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BMJ 1998; 317 doi: (Published 12 December 1998) Cite this as: BMJ 1998;317:1668

Death rates from HIV infection have fallen sharply across Europe, according to data in the Lancet (1998;352:1725-30 Between 1995 and 1998 rates dropped from 23 to four deaths per 100 person years of follow up, a fall of more than 80%. The investigators attribute these dramatic results to new combinations of treatment, but they apply to only 2% of the world's HIV sufferers. The rest live and die outside Europe.

Observer bias can have a marked effect on the reported efficacy of a vaccine, conclude researchers in Pediatrics (1998;102:909-12). During a trial of pertussis vaccine they noticed a wide variation in the number of cases reported by doctors, and worried that underreporting of whooping cough would lead to an overestimate of the vaccine's efficacy. They urge investigators to give clear guidance on diagnosis in vaccine trials, as milder cases can easily be missed or ignored.

Polycystic ovary syndrome is a multisystem disease that means different things to different specialists. One commentator compares sufferers to the lost tribes of Israel wandering through the desert looking for a home (Fertility and Sterility 1998;70:811-2). What they need, he says, is a true generalist who will evaluate them properly, treat the system that is …

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