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Focuses on the working papers on the main proposals for the government's white paper, Working for Patients in Great Britain. Practice budget for general practitioners; Pressure on drug expenditure; Improvement of quality of care; Role of general managers in the leadership of the Family Practitioners Committee.

Discusses a study which developed a methodology for evaluating the impact of research on health care and characterized the research papers cited on clinical guidelines. Code, title and reference of 15 appraised clinical guidelines; Type of cited research; Country of authorship. INSETS: What is already known on this topic;What this study adds.

Considers the essential questions that a physician should consider before a physician changes a medical practice in the light of a published research paper. Practical question to ask about a new piece of research; Fundamental questions about the design of the study; Avoidance of systematic bias; Important numbers found in the methods section of a paper.

Presents guidelines on how to read a scientific paper. Methodological flaws in papers published in medical journals; Decision on validity and relevance of a paper; Questions about prognosis that require longitudinal cohort studies. INSETS: Summary points.;Terms used to describe design features of clinical..;A memorable example of a case report..

Evaluates 'Working for Patients,' a paper submitted by Hospital Junior Staff Committee to the British Medical Association in Great Britain. Concerns regarding the terms and conditions of the services of the junior doctors; Citation on the motion and proposals of the committee; Effect of the proposal to patient care. INSET: Strategy to reduce hours of work.

Presents the description of future online scientific papers by people involved in electronic publishing. Less concern for page limits; Sharing of the entire trajectory of the research project as it unfolds; Substitution of the word `journal' for `book.'

Part IX. Presents a comparison of systemic reviews and meta-analysis of clinical studies. Advantages of each process; Steps in evaluation; Data sources; Characteristics of a good evaluation.

Part VII. Presents the seventh part of a series introducing non-experts to finding medical articles and assessing their value. Papers reporting diagnostic or screening tests; Includes sensitivity tests; Specificity; Positive predictive value; Negative predictive value; Assertion that diagnostic tests are seldom 100 percent accurate; Best measure of a test's usefulness.

Reports the changes in the direction of health policy for blood cholesterol concentrations. Association between cholesterol concentration and risk of ischemic heart disease; Identification of people at high risk for heart disease; Determination of density lipoprotein components.

Part X. Introduces non-experts to qualitative research in medicine. Description of a clinical problem; Analysis of data using reproducible methods; Generation of ideas through inductive reasoning.

Part VIII. Cites information necessary in medical economic analyses. Includes the scientific basis of the study; Costs and benefits of health interventions; Methods of analysis used. INSETS: Summary points.;Sausages, by Jeff Aronson..

Part VI. Focuses on ways of changing the prescribing habits of clinicians. Utilization of personal representatives; Use of surrogate end points in the evaluation of pharmaceutical products; Tips on how to get evidence from personal representatives; Checklist for evaluating information provided by a drug company. INSET: Summary points..

Makes various observations about word processing. Prevalent use of DOS for business word processing; Advantages and disadvantages of typing as a keyboard activity; Advantage of word processor over a typewriter; Use of the table facility; Usefulness of a spell checker. INSETS: Advantages of word processors.;Desk top publishing..

Presents the guidelines for writing papers in Vancouver, British Columbia. Instructions to authors; Importance of checklists to statisticians; Suitability of the paper for publication.

Presents comments on the impact of white paper on the National Health Service (NHS) of Great Britain. Assertions on the significance and focus of the paper in specialist services; Comments on the significance of chapters four, five and six of the paper; Account on the effect of the paper on minority groups.

Presents the guidelines of the `British Medical Journal' for evaluating papers on educational interventions. Theoretical considerations; Study presentation and design; Structure of the discussion.

Focuses on the alternative of the white paper regarding the improvement of the effectiveness of clinical care in the National Health Service in Great Britain. Definition of quality of care; Increase of the annual rate of medical care expenditure; Standardization of diagnostic methods.

Focuses on the reaction of the British Medical Association to the proposals contained in the white paper 'Working for Patients' in Great Britain. Concerns on the harmful effects of the proposals; Opposition to centralized bureaucracy and the methods for paying doctors; Criticisms on the lack of proper consultation with the medical profession.

Examines the reaction of general practitioners towards the proposals contained in the white paper 'Working for Patients' in Great Britain. Rejection of the proposals by general practitioners; Criticisms on the implementation of fixed budgets for specified surgical operations; Concerns on the cost effectiveness of the National Health Service.

Examines the role of medical audit in analyzing the medical practice. Features of medical audit project; Views on the important attribute of medical audit papers by clinicians; Methods for learning and teaching on medical audit.

