@richard-lehman.bsky.social
Reposted
I’ve said it before and I’ll say it again (and again and again…). An integrated team is necessary but not sufficient to deliver coordinated care- let alone care that aligns with patient goals and priorities, minimises the burden of treatment and enables people to live well.
What is the neighbourhood health service?
Ruth Rankine, the director of our Primary Care Network, spoke to BBC Politics London to set it out.
🟡With the NHS, but not just the NHS
🟡Delivering more joined-up care
🟡A new kind of relationship between services and communities.
Ruth Rankine, the director of our Primary Care Network, spoke to BBC Politics London to set it out.
🟡With the NHS, but not just the NHS
🟡Delivering more joined-up care
🟡A new kind of relationship between services and communities.
November 23, 2025 at 8:04 PM
I’ve said it before and I’ll say it again (and again and again…). An integrated team is necessary but not sufficient to deliver coordinated care- let alone care that aligns with patient goals and priorities, minimises the burden of treatment and enables people to live well.
Reposted
Reposted
We are a long way indeed from systematically collecting and acting on the voices of patients. Abolishing Healthwatch and handing responsibility for its work to ICBs (which are themselves undergoing massive reorganisation) is in my own view a very bad move indeed by DHSC.
NEW: Andy Burnham will issue a warning to Wes Streeting over the government’s abolition of a national network of “patient voice” bodies
Burnham's intervention comes amid fears locally that the move could “silence” residents' views
By me, for Politics Home www.politicshome.com/news/article...
Burnham's intervention comes amid fears locally that the move could “silence” residents' views
By me, for Politics Home www.politicshome.com/news/article...
Andy Burnham To Warn Wes Streeting About Closure Of Health Bodies
Andy Burnham will issue a warning to Health Secretary Wes Streeting over the government’s abolition of a national network of “patient voice” bodies...
www.politicshome.com
November 14, 2025 at 10:17 AM
We are a long way indeed from systematically collecting and acting on the voices of patients. Abolishing Healthwatch and handing responsibility for its work to ICBs (which are themselves undergoing massive reorganisation) is in my own view a very bad move indeed by DHSC.
Reposted
A lot of crap research is being done with the microbiome. At the heart of much of the research is fundamentally unreliable data.
Perhaps this is why so much microbiome research is hard to believe.
www.gov.uk/government/n...
www.gov.uk/government/n...
MHRA-led study reveals major inconsistencies in global microbiome research
International collaboration establishes new quality standards to improve reliability of gut health studies – improving accuracy to provide better diagnosis and treatment.
www.gov.uk
November 16, 2025 at 12:46 PM
A lot of crap research is being done with the microbiome. At the heart of much of the research is fundamentally unreliable data.
Reposted
Read the publications here:
Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/
Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/
Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/
Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/
Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/
Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/
August 22, 2025 at 12:59 PM
Read the publications here:
Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/
Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/
Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/
Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/
Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/
Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/
Reposted
"Evidence itself never gives us the answer what to do. It's evidence in the context of values and preferences."
Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social
www.youtube.com/watch?v=433J...
Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social
www.youtube.com/watch?v=433J...
GRADE the trustworthiness of evidence | Prof. Gordon Guyatt
YouTube video by The BMJ
www.youtube.com
July 30, 2025 at 8:37 PM
"Evidence itself never gives us the answer what to do. It's evidence in the context of values and preferences."
Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social
www.youtube.com/watch?v=433J...
Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social
www.youtube.com/watch?v=433J...
Reposted
Ahoy! Learn about the importance of randomisation through history in my library at www.jameslindlibrary.org. For example, read how the GISSI trials embedded patient and public health oriented randomised trials into the Italian health service 40 years ago
www.jameslindlibrary.org/articles/emb...
www.jameslindlibrary.org/articles/emb...
The James Lind Library - The James Lind Library
The James Lind Library uses material from history to illustrate the development of research methods for evaluating treatments.
www.jameslindlibrary.org
August 18, 2025 at 9:27 AM
Ahoy! Learn about the importance of randomisation through history in my library at www.jameslindlibrary.org. For example, read how the GISSI trials embedded patient and public health oriented randomised trials into the Italian health service 40 years ago
www.jameslindlibrary.org/articles/emb...
www.jameslindlibrary.org/articles/emb...
It is very weird indeed.
How anybody could think of calling jam jelly and eating it with ground nut paste.
How anybody could think of calling jam jelly and eating it with ground nut paste.
Some words go together like jelly and peanut butter… wait, that sounds super weird.
A pair of words that is used in a fixed order in an idiomatic expression is called an ‘irreversible binomial.’
