There’s been a big increase in lab testing in UK medicine… knock-on effect is the massive increase in GP workload. Plug for useful website for GPs to consider NNTs and evidence base for interventions: gpevidence.org created by Julian Treadwell

no, 'has it been a while since you last had a blood test' is not a clinical indication to do a blood test no, 'science-backed' doesn't mean what you think it means

At last

“Overdiagnosis is one of the most harmful and costly problems in modern healthcare.” #overdiagnosis #DCIS #overtreatment news-medical.net/health/What-is…

The eminent Michael Baum introducing a rare but sorely needed note of balance into the public discourse about cancer, which even on intelligent and discursive fora such as BBC Radio 4 Today’s podcast gets treated as a black & white, ‘catching it early simply has to be good’ issue

Primary vs secondary care: the hospital strikes back

My letter in the Times has generated a lot of interest so I thought it might help if I described the time line for reaching this frame of mind. I attach a copy of the letter and then run through a series of tweets to tell the story.

Excellent thread from one of the architects of the UK breast cancer screening programmes on the dawning realisation of the unsuspected phenomena of overdiagnosis and overtreatment. A truly scientific mind assimilating challenging new data that changed the prevailing worldview.

Everything in this thread is incorrect. Literally every recommendation. Here's a thread why. 1/7

All clinicians are now much more risk adverse than I’ve ever known them. Making clinical decisions without tests (whether blood or radiological) is sometimes seen as ‘risky’ and certainly not something more inexperienced clinicians would do.

When you’re at work and Deliveroo comes without cutlery

Why does it take so long to qualify as a doctor (undergrad then postgrad training ... usually >10 years)? a 🧵 1/7

this is ideal teaching material: from this academic.oup.com/ehjcimaging/ad… to this theguardian.com/society/articl… and this quote. screening finds things. the key question is whether it finds them usefully and effectively and does not do more harm than good in the process

New research from us! First study to co-design and test the efficacy of evidence-based information about the AMH test. Dr Devora Lieberman Kirsten McCaffery Jesse Jansen jadoust Ben Willem Mol Sarah Lensen A/Prof Michelle Peate Wiser Healthcare Sydney Health Literacy Lab doi.org/10.1093/humrep…

Why you may not need a hlth checkup every year. A physician Dan Morgan proposes a radical but necessary idea: medical minimalism statnews.com/2024/08/23/med… Susan Bewley David Spitzer Margaret McCartney

This is upsetting to see Dr Nikita Kanani (she/her) . This isn’t an evidence based intervention. It is profiting on promises that can’t be kept. The reason this stuff isn’t offered in the nhs (beyond standard BP/cholesterol etc) is to do with the lack of evidence for it.

Can I have blood tests to check everything is alright? Why you don't need to or shouldn't do bmj.com/content/382/bm… via David Spitzer & Jessica Watson et al HT Sam Finnikin Susan Bewley

Ash Paul David Spitzer alf collins Margaret McCartney greg fell FFPH Sebastian Rees Richard Sloggett NHS England Dr Nikita Kanani (she/her) Susan Bewley 𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic Craig Nikolic David Oliver RCGP Victoria Tzortziou Brown Lord Bethell Professor Adam Taylor Uni Fribourg Arnaud Chiolero The Lancet Over-diagnosis was first introduced as a term in the 70s. Over 40 years of countless articles, trials, reviews, conferences, and books have failed to overcome the lure of “early is always best” What more will it take? Another 30 years of teaching EBM?: cebm.ox.ac.uk/news/views/cel…