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Interventions that don’t work and other stories . . .

BMJ 2015; 350 doi: (Published 15 April 2015) Cite this as: BMJ 2015;350:h1892

“We do not recommend that our programme is adopted.” That’s the wonderfully frank conclusion of a paper in BMJ Open (2015;5:e005921, doi:10.1136/bmjopen-2014-005921) about a maintenance programme of three monthly, two hour, refresher sessions after pulmonary rehabilitation for chronic obstructive pulmonary disease. Minerva salutes the chest physicians of Norfolk, and assures them that there is more rejoicing in heaven when one person is honest about something that doesn’t work than when 99 say that more research is needed.

Why did neurologists used to carry a bottle of ink? It was to test olfactory function, in the days before scratch and sniff kits, such as the 40-smell University of Pennsylvania smell identification test. This test was used on American soldiers who had experienced blast injury in Afghanistan or Iraq (Neurology 2015, doi:10.1212/WNL.0000000000001475). All of those who showed central olfactory impairment had intracranial radiographic abnormalities (100% specificity; only 35% sensitivity). But smell identification is very group …

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