Medicine is an artful science

Kieran Quinn

I recently saw a patient with cancer who came to the emergency room complaining of shortness of breath, who was coughing up small amounts of blood, had a racing heart and sharp chest pain that was worse when he took a deep breath. In deciding the likelihood that this patient had suffered a clot in

Should clinical practice guidelines consider value for money?

clinical practice guidelines cost effectiveness health care economics health care policy

In Canada, doctors’ associations regularly incorporate new evidence about medications into clinical practice guidelines that are intended to influence patient care. The Ontario Ministry of Health and Long-Term Care reviews the same evidence to decide which medications it will pay for, and often comes to different conclusions. This results in doctors recommending medications which are

Managing conflicts of interest in research

conflict of interest health care intellectual conflict financial conflict COI

There have been a number of recent reports of conflicts of interest in medical research. There are at least two types of conflicts of interest – financial conflicts, where researchers stand to gain financially from their work; and intellectual conflicts, where researchers stand to gain professionally. Ensuring that all conflicts of interest are declared and

The trouble with guidelines

Shelagh McRae blogger

A friend of mine took her 98 year old, 98 lb mother to the doctor recently. Additional diabetic medication was prescribed because her A1c (also known as glycated hemoglobin -a proxy measure of average blood sugar levels over the previous months) was “not at target”. When my friend questioned the safety of yet more pills

Interpreting randomized trial evidence around mammography

Interpreting Randomized Trial Evidence on Mammography

The Canadian Task Force on Preventive Health Care recently released recommendations about screening for breast cancer.  These recommendations have been criticized by some because they emphasize the results of randomized trials.  This article explores the advantages and limitations of randomized trial evidence regarding screening mammography.  The recent recommendations by the Canadian Task Force on Preventive