Medication-Induced Akathisia: An Overlooked Contributor to Suicide Risk and Iatrogenic Harm
The Medication‑Induced Suicide Prevention and Education Foundation (MISSD) wrote to the BMJ urging clinicians to recognize medication‑induced akathisia as a hidden driver of suicidal ideation. Akathisia, a drug‑triggered neuropsychiatric state marked by intense restlessness, is often missed in training and rarely included in suicide risk screens. MISSD cites thousands of patient reports linking new or adjusted medications to sudden akathisia symptoms and highlights successful public‑health ads that prompted immediate clinical action. The letter calls for systematic medication queries in suicide assessments to curb iatrogenic harm.
Re: China's Primary Care Plan Speaks to Global Challenge
China is accelerating digital transformation of its health system, expanding internet hospitals from fewer than 100 in 2018 to over 3,000 by 2023 and routing millions of tele‑medicine consultations. However, studies reveal that older adults—particularly rural, female, and less‑educated seniors—have...
The Problem May Not Be Fragmentation: It May Be Accumulation (Response to Morley J. The Single Patient Record: A Laudable...
The author argues that the single patient record (SPR) initiative may worsen information overload rather than solve fragmentation. A 2022 study found that over half of documented words in electronic health records are duplicated, highlighting the prevalence of stale data....
The Realities of the Assisted Dying Bill
A letter signed by eight peers challenges the claim that the UK Assisted Dying Bill enjoys broad parliamentary support, noting that backing has dropped to just 23 MPs. The authors highlight that the legislation was drafted in under four weeks,...
Mandatory, Standardised Food Labelling Should Be Just One Element of a Multifaceted Campaign
The authors acknowledge the prevalence of unhealthy foods and the UK’s rising obesity rates, but argue that a mandatory, standardised food‑labelling scheme alone will not solve the problem. They highlight the broader obesogenic environment—affordability, marketing, physical‑activity opportunities, and social norms—especially...
Re: Increasing Participation in Cervical Cancer Screening
A recent BMJ rapid response from Chinese gynecologic oncologists highlights the promise of self‑sampling, especially menstrual‑blood HPV testing, which achieved 94.7% sensitivity for CIN2+ in a 3,068‑woman study. They note that national cervical‑cancer screening coverage rose to 51.5% in 2023‑24,...
Re: Lyme Disease Cases in England Rise 20% in a Year
Recent UK surveillance data show a 20% increase in laboratory‑confirmed Lyme disease cases in England, but the figures exclude clinically diagnosed infections. Since the 2018 NICE guideline recommends treating erythema migrans rash without testing, many cases go unrecorded, potentially masking...
"We Are Training NHS Leaders to Be Disappointed"
The BMJ letter argues that NHS leadership programmes invest heavily in training doctors but fail to deliver real authority or protected time, leaving participants ill‑equipped to enact change. While participants gain self‑awareness, the structural constraints of budget cycles, risk appetite,...
Re: Politicised Narratives About Cousin Marriage Risk Undermining Progress
Catherine Cole, a pediatric haematologist who worked in Qatar where more than half of marriages are between cousins, writes to BMJ highlighting two health challenges that extend beyond classic autosomal‑recessive disorders. She notes that consanguinity is associated with dysregulated immunity,...
Disentangling Algorithmic Efficacy From Implementation Intensity in AI-Assisted Stroke Care
The BMJ letter critiques the GOLDEN BRIDGE II cluster trial, which reported better acute ischemic stroke outcomes using an AI‑assisted clinical decision support system (CDSS). The authors argue the study’s design conflates the algorithm’s performance with extensive implementation support, including...
Re: Improving Palliative Care in the UK
The letter urges the UK to leverage coordinated clinical leadership to transform palliative and end‑of‑life care, citing the National Audit of Care at the End of Life (NACEL) as a critical tool. NACEL’s 2025 audit covered 22,000 deaths—about 8 % of...
When the Camera Enters the Consultation Room
A letter to the BMJ highlights a growing privacy risk as physicians in China film patient interactions for social‑media platforms like Douyin and Kuaishou. Unlike typical influencers, these clinicians have medical authority and institutional backing, making their content especially persuasive...
Parent-Rated Improvement Is Not Enough to Establish Clinical Scalability
A multicentre, sham‑controlled trial examined accelerated continuous theta burst stimulation (a‑cTBS) targeting the left primary motor cortex in children with autism spectrum disorder, including many with co‑occurring intellectual disability. The study reported modest improvements on the caregiver‑rated Social Responsiveness Scale...
Cancer-Specific Mortality Versus Overall Survival in Prostate Cancer Screening
A recent BMJ letter challenges the reliance on cancer‑specific mortality as an endpoint in prostate cancer screening studies, arguing that overall survival (OS) is a more objective measure. The author notes that no randomized trial has demonstrated an OS benefit...
Re: Prophylactic Tranexamic Acid for the Prevention of Postpartum Haemorrhage in Women with Placenta Praevia: Multicentre, Double Blind, Randomised, Placebo...
Zhang et al. reported that prophylactic tranexamic acid (TXA) lowered a composite postpartum haemorrhage (PPH) endpoint in women undergoing caesarean delivery for placenta praevia. The reduction stemmed from calculated blood loss derived from haemoglobin and haematocrit changes, while gravimetric blood loss...