引用次数: 0

Patient involvement in developing clinical guidelines 患者参与制定临床指南

The BMJ Pub Date : 2024-11-08 DOI: 10.1136/bmj.q2433

Trisha Greenhalgh, Cheryl Misak, Rebecca Payne, Nadia Swann

{"title":"Patient involvement in developing clinical guidelines","authors":"Trisha Greenhalgh, Cheryl Misak, Rebecca Payne, Nadia Swann","doi":"10.1136/bmj.q2433","DOIUrl":"https://doi.org/10.1136/bmj.q2433","url":null,"abstract":"Experiential evidence must be open to scrutiny and criticism The literature on development of clinical guidelines generally accepts that patients and carers should be involved in the process.123 Patients contribute subjective and practical knowledge of a condition, including what it feels like, what challenges it poses to living a productive and fulfilling life, and how to manage symptoms and flare-ups. Patient knowledge (“experiential evidence” or “lived experience”) often complements but sometimes conflicts with the professional knowledge of clinicians and academics on guidance development panels. Patient input to guideline panels has contributed to better care experiences and better health outcomes2 but is not without controversy. Most guideline development panels worldwide follow the grading of recommendations assessment, development, and evaluation (GRADE) approach. These methods set out how to assess and combine research evidence by weighting it according to study design, risk of bias, and magnitude of effect.4 GRADE methods are widely accepted but have been described as hierarchical, quantitative, and exclusively focused on research evidence.567 Partly in response to such criticism, GRADE guidance has evolved to incorporate research into patients’ values and preferences (usually in the form of patient reported outcome measures).89 However, this approach to capturing the patient experience has been justifiably criticised for “subordinating patient …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sharp Scratch episode 123: Time out—why taking time out of medical school is not a personal failing 锐利划痕》第 123 集：抽出时间--为什么从医学院抽出时间并不是个人的失败

The BMJ Pub Date : 2024-11-08 DOI: 10.1136/bmj.q2476

George Webster

引用次数: 0

When I use a word . . . Academic integrity—felonies and misdemeanours 当我使用一个词时 . .学术诚信-重罪与轻罪

The BMJ Pub Date : 2024-11-08 DOI: 10.1136/bmj.q2473

Jeffrey K Aronson

{"title":"When I use a word . . . Academic integrity—felonies and misdemeanours","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.q2473","DOIUrl":"https://doi.org/10.1136/bmj.q2473","url":null,"abstract":"Academic norms include: preservation of academic autonomy; integrity in academic practices; a priori formulation of hypotheses and publication of protocols; the use of appropriate methods by which evidence is obtained; the use of appropriate methods for interpreting the accumulated knowledge so obtained; the need to take heed of the possible consequences, both intended and unintended, of research; the use of comprehensible language in describing outcomes and their interpretation; universalism; communality; disinterestedness; organised skepticism, but limited to one's own sphere of academic interest; appropriate curiosity; avoidance of inappropriate enthusiasm; and respect for the work of others. Violation of all of these is possible, and different types of violations are known by different terms: “research misconduct” refers to three major violations, fabrication, falsification, and plagiarism; I prefer to call these collectively by the legal term “felonies,” emphasising their gravity and importance. Other violations are known as “questionable research practices,” which I prefer to call by the stronger term “misdemeanours,” again emphasising their importance, although they are less grave than felonies. Interest in detecting, reporting, and discussing these violations has increased markedly since 1990, but I have found only two systematic reviews, one of which, disappointingly, but perhaps not unexpectedly, shows that there is little useful evidence on the subject, and a second, which shows that the likely prevalences of both types, felonies and misdemeanours, are higher than one would want, although probably estimated at lower than they truly are. The definition of a “norm” in the Oxford English Dictionary ( OED ) relevant to academic practice is “A standard or pattern of social behaviour that is accepted in or expected of a group.”1 In this case the group is the amorphous collection of academics, in whatever discipline they are involved. The relevant definition of an academic is “a member of a university or …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Guidance on terminology, application, and reporting of citation searching: the TARCiS statement 引文检索术语、应用和报告指南：TARCiS 声明

The BMJ Pub Date : 2024-11-07 DOI: 10.1136/bmj.q2458

British Medical Journal Publishing Group

引用次数: 0

SGLT-2 inhibitors for the prevention of recurrent nephrolithiasis 用于预防复发性肾结石的 SGLT-2 抑制剂

