The articles pouring out of the American journals are impressive. There seems a flood of data on lifestyle, diet, exercise and smoking. There is also a serious self-examination of their public health needs and their ability to provide these.
There is a strong tension between the medical profession, the legislation and big pharma. There seems no resolution in sight. The UK NHS is also being seriously re-examined, with private care being more and more debated as a “partner” in providing the needs of its citizens, while the medical governing bodies are realigning themselves.
JASS tries to keep out of politics but doesn't always manage to do so!
One point about the hormonal replacement trials. The differences that are being uncovered are exceedingly small. The RUTH trial summarised this month confirms this. We are talking in points of one percent differences in outcomes. What concerns me is the lack of data from women starting HRT at their menopause and then continuing - not women aged 68 on a trial. And what about quality of life measures? I know the problems of global scores, but that is what it's all about in the end.
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