‘Peanut butter and jelly’ is an example of an irreversible binomial.
🧵⬇️
A pair of words that is used in a fixed order in an idiomatic expression is called an ‘irreversible binomial.’
‘Peanut butter and jelly’ is an example of an irreversible binomial.
🧵⬇️
July 17, 2025 at 11:33 AM
It is very weird indeed.
How anybody could think of calling jam jelly and eating it with ground nut paste.
How anybody could think of calling jam jelly and eating it with ground nut paste.
Nice blog highlighting total vacuity in The Plan.
Its lack of originality may be pardonable, but its lack of substance is not.
These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.
Its lack of originality may be pardonable, but its lack of substance is not.
These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.
Alongside tech, the 10-Year Health Plan sees Labour betting big on establishing a ‘neighbourhood health service’ to reduce costs and improve care.
In this blog, @jaketreenotsea.bsky.social and @luisaptg.bsky.social ask how will it happen, and will it work?
Read more ⬇️
https://bit.ly/4evb4jo
In this blog, @jaketreenotsea.bsky.social and @luisaptg.bsky.social ask how will it happen, and will it work?
Read more ⬇️
https://bit.ly/4evb4jo
July 8, 2025 at 11:08 AM
Nice blog highlighting total vacuity in The Plan.
Its lack of originality may be pardonable, but its lack of substance is not.
These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.
Its lack of originality may be pardonable, but its lack of substance is not.
These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.
Reposted
Treatment burden= the work that NHS staff ask/demand of patients in order to optimally manage their clinical condition(s). It’s a *big issue* for patients and we don’t talk about it enough.
For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…
For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…
June 18, 2025 at 9:00 AM
Treatment burden= the work that NHS staff ask/demand of patients in order to optimally manage their clinical condition(s). It’s a *big issue* for patients and we don’t talk about it enough.
For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…
For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…
I've just been having some exchanges across on the Musk site which have warmed my heart.
Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.
Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.
June 11, 2025 at 2:41 PM
I've just been having some exchanges across on the Musk site which have warmed my heart.
Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.
Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.
Reposted
If your business model only works because you're allowed to do crimes, you don't have a business.
www.theguardian.com/business/202...
www.theguardian.com/business/202...
Bidders demand Thames Water granted immunity over environmental crimes
Exclusive: ‘Ransom note’ requests would leave Environment Agency unable to prosecute company or management
www.theguardian.com
June 8, 2025 at 6:43 AM
If your business model only works because you're allowed to do crimes, you don't have a business.
www.theguardian.com/business/202...
www.theguardian.com/business/202...
Reposted
May 13 2025: 10th anniversary of death of Dave Sackett. Read extended questions & answers he prepared shortly before his death to describe his multiple careers, importance of fair tests and evidence-based medicine www.jameslindlibrary.org/sackett-dl-2... @cebmoxford.bsky.social #EBM #EBHC #Cochrane
Sackett DL (2015) - The James Lind Library
Extended questions and answers prepared by Dave Sackett shortly before his death in 2015, edited by Brian Haynes.
www.jameslindlibrary.org
May 13, 2025 at 7:27 AM
May 13 2025: 10th anniversary of death of Dave Sackett. Read extended questions & answers he prepared shortly before his death to describe his multiple careers, importance of fair tests and evidence-based medicine www.jameslindlibrary.org/sackett-dl-2... @cebmoxford.bsky.social #EBM #EBHC #Cochrane
Brilliant video -
www.youtube.com/watch?si=5BP...
Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.
www.youtube.com/watch?si=5BP...
Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.
Yes, Doctors: AI Will Replace You
YouTube video by Sheriff of Sodium
www.youtube.com
May 13, 2025 at 3:03 PM
Brilliant video -
www.youtube.com/watch?si=5BP...
Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.
www.youtube.com/watch?si=5BP...
Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.
Medicine will, and should, be carried out with the universal help of intelligent and compassionate machines in the hands of patients. Machines that know what they are doing and learn from everything they do.
While this is already beginning to happen, the rest is simply falling apart.
While this is already beginning to happen, the rest is simply falling apart.
May 8, 2025 at 1:44 PM
Medicine will, and should, be carried out with the universal help of intelligent and compassionate machines in the hands of patients. Machines that know what they are doing and learn from everything they do.
While this is already beginning to happen, the rest is simply falling apart.
While this is already beginning to happen, the rest is simply falling apart.
Reposted
The government was wrong to cut winter fuel payments.
It was wrong to keep the 2-child benefit cap.
It was wrong to slash disability benefits.
Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.
It was wrong to keep the 2-child benefit cap.
