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UK National Screening Committee position statement on surrogate outcomes in cancer screening trials

British Medical Journal - Mié, 27/05/2026 - 12:36

In this article (BMJ 2026;393:e629407; doi:10.1136/bmj-2026-629407) the first initial of D Gareth Evans was omitted. The online version has been corrected.

Categorías: Novedades Bibliográficas

The DRC Ebola outbreak has exposed the consequences of global health underfunding

British Medical Journal - Mié, 27/05/2026 - 12:31

Various media outlets have described the current Ebola outbreak affecting eastern Democratic Republic of the Congo (DRC) and Uganda as “a perfect storm.”1 A convergence of critical factors has made the outbreak difficult to control: a rare virus for which there are no licensed vaccines or therapeutics, combined with transmission occurring in conflict affected areas characterised by high population mobility, weak health infrastructure, and longstanding challenges around community trust and engagement.The outbreak is caused by Bundibugyo, a rare Ebola-causing virus identified in two previous outbreaks, Uganda in 2007 and DRC in 2012. Unlike Ebola virus (formerly Zaire ebolavirus), which caused the devastating West African epidemic of 2014-16, there are currently no approved vaccines or therapeutics for Bundibugyo virus disease. This raises a difficult question: if Ebola has been recognised for decades, why do we still not have vaccines for all Ebola viruses?The answer reflects an uncomfortable reality about how the...

Categorías: Novedades Bibliográficas

Streeting's time as health secretary: a missed opportunity

British Medical Journal - Mié, 27/05/2026 - 12:26

Wes Streeting's time as health and social care secretary has been a missed opportunity. Instead of using Labour's overwhelming majority to fix the fundamental problems of the NHS he embarked on the unnecessary abolition of NHS England while failing to put in place a credible plan for reform.Labour's 2024 general election manifesto promised not just to improve NHS performance but ensure its long term success through three shifts: hospital to community, treatment and prevention, and analogue to digital.1 This was supposed to be part of a pan-government “health mission” to help people to live longer healthier lives, which was quietly ditched.It took 12 months to publish the 10 Year Health Plan for England.2 It was well received, but Streeting failed to set out how it would be delivered. By the time he resigned almost a year later he had still not published either the delivery plan or the workforce plan,...

Categorías: Novedades Bibliográficas

Outcome switching in cohort studies of interventions: meta-epidemiological study

British Medical Journal - Mié, 27/05/2026 - 12:25

AbstractObjectivesTo study the prevalence and characteristics of outcome switching, the completeness of outcome prespecification, and factors associated with outcome switching in observational cohort studies of interventions.DesignLongitudinal meta-epidemiological study.SettingRegistry records and journal publications.ParticipantsControlled cohort studies investigating the effects of interventions. Eligible studies were registered on ClinicalTrials.gov within one month of their start date (2014-16) and had published results in peer reviewed journals by 2024.Main outcomes measuresFirstly, proportion of studies with outcome switching identified by comparing the prespecified outcomes in the registry and those reported in the journal publication of results. Discrepancies were categorised as omission (prespecified primary outcomes not reported), downgrading (prespecified primary outcomes reported as non-primary), upgrading (prespecified non-primary outcomes reported as primary), and introduction of new primary outcomes (not registered as an outcome). Secondly, proportion of studies with completely prespecified primary outcomes, defined as registry entries that include the measurement variable, analysis metric, method of aggregation (the statistic summarising the outcome within each study group), and time point.ResultsOf 9965 registration records screened, 124 eligible studies with results published between 2015 and 2024 were included. Only 30 studies (24%) completely prespecified their primary outcomes. Outcome switching occurred in 60 (48%) studies, but only two provided an explanation. The most common types of switching were omission (n=32, 26%) and downgrading (n=32, 26%), followed by the introduction of new primary outcomes (n=25, 20%), and upgrading (n=2, 2%). Among 57 studies with outcome switching other than omission (ie, outcome results were reported), statistically significant results were favoured in 77% (44/57) by introducing or upgrading a new significant primary outcome or downgrading a non-significant one. No study characteristics were significantly associated with outcome switching in multivariable logistic regression.ConclusionsOutcome switching and inadequate outcome prespecification were common in cohort studies of interventions. Most changes were unexplained and favoured statistically significant results, raising concerns about potential selective reporting and highlighting the need for improved transparency in outcome reporting.Study registrationOpen Science Framework (https://osf.io/xn5zt/).

Categorías: Novedades Bibliográficas

Conocimiento, colaboración y liderazgo en la batalla contra la infección y aparición de resistencias

Último número Revista Medicina Intensiva - Vie, 07/04/2023 - 23:15

F. Gordo Vidal
Med Intensiva. 2023;47:191-2

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