Read the publications here:

Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/

Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/

Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/

YouTube video by The BMJ GRADE the trustworthiness of evidence | Prof. Gordon Guyatt

"Evidence itself never gives us the answer what to do. It's evidence in the context of values and preferences."

Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social
www.youtube.com/watch?v=433J...

Ahoy! Learn about the importance of randomisation through history in my library at www.jameslindlibrary.org. For example, read how the GISSI trials embedded patient and public health oriented randomised trials into the Italian health service 40 years ago
www.jameslindlibrary.org/articles/emb...

It is very weird indeed.
How anybody could think of calling jam jelly and eating it with ground nut paste.

Nice blog highlighting total vacuity in The Plan.
Its lack of originality may be pardonable, but its lack of substance is not.
These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.

Treatment burden= the work that NHS staff ask/demand of patients in order to optimally manage their clinical condition(s). It’s a *big issue* for patients and we don’t talk about it enough.
For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…

I've just been having some exchanges across on the Musk site which have warmed my heart.
Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.

Bidders demand Thames Water granted immunity over environmental crimes Exclusive: ‘Ransom note’ requests would leave Environment Agency unable to prosecute company or management

If your business model only works because you're allowed to do crimes, you don't have a business.

www.theguardian.com/business/202...

May 13 2025: 10th anniversary of death of Dave Sackett. Read extended questions & answers he prepared shortly before his death to describe his multiple careers, importance of fair tests and evidence-based medicine www.jameslindlibrary.org/sackett-dl-2... @cebmoxford.bsky.social #EBM #EBHC #Cochrane

Yes, Doctors: AI Will Replace You YouTube video by Sheriff of Sodium

Brilliant video -
www.youtube.com/watch?si=5BP...
Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.

Medicine will, and should, be carried out with the universal help of intelligent and compassionate machines in the hands of patients. Machines that know what they are doing and learn from everything they do.
While this is already beginning to happen, the rest is simply falling apart.

The government was wrong to cut winter fuel payments.

It was wrong to keep the 2-child benefit cap.

It was wrong to slash disability benefits.

Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.

F1000Research Article: The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews. Read the latest article version by Andrew D. Oxman, Allen Nsangi, Laura Martínez García, Margaret Kaseje, Laura Samsó Jofra, Daniel Semakula, Heather Munthe-Kaas, Sarah E. Rosenbaum, at F1000Research.

The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews #AndyOxman @sarahros.bsky.social f1000research.com/articles/13-...

Apologies: the one invading the US and Manchester is P. tomentosa not fargesii.

Most decision making in healthcare is informed by clinician biases. There are lots of reasons for this, one of them being that nobody can keep up with the rapidly evolving evidence base. To quote @richard-lehman.bsky.social we need reliable AI driven satnav to inform decision making processes.

Also let's not forget Olga Nethersole's role in setting up the People's League for Health - a pioneer of patient activism on behalf of impoverished pregnant women.
A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social

Dealing with Medical Uncertainty in and through the History of Medicine "Dealing with Medical Uncertainty in and through the History of Medicine" published on 10 Mar 2025 by Brill.

Volume 108 on Dealing with Uncertainty in and through the History of Medicine now out in Brill’s Clio Medica series.

brill.com/display/titl...

Ahoy!If you'd like to read more from Dave Sackett, try the article he wrote for me in 2015 about why he became a clinical trialist www.jameslindlibrary.org/articles/why...

Once you start looking, it’s tramlines not guidelines everywhere. Inexorably leads to overdiagnosis and overtreatment.

The UK nuclear "deterrent" will expire within months without US tech support and components - likely to be withdrawn by Trump.

So many layers of insanity here.

It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.

Well done Tom for persisting in a demanding career despite the curse of unpredictable migraine.
Retired and 74, I still get frequent auras but they pass in 30-40 mins and never develop into the terrific headaches of my younger days. Don't know if that's any comfort.

🟠 How It Was Created:
An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach.

(4/6)

This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance.
Editorial: www.bmj.com/content/388/...

(6/6)

Looking for new sources of clinical evidence to help you make smarter decisions about patient treatment?

On 25 Feb @juliantreadwell.bsky.social of @bristoluni.bsky.social reveals how the GP Evidence website can be the goldmine of information you're looking for.

@stokemacca.bsky.social

#learning

Quite soon Spring will begin in New Haven, heralded by some of these trees bearing amazingly scented ragged balls of yellow or red flower - witch-hazels. Yale is full of them.

The challenge for generative AI is to reverse this stress, strain and suffering, not worsen it.
I and a group of colleagues know this can be done, but it needs vision and close listening to patients and doctors, improvising real-life solutions using open systems.

Paper out on digitally-driven stress, strain, and suffering in UK GP

To harness tech’s benefits, practices need to be *change-ready*: have strong working relations, time and resource to make informed decisions RE what tech and when (for the local staff/patient context) and the capacity to implement

Why GenAI in medicine needs to go through a phase of improvisation and experimentation just now. Everybody needs to share learning on how to make things safer, more frugal, more adaptable, using open access systems.
Patients can teach us how to do this. @sarariggare.bsky.social

Whether "open, inclusive, transparent, ethical, safe, secure and trustworthy" Al is even possible is another matter altogether, but it will be very interesting to see which governments sign up to the ambition to achieve it - and which decide to stay toughing it out in the arena in the hope of delivering a beat down to their opponents. If the only possible future for global Al is extractive and divisive, the pursuit of dominance will result in painful and costly real-world conflict - the very opposite of the "national renewal" that Starmer hopes these technologies will bring about.

I feel sad and angry about the UK government's decision not to sign the statement from the AI Action Summit. Not because I think it presents a rare new hope, but because they have decided to follow Trump and Musk. blogs.lse.ac.uk/politicsandp...

And after that, Proust will keep you going for a considerable time