Applying imperfect treatments better, debating rationing, and abusing impact factors

BMJ 1997; 314 doi: (Published 15 February 1997) Cite this as: BMJ 1997;314:0

John Swales, director of research and development in the National Health Service, asks us to imagine that we had a perfect treatment for hypertension (p 466). We could do much good with such a treatment, but we could do more, he reminds us, by making sure that everybody with hypertension was treated with our current imperfect treatments. That's a theme in this BMJ.

In Japan operative mortality with patients with gastric cancer is 2% and five year survival is 86% (p 467). Similar results can be achieved in Britain, …

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