Evidence Matters

@HeldinEU Yes.

When you phone your mother every day, she has been ill, but is getting better and things between her and dad seem to be not quite as bad it's ok to declare when the one hour of international call you get in one piece with your flat rate ends, isn't it?

It is with a very heavy heart that I advise friends, and colleagues, and followers of Richard Lehman of his passing. His daughter Hannah wishes the news to be shared widely among his academic and medical circles. Richard had been unwell but was active and generous in supporting many of us, right until the end. He was also active on this platform, advocating for patients tirelessly. Richard, my friend, you will be missed. ❤️

@crblease A life of public service well-lived. Well loved in life, the memory of him is a treasure for those fortunate enough to have met him in any of his capacities.

@HeldinEU My mother would have insisted that this be done for any one who was family, no matter how brief nor remote the association.

We all have an ex BIL who served as a stasi officer, right?

@SketchesbyBoze I first read about accidential food poisoning by the confusion of daffodil bulbs and shallots/onions by reading an Agatha Christie short story (The Herb of Death) in Thirteen Problems: The Tuesday Club Murders.

Agatha Christie knew poisons so well, her books have been consulted when diagnosing patients. In 1976, a London infant was dying of a rare illness. Her nurses, having read The Pale Horse, realized she had been poisoned with thallium. Murder mysteries saved her life.

@michaelzlin Anglo-Saxon had the term longsumne lof. Those who die continue their purpose when people tell stories about them to others. The stories change those who hear them. Their influence lives in those who know the stories, or who were changed. You've done this for Pengli. Thank you.

It is with a heavy heart that I share the sad news that one of my lab members, Pengli Wang, PhD student in chemical engineering, has passed away on Friday, May 1, at the age of 28, in an unexpected accident. I’ve struggled to write this because it is hard to put into words just how much Pengli meant to our lab, his friends, the Stanford graduate student community, and of course his family. From my own limited perspective, Pengli was any advisor’s dream student: creative, insightful, courageous, and an extraordinarily gifted experimentalist. He was a true polymath, self-taught in everything from computational protein structural modeling to high-throughput protein engineering to animal behavioral testing. In only 3.5 years in the lab, Pengli had already made an enormous and lasting impact on the field of protein engineering. He has a co-first-author paper in press describing a new method that will transform both empirical and AI-based protein engineering. He also recently submitted a first-author paper on imaging neurotransmitters through enzymatic light emission, enabling us to observe cellular communication in living animals completely noninvasively. I expect this work will lead to new ways of investigating and understanding neurological and metabolic disease. Arthur C. Clarke wrote that “any sufficiently advanced technology is indistinguishable from magic.” Pengli was the best magician, producing eye-opening tricks, each better than the last. The loss of his future contributions is immeasurable, but the technologies he already created will continue to benefit science and medicine for years to come. What truly made Pengli special, though, was his kindness and joy for life. He never hesitated to help others, and he generously mentored many newer lab members, all of whom spoke about what an exceptional teacher he was. He also had an unforgettable spirit — the loudest and funniest laugh in the room, and an ability to eat astonishing amounts of food while somehow remaining skinny. He is deeply missed by everyone who knew him. Pengli, may you rest in peace and in the lasting glow of your accomplishments. You represented the very best of humanity and will forever remain an inspiration to all of us. 💔

@ksaraholland @Tanhouse1 Which appraisal was that? TA1014? nice.org.uk/guidance/ta101…

@doctor_oxford @Tanhouse1 We asked NICE for exactly the same price for alectinib as ceritinib after vastly superior efficacy H2H in Ph 3. NiCE said no, we hadn’t shown ceritinib followed by alectinib wasn’t better - asking pts to have scary brain mets to access it. Unethical cost containment.

This may seem arcane, but it’s a deeply concerning & spectacularly cynical move from this government to sideline NICE - the National Institute for Health and Care Excellence - whose role is vitally important in protecting NHS patients from the lobbying clout of the Pharma industry lobby. Until now - and since 1999 - NICE has made independent, evidence-based decisions about which medicines constitute value for money for the NHS to buy. Largely free from political manipulation, it’s renewed internationally as a model of how to protect patients against excessive drug company prices. It enables the NHS to strike hard bargains with Big Pharma. But @wesstreeting has just used a statutory instrument in parliament (that no-one has voted on) to award himself power to dictate what the NHS pays for drugs, overriding NICE’s vital role in insulating the NHS from pharmaceutical price gouging. Why would he do something so self-evidently bad for patients? Because, it seems, this is a price the government is willing to pay to do a deal with Trump on US-UK drug pricing. What an outrageous power grab for a man who claims to care about patients. Already hospitals up and down the country are cutting staff and closing services under pressure to make cost savings. But every pound spent on, essentially, increasing profits for US Pharma is money that *doesn’t* get spent on nurses, doctors and treatments we know are good value for money. As the editor of the BMJ, @KamranAbbasi, wrote this week, this: "will end up harming vulnerable people to boost the profits of already obscenely profitable drug companies." Starmer has shamelessly caved in to the White House. Even the former Tory Health Secretary, Andrew Lansley, now a Lord, has joined forces with Labour and Lib Dem MPs opposing Streeting’s power grab. Truly an appalling move from a government that claims they’re rebuilding the NHS while, in this case, blatantly undermining our abilities to provide cost-effective care.

