Reviews Minerva


BMJ 2001; 322 doi: (Published 31 March 2001) Cite this as: BMJ 2001;322:806

It's always fun to test doctors against computers, and usually the doctors do reasonably well. So did four vascular surgeons who tested their decision making skills against a computerised, evidence based decision tool (Quality in Health Care 2001;10:4-9). Faced with a list of fictional patients—all with asymptomatic abdominal aortic aneurysms—they disagreed with the computer only over the trickier ones. The surgeons were more likely than the computer to propose surgery for older, sicker patients and less likely to propose surgery for younger patients with small aneurysms.

People who think of themselves as unhealthy have a higher mortality than those who don't, report public health doctors from Finland (Journal of Epidemiology and Community Health 2001;55:227-32). Unsurprising perhaps, though the link with early death persists even when medical history, risk factors for cardiovascular disease, and education are accounted for. The simplest explanation is that healthy thinking leads to healthy living, which leads to longer life. If only it were true.

The incidence of severe malaria in Canada has more than doubled since 1994, reaching a peak in 1997, when 1036 cases were reported—more than 10 times the incidence in the neighbouring United States. Tropical disease specialists blame several factors, including adverse publicity about mefloquine, their drug …

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