Re: Alzheimer’s Drugs Targeting Amyloid Do Not Produce Clinically Meaningful Effects, Concludes Cochrane Review
A recent Cochrane review concluded that amyloid‑targeting drugs for Alzheimer’s disease do not deliver clinically meaningful benefits, prompting disappointment among researchers, investors, and caregivers. In a BMJ rapid response, emeritus professors Elaine and Robert Perry argue that cholinergic therapy—available for three decades—remains a viable option, citing improvements in cognition, behavior, and disease‑specific response patterns. They highlight advances such as drug‑specific efficacy differences, combination regimens with memantine, novel delivery routes, and natural‑product cholinesterase inhibitors. The letter also notes emerging strategies like muscarinic M1 agonists and deep‑brain stimulation of basal forebrain nuclei as future avenues.
Re: Matt Morgan: The Sticky Floor Test—Why I’m Returning to Face-to-Face Communication
In a recent BMJ rapid response, consultant paediatric gastroenterologist Ieuan H. Davies echoes Matt Morgan’s call to revive face‑to‑face communication in healthcare. He argues that email and instant messaging have become the default, often crowding complex clinical discussions in endless...
Misinterpretation of Trial Information Can Lead to Misleading Conclusions: Dispiriting SPIRIT- A Response to Greenhalgh Et Al
In a rapid response, the authors of the Medical Masks vs N95 Respirators trial refute Greenhalgh et al’s claim that the study underwent retrospective protocol changes that could bias results. They clarify that the protocol remained unchanged, with universal masking...
The Doctor Will Post You Now
Physicians face a growing dilemma as patients turn to TikTok, chatbots and other digital platforms to evaluate and choose their providers. Without a visible online presence, doctors risk becoming financially invisible to algorithm‑driven search tools. Existing professional standards, such as...
Re: Recognising Cardiac Syncope and the Short QT Syndrome
A recent BMJ correspondence highlights short QT syndrome as an often‑overlooked cause of cardiac syncope. The author cites a 52‑year‑old patient with a QTc of 327 ms who experienced R‑on‑T extrasystoles and sustained polymorphic ventricular tachycardia. Diagnostic criteria include a QTc...
Re: Women’s Health Strategy Must Include Invisible Chronic Illnesses
A recent letter to the BMJ urges that the UK’s new women’s health strategy go beyond reproductive care to address invisible chronic illnesses that disproportionately affect women. The author highlights conditions such as Long COVID, ME/CFS, POTS, fibromyalgia, migraine, autoimmune...
Inclusive Clinical Trials: An Oxymoron?
The author argues that mandating the inclusion of pregnant and breastfeeding women in pivotal clinical trials is driven more by sentiment than scientific rigor. He highlights that strict eligibility criteria are essential for internal validity, and adding these populations would...
Re: BMA to Push for Private Practice as NHS Failings Prompt More Patients to Pay for Care
The British Medical Association is urging greater support for private general practice as NHS shortcomings push more patients to pay for care. A recent letter highlights that private medical insurance typically excludes independent GPs, limiting genuine patient choice. The author...
Re: Managing Resistant Hypertension . . . And Other Research
A retired physician, David Levine, wrote to BMJ questioning the reported cardiovascular event numbers in a recent LDL‑lowering study, noting that the intensive‑therapy arm was listed with 147 events versus 100 in the conventional arm. He suggests the figures may...
Neuromuscular Monitoring: An Overlooked but Evidence-Based Non-Drug Intervention in Preventing Postoperative Pulmonary Complications
Quantitative neuromuscular monitoring (QNM) is a proven, non‑drug strategy that halves the incidence of residual neuromuscular block after abdominal surgery and markedly lowers postoperative pulmonary complications (PPCs). Observational data from the POPULAR study of 22,803 patients showed a 30‑50% reduction...
Re: Flawed NHS League Tables Won’t Help Patients and Could Punish Struggling Trusts, Experts Warn
A letter to the BMJ argues that the NHS Oversight Framework’s league tables are fundamentally flawed because they exclude health‑inequality metrics and impose a blanket financial penalty that caps trust scores at three. The framework treats all 134 acute trusts...
Re: Peer Support Intervention (ABA-Feed) to Improve Breastfeeding: UK Based, Multicentre, Parallel Group, Randomised Controlled Trial
The author’s response to the ABA‑feed trial highlights three critical issues: the study’s sample‑size assumptions were based on a 44% breastfeeding baseline, yet the control group achieved 68.8%, reducing statistical power. The intensive “usual care” already provided in the UK—midwife...
