blogs wanted

08Jan10

I’ve spent some time searching for blogs that I’d like to link to from this site. But with the honorable exception of Ben Bad Science and his highly intelligent posse there doesn’t seem to be much out there. Am I missing something?

If you write an informed blog on health matters, particularly UK based, and especially on public health, nursing, GPs, drugs or the health effects of climate change, get in touch. I’d love to read your thoughts.

Reply by adding a comment to this post or, if you prefer, send me an email.

With thanks.

Filed under: climate change, drugs, GPs, nursing, public health   |  Leave a Comment
Tags: blogs, climate change, drugs, GPs, health, nursing, post, public health, thoughts

error by design?

31Dec09

Old news, perhaps, that companies should seek to misrepresent data – sometimes it seems easier to accept the default position that all large companies are lying. But it’s important to try to remain objective, I guess.

Anyway, to get to the point of this, in 2007 and again in 2009, Boots got major media attention for one of its cosmetic products, No. 7 Protect Perfect Beauty Serum (Google has lots of links). Especially following a BBC Horizon programme extolling the scientific virtues of the product.

In a short and elegant article in the latest copy of Significance Martin Bland examines the most recent evidence published in support of this product trial. Oddly enough this the trial paper is the only one in that issue of the British Journal of Dermatology to be Open Access (ie available to everybody).

Bland reports basic methodological and statistical oddities and errors.

• Item 1: the control group study lasted only 6 months, and active treatment was substituted in this group for the next 6 months.
• Item 2: the non-significant differences between control and active groups at 6 months did not appear to include data from drop outs in the control goup, which might skew the results.
• Item 3: Nor were comparisons made directly between groups. Instead significance tests were done in each group and then the results compared. That’s a no-no, apparently.
• Item 4: no adjustments were made for multi-testing (of outcomes that were in any case not pre-defined) at 12 months.

Bland concludes that the data do not support the story. Also that science, used as what he calls a ‘brand’ or an ‘endorsement’ can have major influence and that journalists, even those in the public eye, do not understand statistics, especially the use of P values. Which of course Boots and other such companies know, very well.

It seems only fair to point out that since it’s first online publication Watson et al have corrected one of Bland’s gripes, that sources of funding for the study were not mentioned, with a statement that ‘This study was funded by Alliance Boots Ltd’.

As if we hadn’t guessed.

Reference
Bland M. Keep young and beautiful: evidence for an ‘anti-aging’ product? Significance 2009, 6, 4: 182-183.

Filed under: news, statistics   |  Leave a Comment
Tags: brand, cosmetics, data, Google, No. 7 Protect Perfect Beauty Serum, P values, pharma, publication, science, statistics

got to be the news story of the day

30Dec09

Lady Thatcher rejected offer of ’20 karate ladies’ as bodyguards

Lady Thatcher refused to be protected by 20 “karate ladies” at a summit in Japan unless male world leaders were given the same number of “karate gentlemen”.

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Tags: news

whose interests?

30Dec09

A good story on a community that’s standing up to supermarkets.

Or at least a part of that community is. There are some who say they support shopping at Tesco’s, mainly for reasons of price of course. Indeed, one of the commentators on the story says:

It is a class issue and it is unfair a minority who want to preserve our town means the many people low-earning have to travel out of our towns to find a supermarket with special offers and cheap goods

There is a huge faultline here, one with great resonance for our future.

I have spent some of my life in poverty and one thing that’s stayed with me is the lack of other people’s understanding of your ability to take a long-term view. For example, it’s always cheaper in the long-run for a consumer to buy a multi-pack of baked beans, rather than just one. But that’s no use to you if you only have enough cash to buy one tin and no access to credit.

Similarly it’s better for you to buy fresh fruit and veg, but those who have most to gain from this important public health objective can only afford to buy shit.

This is how we enable those with most power to align themselves with those who have none.

Filed under: food, public health, shopping   |  Leave a Comment
Tags: capitalism, poverty, price, shopping, supermarkets, Tesco

making sense of targets

16Dec09

When the Quality and Outcomes Framework was first introduced, I was involved in a lot of work (much of it for pharma companies) that attempted to help GPs meet their targets. Much of this was in hypertension, which made sense in a peverse way as there’s oodles of money to be made in hypertension work – for both doctors and pharma companies.

Salutary reading, then, to see this:

I seethe with indignation when careless commentators announce blithely that hypertension is the commonest condition seen in general practice, as they often do. It is not. It may be the commonest condition included in the QOF, but it is knocked into a cocked hat by childhood eczema and kicked clean overboard by skin disease as a whole.