Objective To evaluate changes in the role of academics and the sources of funding for the medical research cited most frequently over the past decade. Design Database analysis. Data sources Web of Knowledge database. Methods For each year from 1994 to 2003, articles in the domain of clinical medicine that had been cited most often by the end of 2004 were identified. Changes in authors' affiliations and funding sources were evaluated. Results Of the 289 frequently cited articles, most had at least one author with a university (76%) or hospital (57%) affiliation, and the proportion of articles with each type of affiliation was constant over time. Government or public funding was most common (60% of articles), followed by industry (36%). The proportion of most frequently cited articles funded by industry increased over time (odds ratio 1.17 per year, P = 0.001) and was equal to the proportion funded by government or public sources by 2001. 65 of the 77 most cited randomised controlled trials received funding from industry, and the proportion increased significantly over time (odds ratio 1.59 per year, P = 0.003). 18 of the 32 most cited trials published after 1999 were funded by industry alone. Conclusion Academic affiliations remain prominent among the authors of the most frequently cited medical research. Such research is increasingly funded by industry, often exclusively so. Academics may be losing control of the clinical research agenda. [ABSTRACT FROM AUTHOR]

Objectives: To identify patients with ischaemic heart disease by using a practice computer and to estimate the work required to do so.Design: Cross sectional study. Data from the notes and from the computer records of 1680 patients were used to build a database. This was used to compare different methods of identifying patients with ischaemic heart disease.Setting: 11 general practices in the Battersea primary care group in south London.Subjects: 1 in 40 random sample of patients aged 45[ ]or older.Main outcome measures: Numbers of patients identified with ischaemic heart disease.Results: The combination of the Read code for ischaemic heart disease (G3) and a prescription for a nitrate had a 73% sensitivity and a yield (100/positive predictive value) of one case of ischaemic heart disease for every 1.2 sets of notes reviewed. By searching the records of patients also receiving aspirin, atenolol, digoxin, or a statin, the sensitivity was increased to 96% but the yield fell to one in three.Conclusion: Although commonly used to identify cases, a computer search for G3 code or nitrate missed almost 30% of patients with ischaemic heart disease. A substantially higher percentage of patients can be identified by adding other drugs to the search strategy. [ABSTRACT FROM AUTHOR]

Focuses on the growth and restructuring of the National Health Service (NHS). Impact of medical insurance and hospital independent revenues; Role of the NHS as the catalysts; Collaboration of top companies for better hospitals.

Focuses on the economic aspects of health care. Comparison of costs of competing interventions; Outcome maximization design for economic evaluation; Opportunity costs and ethical implications of outcome maximization studies. INSETS: Current designs of economic evaluations.;Proposed outcome maximisation designs for economic evaluations..

Focuses on team approach in health care in Great Britain. Medical personnel's adaptation and development of new skills; Necessity of clarifying training, status, authority, working relationship, career structure and remuneration of affected personnel.

Focuses on the comments of Royal College of Physicians and General Medical Council on the white paper 'Working for Patients in London, England. Introduction of pilot schemes; Reservations on the free market systems in the National Health Services; Debate on the potential effects of the white paper on medical educational and research.

The article discusses an internal audit that revealed the three most widely read papers published in the "British Medical Journal" in 2005 including an article that focused on a study about the increased risk of myocardial infarction in patients taking cyclooxygenase-2 inhibitor medication, and two articles that focused on the link between selective serotonin reuptake inhibitors and suicide. The audit used three criteria: the number of citations a paper received, the number of times it was accessed on the web, and the number of rapid responses it created.

Presents a study on the relation between online "hit counts" and frequency of citations on research papers featured in the "British Medical Journal." Methods of his study; Results which found the average hit count for papers in the first week after publication was higher than the average hit five years later; Average hits for various types of trial and reviews; Findings that research papers attracting the most hits on the web site in the first week of publication were cited more often than less frequently accessed papers; Opinion of the author that "scientific value" explains the association between hits and citations.

Presents research on patient non-compliance and the use of paper diaries to reduce recall bias and produce more accurate data. Use of a paper diary that could objectively record when patients made diary entries in order to compare patients' reported and actual compliance with diary keeping; Comparison with an electronic diary designed to enhance compliance in order to assess what compliance rates might be achieved; Methods and results.

The article focuses on medical publishing and argues against fast tracking of research papers. The editorial policy at "Lancet," "JAMA" and "BMJ" are mentioned. There are three categories for classifying fast-track authors: the naive, the opportunistic, and the self important. Some things that are best done quickly are mentioned, as well as the idea that craftmanship is relevant in research.

Reports on a study of how often research publications about child health report ethics committee approval or informed consent. Methods; Results; Surprise at the percentage of papers that did not report ethical approval; Proposed reasons why approval was not cited, including confusion about how and when to seek approval; Recommendations for how to prevent unethical research from being published.

