Recent developments in Bell's palsy: Does a more recent single research paper trump a systematic review?

doi:10.1136/bmj.329.7474.1103-a

BMJ 2004;329:1103 (6 November), doi:10.1136/bmj.329.7474.1103-a

Letter

Recent developments in Bell's palsy

Does a more recent single research paper trump a systematic review?

The first 150 words of the full text of this article appear below.

EDITOR—I am a jobbing general practitioner, and the paperby Holland and Weiner on Bell's palsy left me confused.¹ Totreat somebody is a hard decision—not to treat somebody,even harder.

In 2002 the BMJ published an article about recent advances inneurology that proposed that there might be a case for prednisolonebut none so far for antiviral agents.² This was based on systematicreviews.

This article quotes from just two more recent papers (Axelssonet al and Murakami et al^3
4) and says that now the evidencebase is clearly in favour of using antivirals. Given that furtherrandomised controlled trials are in the pipeline, the authors'full support of antiviral use is more opinion than evidence,is it not?

Does a single more recent research paper trump a previous systematicreview?

I was also concerned by the statement in the blue box at thestart . . . [Full text of this article]

James A Cave, general practitioner

Newbury RG20 8UY ectopicmailbox-collector1@yahoo.co.uk