Intended for healthcare professionals



BMJ 2004; 328 doi: (Published 29 April 2004) Cite this as: BMJ 2004;328:1084

Wouldn't it be nice to find an efficacious alternative to discectomy? Sadly, a prospective randomised trial of epidural injection of a steroid versus full blown surgery in people with a symptomatic herniated lumbar disc found that the injection wasn't as effective as surgery in reducing symptoms or disability. Epidurals did, however, have a role: nearly half the patients who received one, having had no relief from non-invasive care, reported relief from pain for up to three years (Journal of Bone and Joint Surgery 2004;86-A: 670-9).

“Observational blindness” can lead to a missed diagnosis. In an effort to overcome this, a medical educator at Yale University School of Medicine teamed up with the Yale Center for British Art to help medical students learn about art appreciation. After just two hours studying a classical painting and discussing what they saw, the students' diagnostic skills improved. Compared with a group of students who sat through an additional anatomy lecture, those who had attended the fine art class were better able to pick out clues in photos of patients (

Obesity has an effect on the onset of functional impairment in elderly people independent of general health and health related behaviours such as drinking and …

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