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Evidence-based medicine is not about consensus

The decision by NICE to pause the publication of new guidelines for ME/CFS was misjudged On 17 August the UK’s National Institute for Health and Care Excellence (NICE) “paused” publication of its updated guideline on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Earlier in August, three members of NICE’s 21-person guideline committee…

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On the results of laboratory accidents

Laboratory containment measures might have improved in recent years, but the universal propensity for human folly remains the same It was mid-summer 1978 and I was a recent microbiology graduate. Sat at a bench in a London hospital diagnostic virology lab, I had been asked to dispense a volume of culture medium. So, I selected…

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The problem of retractions and contentious papers

Failing to correct erroneous scientific and medical research makes fools of us all A truth that’s told with bad intent Beats all the lies you can invent William Blake (1757–1827) On 9 November, Pfizer and BioNTech announced that their vaccine was ‘more than 90 per cent effective in preventing Covid-19 in participants without evidence of…

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The arts in medicine

The art of people with chronic diseases, such as epilepsy, can enhance our understanding of living with illness Let’s begin with an ending: “The art of persons with epilepsy helps us understand what it means to have epilepsy, providing windows into its complexity and comorbidities.” That is Steven C Schacter’s conclusion to his exploration of…

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If everyone felt that way

The role of saturated fat in the diet and cholesterol in the blood is in need of re-evaluation On 13 March this year, the Secretary-General of the United Nations António Guterres wrote a piece titled ‘Covid-19: We will come through this together’ https://www.un.org/en/coronavirus/covid-19-we-will-come-through-together. I thought of Joseph Heller and Arthur Koestler. Though separated in time…

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When everybody is an expert…

‘Science’ does not refer to one thing, and neither does ‘the public’ In a piece for The Critic (28 May 2020,  https://thecritic.co.uk/the-ecstasy-of-sanctimony/), a writer called Seymour Silk defends his neighbour Dominic Cummings (top tip: select ‘safe search’ before Googling those names together) and the excursion the latter undertook with his family from London to Durham.…

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The smell of human adventure

Who is brave enough to tackle Everest’s faecal time bomb? In the June 2013 issue of National Geographic, Mark Jenkins wrote of Mount Everest that the two standard routes, the northeast and the southeast ridges, “are not only dangerously crowded, but also disgustingly polluted, with garbage leaking out of the glaciers and pyramids of human…

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The annual outbreak of veisalgia on New Year’s Day

Descriptions of the effects of alcohol in medical literature are many and varied hroughout 2019 I had been deferential to my low tolerance for alcohol. So, what led me to deem it polite to accept our neighbours’ New Year party invitation, but impolite to stop them filling and re-filling my glass with liqueur the colour…

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Environmentalism is a cry from the soul

Public services, such as healthcare, should understand the impact they have on the environment In May 1982, after Argentina had invaded the Falklands, the British Prime Minister Margaret Thatcher offered this insight to the Scottish Conservative Party conference: “It is exciting to have a real crisis on your hands, when you have spent half your…

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Separating the scientists from the paranoid

Those who seriously evaluate the merits of vaccination should not be grouped with anti-vaxxers Olshansky and Hayflick noted in AIMS Public Health (2017; 4:127-138) that vaccines derived from the WI-38 cell strain had treated or averted 4.5 billion cases of poliomyelitis, measles, mumps, rubella, chicken pox, shingles, adenovirus, rabies and hepatitis A infections worldwide, saving…

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