Objectives To evaluate how acceptable authors find the BMJ 's current practice of publishing short versions of research articles in the paper journal and a longer version on the web and to determine authors' attitudes towards publishing only abstracts in the paper journal and publishing unedited versions on bmj.com once papers have been accepted for publication. Design Two cross sectional surveys. Setting General medical journal. Participants Survey 1: corresponding authors of a consecutive sample of published BMJ research articles that had undergone the ELPS (electronic long,paper short)process.Survey 2: corresponding authors of consecutive research articles submitted to BMJ. Results Response rates were 90% (104/115) in survey 1 and 75% (213/283) in survey 2. ELPS is largely acceptable to BMJ authors,but there is some concern that electronic information is not permanent and uncertainty about how versions are referenced.While authors who had experienced ELPS reported some problems with editors shortening papers,most were able to rectify these. Overall, 70% thought that the BMJ should continue to use ELPS; 49% thought that publishing just the abstract in the printed journal with the full version only on bmj.com was unacceptable; and 23%thought it unacceptable to post unedited versions on bmj.com once a paper had been accepted for publication. Conclusions It is acceptable to authors to publish short versions of research articles in the printed version of a general medical journal with longer versions on the website.Authors dislike the idea of publishing only abstracts in the printed journal but are in favour of posting accepted articles on the website ahead of the printed version. [ABSTRACT FROM AUTHOR]

Reports the launching of the British government's white paper on health service. Identification of hospitals covered by the National Health Service trusts; Features of the white paper; Arguments on hospital privatization.

Comments on the retraction of the paper `Evidence of unmet need in the care of physically disabled adults,' which was written by the author and Mark H. Williams, in the British Medical Journal 1993;306:95-8. Reason for the retraction; Details on Williams; Information on the paper.

Focuses on the criticisms of the Central Committee for Community Medicine and Community Health on the white paper 'Working for Patients' in Great Britain. Prevalence of the concept of short stay services and general practice; Vagueness in the role of private hospitals and community health service; Uncertainty in the impact of the structure on public health doctors.

Features the white paper and the details to the government contract for general practitioners in Great Britain. Reduction of the working hours of junior doctors; Views of rural practitioners of the new contract; Discussion on the anxiety among honorary secretaries of the British Medical Association on the annual gathering.

Presents guidelines on writing a classic paper. Importance of getting into the writing mood; Vitality of the article title; Considerations in choosing a writing style.

Focuses on the speakership of physician David Owen in the meeting of the Royal College of Physicians of Edinburgh in Scotland. Concentration on the white paper and the reform of the public health services; Dejection of Owen on the modification of the National Health Service; Privatization of the health services.

Focuses on the funding of the National Health Service in Great Britain. Response of the government to the problem of NHS crisis in 1987 to 1988 period; Proposals for efficient NHS; Significance of white paper on the performance of medical professionals; Need of measures of patient satisfaction to medical services.

Focuses on the verdict of the House of Commons Social Services Committee regarding the white paper 'Working for Patients' in Great Britain. Rejection of Conservative Party on the proposal; Overview of the points cited by the Committee; Concerns of the Committee over the budget allocations of the program.

The article looks at how Donald Kennedy, the editor of "Science" magazine, stated that his journal will make its review procedures more tight and would work with journals such as "Nature" to attempt to identify fraudulent papers. The article discusses the retraction of papers on stem cells from human embryos by South Korean research Hwang Woo Suk.

Comments on the complexity of research papers. Belief that doctors use formulaic style to perpetrate a slight-of-hand result that is dishonest in order to support their idea; Use of complicated statistics in research papers, and question on how many doctors really know what it means; Suggestion that doctors provide a commonsense interpretation of their data that honestly levels with the reader.

Discusses the British government's genetic white paper which includes a vision for a new health care system offering personalized health care that is based on a person's genetic profile. Statements by Health Secretary John Reid; The white paper which outlines the potential for gene therapy; The Human Genetic Commission which has been asked to consider the case for screening babies at birth and storing genetic information for future use; Criticism of governmental safe-guards for accessing genetic test results.

Reports on support for pathologist Dick van Velzen's research paper on cystic fibrosis. Criticism of van Velzen for obtaining and storing children's organs without the parents' consent; How his coauthors, Rosalind Smyth and Deborah Ashby, and the Cystic Fibrosis Trust have backed the paper's findings; Details of the paper which speculated that there was a dose related association between high strength pancreatic enzyme preparations and fibrosing colonopathy; Concern that van Velzen biased the study.

Offers a look at the role of a reviewer in the authorship of papers printed in medical journals. Involvement of the reviewer in the writing process; Responsibility of the reviewer in providing information; Recognition of the contribution of reviewers to articles.

Discusses how the use of paper prescriptions will be obsolete in England when a system of electronic transmission of prescriptions is phased in by 2005. Description of the system and how it is used; Evaluation of the system.