Posts Tagged ‘Evidence-based medicine’

Was Thatcher the Milk Snatcher right?

By Bob Bury - 10th August 2010 4:23 pm

So, they’re not going to snatch the milk from the hands of our under fives? Well, that’s nice. But why the U-turn? Well, it’s because Dave ‘doesn’t like’ the idea, and also because the free provision ‘dates back to the war’. Jeez - I guess that means we can anticipate the return of powdered egg and Woolton pie to our national diet.

We’re told that nothing is sacred in the search for financial savings. Except that it now seems that some things are actually sacred - namely, any savings schemes that Dave ‘doesn’t like’ or decisions to cut anything that has ‘been around for a long time’. In the case of homeopathy, the saving grace seems to have been the fact that lots of people ‘find it helpful’ (and of course, the nutjob P of Wales likes the odd slug of arnica when he isn’t talking to flowers, so that presumably won’t have done the homeopaths any harm).

Does anyone else see the link between this craven publicity-seeking, and last week’s intemperate rant against homeopathy? Yes, that’s right, it’s the evidence-based thing again. Is there any actual evidence that giving young children a bottle of milk every day improves their nutrition of general health in any way? No - that’s a genuine question. My instinct is that there isn’t, but no doubt one of you will tell me if I’m wrong.

It might have been different 50 years ago, but these days kids should be getting everything they need from their diet without supplementary milk. And yes, of course I know that some parents feed the fruit of their feckless loins on crap, but I don’t see how giving them a third of a pint of fat-laden calcium solution every day until they are five will mitigate significantly against the effects of the rest of a childhood spent consuming turkey twizzlers and Vimto, graduating to deep-fried pizza and Tennents Super when adolescence kicks in.

So, milk, homeopathy, it’s all the same. If someone, somewhere, whose opinion the politicians regard as important (like a voter, or an heir to the throne, for example) thinks that something is a good thing, it won’t be cut, no matter how little evidence there is for its worth or how much money we waste on it. Actually, I hope one of you does write in saying that there’s good evidence for the positive effects of free milk - it would stop me feeling so angry about this twattery. My therapist says that anger is bad for me, as well as for the dickheads I take it out on. Whoops - terminal preposition. One for the pedants.

Unmask the truth behind evidence-based medicine

By Katherine Teale - 22nd November 2009 9:55 pm

Evidence-based medicine used to seem quite simple to me, until this week. My mother-in-law, at 78, has decided to stop taking her enalapril on the grounds that she was “getting hooked on it”.

I’ve just taken her BP, and it’s 208/118. Mine is now 220/100 because I’ve just spent half an hour trying to describe the evidence for long-term blood pressure control in the elderly.

All in all it’s been a trying week - someone told me recently that we are happiest during our twenties, and then not again until we hit 60. That would explain a lot, as I’m slap-bang in the middle of the “happiness trough”; and it would also explain my mother-in-law’s permanent state of euphoria.

All she requires for happiness is a pot of Yorkshire tea and Corrie on the box. Perhaps a complete lack of insight really is the only way to achieve happiness. To this end I’ve decided to try a little experiment - henceforth I’m only going to read celebrity  news, concentrating on Katie Price and Peter Andre’s ongoing life-choices (so there’s plenty of material), and see if I’m any happier after a couple of weeks. 

Meanwhile, at work, life is being enhanced by a heated argument involving clinical autonomy and the evidence-base for wearing surgical facemasks. Theatre management is attempting to enforce a universal facemask rule - but we have some surgeons who adamantly refuse to do so (particularly, and in my opinion somewhat bizarrely, the gynaecologists) and obviously all the anaesthetists take it as a personal affront.

Of course the evidence for facemasks reducing infections is sketchy to say the least, although it has been demonstrated that wearing them reduces bacterial growth on agar plates placed near the op site.  

But it turns out evidence isn’t what it used to be. For a start, it changes radically from one year to the next - one moment it’s dangerous to drink alcohol, the next it’s good for you, then we’re being told that the calorie limits we’ve all used for years are too low (although frankly who cares, since everyone ignores them anyway).

If we can’t even agree on things for which there is copious evidence like evolution or global warming, then what chance is there for something as nebulous as wearing a facemask?

Basically we’ve got to wear masks because the trust thinks it’s good for discipline, and, in conjunction with other things, it may (or may not) help to reduce infections. In the anti-mask camp, the following convincing arguments have been advanced: A. they’re itchy B. they’re hot C. they make people sneeze, and D. we don’t like being told what to do by a set of jumped-up managers who probably wouldn’t even recognise a Chi squared test. Talking of which, where are the double-blind randomised controlled trials which we demand for anything we don’t want to do?

I only wish that I had so few things to worry about that I could be upset about wearing a face mask. Really, on the scale of life’s tragedies, it doesn’t really float my boat.

On the way home, I notice the headline in the paper “Peter left me for Nanny” Katie Price exclusive. Now that really is something worth getting worked up about.