It was wrong to slash disability benefits.
Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.
May 6, 2025 at 9:19 AM
The government was wrong to cut winter fuel payments.
It was wrong to keep the 2-child benefit cap.
It was wrong to slash disability benefits.
Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.
It was wrong to keep the 2-child benefit cap.
It was wrong to slash disability benefits.
Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.
Reposted
The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews #AndyOxman @sarahros.bsky.social f1000research.com/articles/13-...
F1000Research Article: The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews.
Read the latest article version by Andrew D. Oxman, Allen Nsangi, Laura Martínez García, Margaret Kaseje, Laura Samsó Jofra, Daniel Semakula, Heather Munthe-Kaas, Sarah E. Rosenbaum, at F1000Research.
f1000research.com
May 4, 2025 at 9:10 PM
The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews #AndyOxman @sarahros.bsky.social f1000research.com/articles/13-...
Reposted
Most decision making in healthcare is informed by clinician biases. There are lots of reasons for this, one of them being that nobody can keep up with the rapidly evolving evidence base. To quote @richard-lehman.bsky.social we need reliable AI driven satnav to inform decision making processes.
i think these people are in the grip of a genuine delusion www.nbcchicago.com/news/busines...
Bill Gates: Within 10 years, AI will replace many doctors and teachers—humans won't be needed ‘for most things'
Over the next decade, advances in artificial intelligence will mean that humans will no longer be needed "for most things" in the world, says Bill Gates.
www.nbcchicago.com
March 28, 2025 at 9:09 AM
Most decision making in healthcare is informed by clinician biases. There are lots of reasons for this, one of them being that nobody can keep up with the rapidly evolving evidence base. To quote @richard-lehman.bsky.social we need reliable AI driven satnav to inform decision making processes.
Also let's not forget Olga Nethersole's role in setting up the People's League for Health - a pioneer of patient activism on behalf of impoverished pregnant women.
A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social
A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social
March 28, 2025 at 7:29 PM
Also let's not forget Olga Nethersole's role in setting up the People's League for Health - a pioneer of patient activism on behalf of impoverished pregnant women.
A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social
A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social
Reposted
Volume 108 on Dealing with Uncertainty in and through the History of Medicine now out in Brill’s Clio Medica series.
brill.com/display/titl...
brill.com/display/titl...
Dealing with Medical Uncertainty in and through the History of Medicine
"Dealing with Medical Uncertainty in and through the History of Medicine" published on 10 Mar 2025 by Brill.
brill.com
March 25, 2025 at 9:42 PM
Volume 108 on Dealing with Uncertainty in and through the History of Medicine now out in Brill’s Clio Medica series.
brill.com/display/titl...
brill.com/display/titl...
Reposted
Ahoy!If you'd like to read more from Dave Sackett, try the article he wrote for me in 2015 about why he became a clinical trialist www.jameslindlibrary.org/articles/why...
March 17, 2025 at 12:41 PM
Ahoy!If you'd like to read more from Dave Sackett, try the article he wrote for me in 2015 about why he became a clinical trialist www.jameslindlibrary.org/articles/why...
Reposted
Once you start looking, it’s tramlines not guidelines everywhere. Inexorably leads to overdiagnosis and overtreatment.
I looked through 7-8 national clinical pathways today. None mentioned shared decision making (an ethical and professional standard and clinico-legal obligation). They are all biomedical treatment escalators that wouldn’t stand up to scrutiny in a court of law should patients come to harm.
March 21, 2025 at 6:53 PM
Once you start looking, it’s tramlines not guidelines everywhere. Inexorably leads to overdiagnosis and overtreatment.
Reposted
The UK nuclear "deterrent" will expire within months without US tech support and components - likely to be withdrawn by Trump.
So many layers of insanity here.
It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.
So many layers of insanity here.
It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.
March 9, 2025 at 8:56 AM
The UK nuclear "deterrent" will expire within months without US tech support and components - likely to be withdrawn by Trump.
So many layers of insanity here.
It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.
So many layers of insanity here.
It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.
Reposted
🟠 How It Was Created:
An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach.
(4/6)
This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance.
Editorial: www.bmj.com/content/388/...
(6/6)
An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach.
(4/6)
This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance.
Editorial: www.bmj.com/content/388/...
(6/6)
February 20, 2025 at 2:36 PM
🟠 How It Was Created:
An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach.
(4/6)
This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance.
Editorial: www.bmj.com/content/388/...
(6/6)
An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach.
(4/6)
This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance.
Editorial: www.bmj.com/content/388/...
(6/6)