Medicine and Science from The BMJ

Our whole society views risk in medicine wrongly, argue Jerome Hoffman and Hemal Kanzaria from the University of California Los Angeles. In this podcast they slay some strongly held myths about medicine's ability to heal, and say that one of our big beliefs, that death is not inevitable, is leading to overtreatment. Read their full analysis of the situation: http://www.bmj.com/content/349/bmj.g5702 For more information about overdiagnosis and overtreatment, visit www.bmj.com/too-much-medicine

Allyson Pollock, professor of global health, and Peter Roderick, a barrister and senior research fellow, both at Queen Mary University of London, argue that, through various mechanisms in the 2012 Health and Social Care Act, the NHS in England could be turned into a small core service. For full healthcare coverage, will we have to turn to commercial medicine? Read their analysis article: http://www.bmj.com/content/349/bmj.g5603 The NHS Reinstatement Bill Campaign: http://www.nhsbill2015.org/

Cerebral palsy is a clinical diagnosis, which describes a wide spectrum of neurological disability – all as a result of some sort of trauma to the developing brain, either pre or post natally. Neil Wimalasundera, a consultant in paediatric neurodisability at Great Ormond Street Hospital, and one of the authors of The BMJ clinical review discusses how to diagnose and manage cerebral palsy in children. Read the full clinical review: http://www.bmj.com/content/349/bmj.g5474

Jocalyn Clarke, executive editor at icdd,b, argues the solutions proposed to improve global health are too focused on the medical, and fail to tackle the underlying socioeconomic factors which will undermine those efforts. Read her full analysis of the situation: http://www.bmj.com/content/349/bmj.g5457

In April 2006 one of the largest hospitals in the Netherlands hit the national headlines with the exposure of “scandalously” poor results for cardiac surgery. Melvin Samsom, CEO of the hospital, explains how the high death rates galvanised quality improvement and innovative change, transforming it into a model for patient participation. Read more about the transformation at: http://www.bmj.com/content/349/bmj.g5765

Kawasaki Disease presents as fever and rash, which makes diagnosis difficult. In this podcast, Anthony Harnden, professor of primary care at the University of Oxford, describes what to watch out for to ensure you don’t miss the diagnosis. Read the full article: http://www.bmj.com/content/349/bmj.g5336

Is medicine trying to learn too much from aviation? Kevin Fong, consultant anaesthetist at UCLH is currently working with Kent, Surrey and Sussex air ambulance. At Risky Business he talked to The BMJ about why he thinks medicine is trying to learn too much from aviation.

Screening tests were central to many of the discussions taking place at the Preventing Overdiagnosis conference (preventingoverdiagnosis.net) To sum up some of the problems with screening we’re joined by Carl Heneghan, director of the Centre for Evidence Based Medicine at the University of Oxford, and John Broderson, associate professor in the Research Unit and Section of General Practice at the University of Copenhagen. For more on over diagnosis, visit www.bmj.com/too-much-medicine

A recent clinical review in The BMJ discusses diagnosis and management of prolactinomas and non-functioning pituitary adenomas. One management option is surgery to remove the tumour, often this can done trans-sphenoidally. Though major complications of this type of surgery are low (~1%), there are still effects that can be distressing to patients, and should be discussed. In this interview the patient wished to remain anonymous, so we have re-recorded her words. She describes the way in which attempts to reassure her about the surgery made he under-estimate the risks involved. Read the full review: http://www.bmj.com/content/349/bmj.g5390

Stephen Martin, an associate professor at the University of Massachusetts Medical School, thinks we're overtreating otherwise healthy patients who have mild hypertension. In this podcast he sets out his argument, and explains why prescribing drugs to these people may actually be doing more harm than good. Read the full analysis article: http://www.bmj.com/cgi/doi/10.1136/bmj.g5432