PreVenTB Trial: Considerations for Interpreting Extrapulmonary Tuberculosis Efficacy and Tuberculin Skin Test-Stratified Analyses
The PreVenTB phase‑3 trial evaluated the recombinant BCG vaccine VPM1002 and the subunit vaccine Immuvac in 12,700 Indian household contacts, but neither met the primary endpoint of preventing microbiologically confirmed tuberculosis. The authors noted a 23.1% versus 20.3% six‑month tuberculin...
Re: Effect of a Clinical Decision Support System on Stroke Care Quality and Outcomes in Patients with Acute Ischaemic Stroke...
A cluster‑randomised trial (GOLDEN BRIDGE II) evaluated an AI‑driven clinical decision support system (CDSS) for acute ischemic stroke. The intervention lowered three‑month vascular events from 3.9% to 2.9% (adjusted HR 0.74) and improved several composite performance measures. However, the study found no significant...
When Political Speech Becomes a Clinical Exposure
The letter highlights chronic underfunding of women’s health research and warns that high‑profile political statements can act as a clinical exposure, rapidly altering prescribing patterns. Data from the United States show a 10% drop in acetaminophen orders for pregnant women...
Attacks on Medical Facilities During War Demand Global Response
Recent WHO data cited by the BMJ show 43 attacks on health facilities in Iran and Lebanon since late February, killing dozens of health workers and crippling hospitals. These assaults breach the Geneva Conventions, which guarantee medical neutrality even as...
Re: Accuracy of Glomerular Filtration Rate Estimation Based on Creatinine and Cystatin C for Monitoring Moderate Chronic Kidney Disease in...
A recent longitudinal cohort study examined how well estimated glomerular filtration rate (eGFR) equations, using creatinine alone or combined with cystatin C, track measured GFR in adults with moderate chronic kidney disease. The combined creatinine‑cystatin C formula showed a modest gain in...
Re: Weight “Regain” In Obesity Shifts Responsibility From Biology to Personal Inadequacy
The author agrees with recent criticism of the term “weight regain,” emphasizing that obesity is a chronic, biologically driven condition. She highlights that GLP‑1 receptor agonists cause loss of both fat and lean tissue, triggering adaptive reductions in energy expenditure...
Re: AI Supported Diagnostic Innovations for Impact in Global Women’s Health
In a response to Linder et al.’s analysis of AI‑driven women’s health diagnostics in low‑ and middle‑income countries, Mon Yee Htet Paing highlights China’s rapidly expanding AI medical‑device ecosystem as a practical template. Between 2020 and 2025, China approved 154 AI‑based devices, with approvals...
Restrictive US Abortion Laws Negatively Affecting Physicians in Addition to Their Patients
A new BMJ rapid response highlights how restrictive abortion bans across most U.S. states are harming physicians as much as patients. Only 13 states provide a clear health‑exception, leaving doctors in the remaining 37 states uncertain about legal limits. The...
Re: The Power of the Markets: The Scandal that Keeps on Taking
A letter to the BMJ criticizes the pharmaceutical industry’s reliance on experimental trials that deny patients post‑trial access to new drugs. It argues that powerful, profit‑driven groups manipulate regulations, limiting transparency and compromising the NHS’s ability to provide affordable treatments....
When Risk Becomes Disease
Elspeth Davies, diagnosed with melanoma in situ at 17, describes a life of constant medical surveillance that blurs the line between being at risk and having disease. Scholars argue that modern health practices increasingly treat risk itself as a disease,...
Re: The United States Is Driving a Public Health Emergency of International Concern
In a recent BMJ rapid response, James Dickson critiques Herder et al.’s emphasis on the legal mechanism of a Public Health Emergency of International Concern (PHEIC). He argues that declaring a PHEIC cannot overcome the political realities that drive global health...
It's Time to Think About Inequality When Addressing Youth Mental Health
A recent BMJ rapid response argues that rising socioeconomic inequality is a primary driver of worsening youth mental health in Western nations. It cites UK data showing 75% of 18‑24‑year‑olds believe wealth is essential for success and 64% doubt hard...
