Sunday, 24 February 2013

Keeping childbirth normal

The variation in cesarean section operation (C-section) rates during childbirth is well documented; between hospitals, states and countries. The rates also vary over time, but here the pattern is at least consistent: the rate is increasing. So what? Sure there are complications, but isn’t that worth it if we are saving lives? As usual, it turns out that we have been overestimating the benefits and underestimating the harms of C-sections, which may explain the overuse of this treatment.

Wednesday, 13 February 2013

The antioxidant myth

A recent Scientific American article challenges the myth of antioxidants being associated with ageing. This is not the first time SciAm has covered this topic (here, here and here). The article challenges current perceived wisdom, not only regarding the effectiveness of anti-oxidants but of the underlying theory that oxidative damage causes ageing.  The current evidence tells us that antioxidant supplementation is not only ineffective, it is harmful. The sorry story of antioxidants should really be one of my “Lessons from History” blogs, except that it has not yet been relegated to history. But the story still provides lessons.

Sunday, 10 February 2013

Ethical double standards

Ethics committees (IRBs in the US) are now firmly entrenched in the research environment such that clinical research can only be performed with their approval. Clinical practice, however, is not subject to such approval, yet in many cases the risk of harm (individually and to society) from clinical practice is greater. Are researchers being held to a higher standard than clinicians? Has our concentration on ethical standards for clinical research led to an ethical blind spot for clinical practice?