A recently published and well received dermatology Health Care Needs Assessment found that skin conditions are the most frequent reason for people to consult their general practitioner with a new problem. Around 24% of the population in England and Wales (12.9 million people) visited their general practitioner with a skin problem in 2006, with the most common reasons being skin infection and eczema. It found also that of the nearly 13 million people presenting to GPs with a skin problem each year in England and Wales, around 6.1% (0.8 million) are referred for specialist advice.

The author argues that target setting and financial incentives ‘disadvantage huge and clearly definable groups of patients, distort clinical priorities and drain primary care of flexibility’. Very timely, given that his article is in response to the British Medical Association’s request that targets be relaxed in order to free up time for swine flu vcaccination.

More here.

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Tags: British Medical Association, dermatology, hypertension, quality and outcomes frameworj, skin disease, swine flu

swine flu: a realistic assessment

16Dec09

There were reportedly 138 deaths in England definitely attributable to swine flu between June and November 2009. An estimated 540,000 people had symptomatic flu during this period in England (around 1% of the population). From these figures, the estimated mortality rate was 26 deaths (range 11 to 66) per 100,000 people who had swine flu, or 0.026% of those affected. There was no difference between males and females. The lowest death rate was in children aged five to 14, at 11 deaths per 100,000 cases. The highest rates were for those aged 65 years or over, at 980 deaths per 100,000 cases.

So death rates so far are lower than in other pandemics, and around two-thirds of those who died had co-morbidities. One-third is still a large proportion, of course. Vaccination and other public health measures remain important, and early use of antivirals is probably useful:

The fact that the majority of the patients who died despite taking Tamiflu had received this medication more than 48 hours after the onset of illness appears to support the timely use of antivirals (within 48 hours). However, as the authors point out, this conclusion is limited by the absence of a control group who did not take an antiviral.

Full link here

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Tags: antivirals, death rates, pandemics, swine flu, vaccination

not just for the sake of it

11Dec09

Twenty mph traffic speed zones are associated with 40% drop in road injuries in London.

According to this study the introduction of 20 mph traffic speed zones in London between 1986 and 2006 seems to have been an effective measure for reducing road injuries and deaths. It was was associated with a 41.9% reduction in road casualties.

Full story here.

The authors of the study say that there doesn’t seem to be a migration of casualties to surrounding areas, and that further introduction of safety measures – sleeping policemen, speed cameras etc – could reduce the measures still further.

Like many other people I talk to, I’ve recently completed a speed awareness course (imposed as an alternative to a fine and points), and I was shocked by a) how little I knew about road safety and b) how complacent I had become in my estimation of my driving abilities. The two go together, I suspect.

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Tags: casualties, driving, speed, speed cameras

staying on message

03Dec09

Swine flu cases are now falling, apparently, with marked reductions in rates among infants and younger kids (more), although infection rates may leap again in the New Year.

Not sure when we’re going to get the invitation, but we still plan on vaccinating our 3-yr old daughter, as per the recommendations.

Seemed important to say that.

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Tags: children, swine flu, vaccination

feeling lonely? it might be catching

02Dec09

A number of news papers are talking about the idea,which seems intuitively correct, that lonliness may be contagious.

The study protocol seems sound, although the stats are still to be published, says NHS Choices:

What appears to be new in this research is the idea that loneliness is contagious. This is based on the observation of how social relationships change over time. No clear statistics on this are offered in the draft version of the research appraised in this article.
Overall, this study seems to support common assumptions about loneliness. The authors’ suggestion that better social cohesion of lonely people early on is a sound one: “Because loneliness is associated with a variety of mental and physical diseases that can shorten life, it is important for people to recognise loneliness and help those people connect with their social group.”

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viable alternative, or Tory posturing under any other name?

27Nov09

Are supermarkets bad for our health, social, economic or medical? There’s lots of stuff in this book about how people’s average intake of vegetables has declined in the period when supermarkets came to power (and I say power advisedly).

Add to that the influence supermarkets have on local communities and on pollution (in the form of increased car parking), the quality of goods they provide and the terrible impact they have had on traditional businesses and services over the last 30 years, and you’ve got a well-seasoned recipe for harm. In my opinion.

Now David Cameron’s ideological acquaintance Phillip Blond has picked up on this, as part of his Red Tory serving, and is suggesting that it’s time to break up supermarkets’ power. His idea is to place more faith in local businesses, as I understand it, though there are no indications yet about how this will be done. And when it comes down to it will Cameron have the balls to go down a route that is causing his party’s grandees serious concern?

In the meantime, here’s an enjoyable article about how some farmers are providing food for our tables and fighting back against Blond’s ‘cartels’. Perhaps best to pass over the more stereotypical Torygraph caricaturing of the headline over Jeff Randall’s lead piece in the features section.

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Tags: health, medical, supermarkets, Tory, vegetables