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Editorial

Bandolier chooses items for its pages by a relatively simple process. On the one hand searching PubMed or the Cochrane Library, combined with some diligent journal reading, brings to light both systematic reviews and other important articles with methodological insights. On the other hand people ask about evidence on topics important to them, so we look for it. More often than one might think, these two separate approaches combine with what interests Bandolier , and the results appear in these pages.

General practitioners are most likely to come up with questions, usually following up an issue raised by a patient. Patients themselves are getting in touch, and a local branch of Age Concern has begun to ask important questions, and stimulate Bandolier to work harder on issues important to older people. Nurses, and especially community nurses, are beginning to find that evidence can be helpful to them also.

If there is a thematic change over nearly nine years, it is that the balance is tilting more than ever from wanting information about treatments, and towards wanting information about natural history, diagnosis, and prognosis.

Diagnosis is a problem, but from Scandinavia and North America there is an increasing flow of cracking studies looking at clinical scoring for diagnosis or prognosis, or risk. Two this month, on predicting early survival from stroke and recurrent fallers in the community. No high-tech gizmos, just simple observations. But the studies are fabulous examples of how to do it.

Some nice examples of observational studies, too. Bandolier continues to be impressed by the sorts of observations that can be made about natural history when you know what happened to every patient. From Norway a study on neonatal hip instability on over one million babies, plus the news that exercise does not cause knee arthritis . Methodological issues too, about before and after studies showing (again) how important handwashing can be.


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