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i knew there was an increased risk but from memory it was always quoted as being minimal, if your overweight you have an increased qrisk so will go onto statin and then independently you get diabetes.
He referred to cognitive dissonance and observation bias and recommended a book Mistakes were made but not by me I came across this paper some time ago and it is worthwhile looking at it in detail It is about how systematic reviews go out of date, or have “signals for updating”.
surprisingly the median time for updating was 5.5 years, which means, to my mind, that if you wait 5.5 years a signal will come along telling you that the systemic review is out of date, ie wrong. that there is a 50/50 chance that any systemic review recommendation might not be correct in 5.5 years time!
The NHS advice for statins goes something like this: from which is written by the BMJ group and published by the NHS , the SDM sheet for High Cholesterol states “We don’t know whether people taking statins tend to live longer overall.
Although they are less likely to die of heart and circulation problems, it’s possible they might be more likely to die of other causes.
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What you save in money, you end up spending in wasted time and effort.
to use one example PSA screening was until recently I think still generally considered a “bad thing”. I see 200 men a year with advanced/aggressive prostate cancer that I’d happily give over to the radiologists” I subscribe to a couple of well-known evidence-based GP update courses and noted their evidence on the subject was “out of date” and over-informed by “the guidelines” but there was a reassuring “watch this space” note from one of them re said multi-parametric prostate MRI imaging.
Last year I attended a Medical Controversies Symposium in WA where the Urologist credibly demolished that argument as being based on clearly old evidence of risk vs benefit vs new but evidenced modalities e.g. What I like about the best of GPLectures is the opportunity to listen to engaging witty often humble “experts” explaining their own practice, bridging the gap between primary secondary and tertiary care and bringing research & guidelines to life.
99% or whatever of the worlds cardiologists are not stupid / brainwashed / in the hock of big pharma but there are counter-arguments from similarly intelligent & informed Drs (and patients.
I read Ben Goldacre’s Bad Medicine and wondered how I could recommend any of the top-ten contemporary drugs / classes of drugs to my patients.
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