The Problem of Childcare Is Compounded for Dual-Doctor Couples
A BMJ letter highlights how childcare challenges intensify for dual‑doctor couples, especially trainees juggling frequent rotations and long commutes. The author notes the scarcity of on‑site nurseries, the complexities of less‑than‑full‑time (LTFT) arrangements, and persistent gender expectations that place childcare...
Goodbye Balint, Goodbye Neighbour and Goodbye General Practice ?
The author contends that the traditional general‑practice model—rooted in time‑based observation, simple tools, and communication frameworks from Balint, Neighbour and Pendleton—is being displaced by rapid diagnostic technology and artificial intelligence. Screening programmes, instant imaging and AI‑driven patient research have turned...
From Despair to Alliance: Faith Communities and Public Health as Partners in Reclaiming Society's Moral Compass
Professor Raman Bedi argues that the commercial determinants of health—exemplified by a $28,000‑per‑year price tag for a 95% effective HIV prevention drug and a booming wellness market of unproven products—have eroded shared moral values. He contends that faith communities, with...
Re: The Power of the Markets: The Scandal that Keeps on Taking
Lenacapavir, a once‑monthly injectable for HIV, is priced at $28,000 per patient annually by Gilead Sciences. In a BMJ rapid response, surgeon Simon Bell argued the price reflects the high cost of drug development and that Gilead is not obligated...
Re: Are Fit Notes Fit for the 21st Century?
A recent BMJ letter highlights persistent flaws in the UK fit‑note system, noting that only 6% of notes use the ‘may be fit for work’ option and that prolonged certification correlates with higher mortality. The author cites a BBC investigation...
Re: Make Compassion Visible in Emergency Medicine Again
In a response to Iain Beardsell’s article, emergency‑medicine consultant Chris Turner argues that the profession’s growing systemic strain has dulled compassion, turning clinicians into inadvertent partners in a failing system. He cites moral injury from the shift between risk mitigation...
Re: Machine Learning Based Screening of Potential Paper Mill Publications in Cancer Research: Methodological and Cross Sectional Study
In a rapid response to a BMJ study, Professor Min Dai argues that the machine‑learning model used to flag potential paper‑mill articles in cancer research suffers from serious methodological flaws. The training set, drawn largely from the Retraction Watch database,...
Re: Doctors’ Distinct Work and Professional Role Can’t Be Parcelled Into Generic Tasks for “Tiers” Of Healthcare Staff
Retired GP Ann Bowman wrote to the BMJ in support of a recent article warning against overly generic task‑allocation across healthcare tiers. She acknowledges the pitfalls of "taskification" but points out that resident doctors still perform routine procedures such as...
Re: Glucagon-Like Peptide-1 Receptor Agonists and Risk of Substance Use Disorders Among US Veterans with Type 2 Diabetes: Cohort Study
A BMJ cohort study emulating a target trial found that US veterans with type 2 diabetes who were prescribed glucagon‑like peptide‑1 (GLP‑1) receptor agonists experienced significantly fewer incident substance‑use disorders (SUDs) and related adverse events compared with those on sodium‑glucose...
Re: Doctors Condemn Expansion of GMC’s Appeal Powers After Government “Betrayal”
Doctors have publicly condemned the UK government’s decision to broaden the General Medical Council’s (GMC) appeal powers, calling it a betrayal of professional trust. An independent review commissioned by the GMC, led by Norman Williams, had previously recommended that the regulator...
The Policy Target Is Not Screen Time Alone but Design
A recent BMJ letter argues that policy should focus on social‑media design rather than total screen time. It cites mixed evidence on adolescent mental health, noting that features such as infinite scroll, autoplay and opaque recommendation algorithms can drive compulsive...
Re: Who Would Want to Be a Clinical Academic? Pathway to a Sustainable Workforce
A recent BMJ rapid response highlights a deepening crisis in the UK clinical academic workforce, noting that only 40% of physicians are engaged in research and that recent cuts to incentives—National Clinical Impact Awards now capped at £20,000–£40,000 (≈$25,000–$50,000) versus...
Re: Increase in Remote Overseas Primary Care Consultations
A growing number of UK‑trained GPs are delivering primary‑care consultations from overseas locations, often in low‑tax jurisdictions such as Dubai. This trend raises questions about which regulatory body has authority over remote diagnoses, prescriptions, and liability. Critics argue that doctors...