@melb4886 @doctor_oxford @MichaelH14 What did they base that upon? Did they work at NICE? Or were they a member of a relevant committee?

@doctor_oxford @MichaelH14 Someone knowledgeable once told me that even NICE was heavily influenced by the drug companies anyway.

@LucyGoBag Sentiment analysis would be invaluable. Times when I raise it, I get quirky smile at best. It usually attracts a patient explanation to me of how useless social media is for such serious issues. Or an actual sneer with a dismissive chuckle.

I really hope somebody at the secretariat of this inquiry is monitoring the socials. Because the noise now that this report was not up to scratch is deafening. And that matters…

@LucyGoBag I have this feeling about a number of public inquiries.

It’s getting lost in the noise but I am really struggling with this one. There is not single thing in here that was not known before and sometimes mitigated in earlier plans. An inquiry cannot just report on what happened, it must find ways that people are listened to next time

@pash22 @VerranDeborah @RichardLehman1 @raj_mehta @drjohnm @DBadenoch @PaulGlasziou @deerbrian Pg 4 was what I recall from the proceedings. centerforinquiry.org/wp-content/upl…

@EvidenceMatters @VerranDeborah @RichardLehman1 @raj_mehta @drjohnm @DBadenoch @PaulGlasziou Apparently that study was on adults, not children bmj.com/rapid-response… via @deerbrian

At least two books have described the studies in medicine that have done the most good. But what of the studies that have done the most HARM? Send suggestions please, open or DM. @EvidenceMatters @raj_mehta @pash22 @drjohnm @DBadenoch @PaulGlasziou

@pash22 @VerranDeborah @RichardLehman1 @raj_mehta @drjohnm @DBadenoch @PaulGlasziou Nicholas Chadwick - see pg 57. centerforinquiry.org/wp-content/upl…

@EvidenceMatters @VerranDeborah @RichardLehman1 @raj_mehta @drjohnm @DBadenoch @PaulGlasziou I'm not sure there was anyone. 10 of the 12 retracted their names post-publication

@pash22 @VerranDeborah @RichardLehman1 @raj_mehta @drjohnm @DBadenoch @PaulGlasziou There was - it came out during his testimony to the Omnibus Special Masters process. He was so concerned that he reported it to his supervisor. After a real politik discussion, he had his name removed *before* publication.

@AliJaneMoore @threadreaderapp unroll

My daughter, a resident doctor with a worsening condition which has not responded to self-care and an initial telephone consultation with a GP and prescription, has just been told she can't see a GP - it has to be a "physician associate who can do everything a doctor can."

@RichardLehman1 @raj_mehta @pash22 @drjohnm @DBadenoch @PaulGlasziou For itself - and for the far-reaching consequences for the damage to confidence and trust in trials - Tuskegee?

@RichardLehman1 @raj_mehta @pash22 @drjohnm @DBadenoch @PaulGlasziou Not a study as such, and probably not the greatest harm (people have mentioned Wakefield and the usual suspects) - but, I think of Freeman and lobotomy. archive.ph/HjXYo

@natashaloder Much needed balance and corrective to the news coverage. Thank you.

If you stop taking blood pressure meds, your BP goes up. We call that medicine. If you stop taking GLP-1s, your weight goes up. Scientists are calling it "weight recidivism"—a term for convicted criminals. Why is obesity still treated as a moral failure?

@ShaunLintern @glurcher @ChelwestFT @GreatOrmondSt @CareQualityComm @wesstreeting I've been horrified by how restricted duty of candour is and the lack of auditing for this (effectively).

@glurcher @ChelwestFT @GreatOrmondSt @CareQualityComm @wesstreeting Indeed. But they have to be discovered and exposed and sadly even then I have seen v little in the way of consequence for breaching duty of candour. In my opinion it is routinely breached with no action.

The @ChelwestFT has also carried out a review of Jabbar's patients - but unlike @GreatOrmondSt it has chosen secrecy. Sources tell me a significant number of harmed cases have been found but the trust would not say if it had even informed families. @CareQualityComm @wesstreeting

Bravo! @hmkyale explains that our choice is between ‘a system that has finally integrated the science of aging into cardiovascular care or one that continues to treat our most common patients as exceptional cases. Our science must finally and fully reflect the people we serve’.