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Looks at evidence of the fate of medical research and provides a template for gauging the value of money spent. Provides key issues and learning points which need consideration in order to improve research skills and capabilities. Offers evidence that could be used to improve research governance in health care. Gives learning points for those sponsoring, hosting or managing research and for others becoming involved in research. Concludes that understanding past practices should help in improving those which are current.

Looks at where action research has been used in health care in the UK and suggests lessons can be learned by looking at action research taking place in other fields, such as education, policing and social services.

Increasing attention is being placed on clinical trials as a source of evidence. Presents thoughts about the advantages and disadvantages of clinical trials and their influence on thinking and clinical practice.

First in a series of articles to address the critical appraisal of clinical trials. Provides background of knowledge, ideas and instruments to use to understand better the evidence, and tools used in looking at evidence. Provides a rationale for critical appraisal and three different hierarchies of the evidence.

Examines a particular system for reporting clinical trials: the revised CONSORT system. Identifies its evolution and key components, indicating who may go on to use it, posting its key strengths, and concludes by identifying its outstanding limitations.

The pharmaceutical business has long been a source of controversy, particularly the ability to market a drug for human consumption. The thalidomide disaster of the late 1950s and early 1960s invoked all nations in the 15 member states of the EU to require that a pharmaceutical product intended for human consumption have an official market licence before it is allowed onto the nation’s market. Until December 1994 each nation in the EU could decide itself what products came onto its market. From January 1995 the European Commission, facilitated by the European Medicines Evaluation Agency, has had the power to decide on applications for pan‐EU market licences. Explores the new EU licensing system, drawing from past and present experience, and argues that although complex at least four sets of motivations lie behind the construction of the EMEA system: the EU prisoners’ dilemma; four types of market failures; extensions of politico‐bureaucratic business and, finally, the inability of the pharmaceutical industry to nurture effectively any feasible alternative to the new system.

This paper identifies and explores issues of medication, the elderly, and the problems in securing and using evidence from randomised control trials. Demographic and health care data are presented. While the elderly are a significant set of consumers of medicines, there is a lack of published evidence, in control trial format, on which medications are better for elderly patients. Even if all the trial evidence on a new drug was published before the drug was put on the market, as recently recommended, there are serious issues to consider in securing and using evidence from clinical trials. This paper indicates ten problems in securing and using evidence from randomised control trials. Three examples of randomised control trials involving the elderly are given. While it is easier to call for improvements in the evidence base than to achieve improvements, this paper argues that improvements are fundamentally necessary. This is because if no significant improvement comes through on the evidence base, we will never know if we are providing the elderly with the cost‐effective care and attention that they deserve.

Aims to identify and explore recent legal and policy developments affecting the EU pharmaceutical business environment. Areas addressed are: the declaration of industry policy from the European Commission and the MEPs’ recent response to this, drug licensing, member state trade in pharmaceuticals, price and profit controls, and state aid. States none of these areas are quite so mutually exclusive, and that there is more to the EU pharmaceutical industry than just the drugs it provides and while there is a growing trend towards a single EU market in pharmaceuticals it is highly unlikely that a single market will be achieved in the next decade. Argues that EU policies must facilitate a strong, profitable, pharmaceutical industry. Regardless of how successful the EU pharmaceutical industry is, it is still behind the USA and looks likely to remain so. The EU as a pharmaceutical area is beginning to be eclipsed by newly‐emerging areas in the Fast East and whether or not EU governments have formal, explicit pharmaceutical industry policy, these governments will still affect the pharmaceutical environment. Concludes that the fundamental questions of any industrial policy must be carefully addressed.