The BMJ Pub Date : 2024-11-07 DOI: 10.1136/bmj.q2447

Khashayar Sakhaee

{"title":"SGLT-2 inhibitors for the prevention of recurrent nephrolithiasis","authors":"Khashayar Sakhaee","doi":"10.1136/bmj.q2447","DOIUrl":"https://doi.org/10.1136/bmj.q2447","url":null,"abstract":"New study reports protective effect among people with type 2 diabetes Kidney stones and the systemic conditions associated with them have a major impact on health and the economy in the US and worldwide.12 In recent years, the prevalence of kidney stones has increased in parallel with the epidemics of obesity and metabolic syndrome, as well as cardiorenal disease. Since 1988, when the US Food and Drug Administration approved potassium citrate to prevent recurrent nephrolithiasis, no other drug has been introduced for the secondary prevention of this chronic illness. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are an accepted treatment for type 2 diabetes and have also emerged as a novel therapeutic class with beneficial cardiorenal effects.3 In a linked paper, McCormick and colleagues (doi:10.1136/bmj-2024-080035) report a target trial emulation study evaluating SGLT-2 inhibitors in adults with recurrent nephrolithiasis and type 2 diabetes using the general Canadian population database.4 After inverse probability weighting or propensity score overlap weighting to balance the study groups, the authors compared treatment with SGLT-2 inhibitors versus competitor agents, including glucagon-like peptide-1 (GLP-1) receptor …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The rapid rise of the UK’s cancer vaccine trials 英国癌症疫苗试验的迅速崛起

The BMJ Pub Date : 2024-11-07 DOI: 10.1136/bmj.q2294

Chris Baraniuk

{"title":"The rapid rise of the UK’s cancer vaccine trials","authors":"Chris Baraniuk","doi":"10.1136/bmj.q2294","DOIUrl":"https://doi.org/10.1136/bmj.q2294","url":null,"abstract":"The UK is making progress in developing cancer vaccines, but there are still challenges ahead, Chris Baraniuk reports The UK is on its way to becoming a hotbed of cancer vaccine trials. In May this year,1 it emerged that 30 British hospitals had signed up to be part of the Cancer Vaccine Launch Pad,2 a scheme to enrol NHS patients in messenger RNA (mRNA) cancer vaccine trials. Just three months later, in August, a 67 year old man named Janusz Racz became the first person in the country to receive a new mRNA vaccine,3 as part of a clinical trial, for non-small cell lung cancer. The vaccine, which was developed by the German biotechnology company BioNTech, is designed to present tumour markers to the patient’s immune system and thereby trigger an immune response that will target cancer cells specifically.4 In principle this reduces the risk of toxicity to healthy, non-cancerous cells. Chemotherapy, in contrast, often affects both cancerous and healthy cells. Vaccine trials for melanoma5 and bowel cancer6 using BioNTech jabs are also currently active in the UK. Future trials could target a growing range of cancers, including breast cancer and head and neck cancers, among others. Excitement over the prospect of a new era of cancer vaccine research has been building for some time,7 driven in part by the …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Banning abortion prevents us from providing safe care to all pregnant women 禁止堕胎使我们无法为所有孕妇提供安全护理

The BMJ Pub Date : 2024-11-07 DOI: 10.1136/bmj.q2459

Maryl Sackeim

{"title":"Banning abortion prevents us from providing safe care to all pregnant women","authors":"Maryl Sackeim","doi":"10.1136/bmj.q2459","DOIUrl":"https://doi.org/10.1136/bmj.q2459","url":null,"abstract":"Abortion bans or restrictions in US states are endangering all women, including those with pregnancies that are not viable or are actively harming their health, writes Maryl Sackeim On 24 June 2022, the Supreme Court of the United States overturned Roe v Wade and revoked the constitutional right to abortion. Following the Dobbs decision, control of abortion policies was returned to individual states. The election on 5 November further degrades hope for progress in women’s health. With Donald Trump now the president-elect, a federal abortion ban is likely, and even access to in vitro fertilisation and contraception may be at risk.1 Many political and moral problems exist with a male dominated court and political party deciding who can make decisions about women’s reproductive autonomy. But as a healthcare professional in obstetrics and gynaecology, what concerns me most is the court’s limited view of what is at stake here: the ability to keep pregnant women healthy. Abortion is completely banned in 13 states and heavily restricted in others. This removes far more than access to the narrow definition of abortion these lawmakers used: ending an unwanted pregnancy. Banning abortion takes away the ability of healthcare professionals in obstetrics and gynaecology to do …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical students should be better prepared for observing postmortem examinations 医科学生应为观察尸检做好更充分的准备

The BMJ Pub Date : 2024-11-07 DOI: 10.1136/bmj.q2453

Annie Graham

引用次数: 0

Simplifying the universal health coverage narrative can help to achieve political action 简化全民医保叙事有助于实现政治行动

The BMJ Pub Date : 2024-11-06 DOI: 10.1136/bmj.q2441

Katri Bertram, Justin Koonin

引用次数: 0

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