BMJ  2008;336 (12 April), doi:10.1136/bmj.39546.558148.47

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Think again

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

As medical aphorisms go, "common things are common" is pretty trite. But we do well to remember it, especially when deciding whether one thing causes another: if both things are common, think again. Last year a series of studies in the New England Journal of Medicine suggested a link between bisphosphonates and atrial fibrillation. As Sumit Majumdar writes (doi: 10.1136/bmj.39513.481065.80), it was only a matter of time before osteoporosis, its treatments, and cardiovascular events would be linked. But a large population based case-control study in this week’s BMJ finds no evidence that women taking bisphosphonates are more likely to develop atrial fibrillation or flutter (doi: 10.1136/bmj.39507.551644.BE), and Majumdar concludes that the risk, if it exists at all, is vanishingly small and is unlikely to offset the benefits of fracture prevention.

Atrial fibrillation is certainly common. As Steven Lubitz and colleagues remind us in their Clinical Review, it’s the . . . [Full text of this article]

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It is amazing how complete is the delusion that beauty is goodness!

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