Re: The United States Is Driving a Public Health Emergency of International Concern
A trio of European epidemiologists reaffirmed that the United States’ 2024 withdrawal from the World Health Organization satisfies the International Health Regulations’ criteria for a Public Health Emergency of International Concern (PHEIC). They cite their February 2025 LinkedIn analysis, which...
Re: Prognostic Score for Predicting Respiratory Admissions Among Patients with Chronic Obstructive Pulmonary Disease in Primary Care: Development and Validation...
Researchers responded to feedback on their COPD admission risk score, noting that among six candidate predictors only diabetes remained statistically significant. The model, built on the Birmingham Lung Improvement Studies (BLISS) dataset, was externally validated in the ECLIPSE and CPRD...
From Principle to Practice in End of Life Care
Emily Mayar, an internal medicine trainee, argues that the growing debate on assisted dying should not eclipse the everyday challenges of delivering high‑quality end‑of‑life care. She highlights how unclear treatment escalation plans, staffing shortages, and time pressures on acute wards...
Re: Men Need Fair Information About Screening for Prostate Cancer
A recent letter highlights how the European Randomized Study of Screening for Prostate Cancer’s 23‑year data are being misread. The trial showed one prostate cancer death prevented for every 456 men invited to PSA screening, but the accompanying statistic of...
Re: Accuracy of Glomerular Filtration Rate Estimation Based on Creatinine and Cystatin C for Monitoring Moderate Chronic Kidney Disease in...
A recent BMJ prospective cohort study examined how well glomerular filtration rate (GFR) equations that use creatinine, cystatin C, or both track kidney function in adults with moderate chronic kidney disease (CKD). All equations showed low sensitivity but high specificity...
Re: The Growing Threat of Domestic Wood Burning Stoves—And Industry’s Legal Attempts to Shut Down Clean Air Campaigns
A recent BMJ rapid‑response highlights the rising public‑health threat posed by domestic wood‑burning stoves, which emit high levels of fine particulate matter and carbon monoxide. The article notes that industry groups are filing lawsuits to block local clean‑air campaigns and...
A Silent Strike by the Young Physicians in Japan
Japan’s young physicians are quietly abandoning core specialties, with trainee numbers under 30 dropping 48% in internal medicine, 36% in general surgery, and 17% in paediatrics since 2006. At the same time, entry into cosmetic medicine has exploded 16‑fold, luring...
Re: RSV Vaccination Programme Expanded to 3 Million More Older People
The UK health authorities have announced an expansion of the RSVpreF (Abrysvo) vaccination programme to include an additional three million adults aged 60 and older. Clinical trial data published in the New England Journal of Medicine confirm the vaccine’s ability...
Re: New and Emerging Treatments for Anxiety Disorders
In a letter to the BMJ, GP Gabriel Symonds challenges the premise that anxiety disorders stem from brain pathology, arguing there is no objective evidence for such a claim. He emphasizes that anxiety is a symptom triggered by distressing life...
Re: Prognostic Score for Predicting Respiratory Admissions Among Patients with Chronic Obstructive Pulmonary Disease in Primary Care: Development and Validation...
Physicians Di Micco and Siniscalchi commend the BLISS prognostic score, which estimates two‑year respiratory admissions for COPD patients in primary care. They argue that real‑world outcomes are heavily influenced by acute comorbidities such as pulmonary embolism, COVID‑19, and cancer, as well...
Re: Tessa Richards: BMJ Editor Who Championed Patients
The letter honors Tessa Richards for reshaping the BMJ’s approach to patient involvement, turning the journal into a global exemplar of patient partnership. Her early advocacy led to patient editors, peer reviewers, and mandatory PPI statements becoming integral to BMJ’s...
Re: Medical Training Prioritisation Bill Passes but Clarification Still Needed on IMGs, Leaders Say
The Medical Training (Prioritisation) Act 2026 has been enacted, establishing training‑place priority based on where doctors studied rather than citizenship. In 2025, 25,257 overseas‑trained doctors competed with 15,723 UK‑trained doctors for just 12,833 posts, highlighting a strained recruitment pipeline. The...
Enhancing the Clinical Utility of Emerging Anxiety Models Through Religion-Informed Adaptations
The letter highlights a critical gap in emerging anxiety‑disorder treatments: their limited applicability to religiously themed obsessive‑compulsive disorder, or scrupulosity. It proposes adapting Positive Affect Treatment and exposure‑based protocols with religion‑informed elements such as sacred savoring and faith‑based expectancy violation....