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Electronic and paper update

One of Bandolier's little pleasures is to travel around the UK talking to groups of people in the NHS about EBM and the power of systematic literature appraisal. Over the past five years attitudes have changed. The initial (probably appropriate) apprehension or even (inappropriate) outright hostility has been replaced by a grudging acceptance coupled with a concern about the quality of systematic reviews and guidance based on them.

Bandolier thinks that concern is justified. Concern occasionally arises because the question asked by a systematic review is not the one that professionals want answered. For instance, reviews of antibiotic use for otitis media may say that use of antibiotics makes no difference at a week, but the question Bandolier is asked is whether it makes any difference over 24 to 48 hours? We could find no reviews that answered this.

The major concern, though, comes from the complete lack of understanding by readers of reviews, users of reviews, and most frighteningly by producers of reviews of the enormous potential of bias in studies to produce the wrong answer. Bias (almost) always works to increase the apparent effect of a treatment and show it to be better than it is. It is pervasive, and its effects are large. So this month Bandolier has produced a survivor's guide to bias .

Electronic update

Bandolier continues to build its Internet site. This month many more abstracts of evidence have been added to the alternative therapies, healthy living, pain, migraine and management sites. Many thanks to those who have asked to use Bandolier's 10-tips for healthy living ( Bandolier 78 ), including medical journalists. We have added a BMI chart on the Internet site and are actively searching for sponsors to enable us to build this area more quickly.

If you want to use anything from Bandolier , feel free. All we ask is that you mention Bandolier and include the Internet address (

Paper update

We continue to work to ensure the future of Bandolier on paper for the many people who do not have fast Internet access at work. Stories have flooded in about how difficult some of you find this. The one we especially liked was the hospital with a single computer with Internet access, available in a special room in the library, and available only a few hours a week.

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