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Editorial

Deciding by talking
Brains in gear for new year
Choosing items for Bandolier is a bit like a random walk, peppered with signposts to interesting places, laden down with guidebooks, and with folk continually coming up to tell you about what you've already missed in your travels, or with exciting possibilities about where you might go next. But it's also a random walk with a history, and Bandolier 's history is now 94 issues with a massive Internet site. Despite that, there's always something that connects items or issues and magically pulls them together.

Deciding by talking


In this first issue of 2002 that something was discussions with GPs in November and December. How many cases of Perthes' disease should we expect in our PCO every year? How does our PCO ensure that we get value for money from prescribing? How important is compliance? Why do prescribing advisors sometimes insist that we GPs do things we know to be crazy? How do we know whether we are treating patients with different conditions equitably?

Enough here for a lifetime, let alone an issue. There's masses written on each of these, of course, but modern electronic wizadry, and a bit of luck, enables all sorts of goodies to be pulled from the ether to help.

Brains in gear for new year


For instance, the equity question is helped by some exceptional work from Scotland following up for five years everyone who in 1991 had an initial hospital admission for common cardiac conditions or cancer. Policy making about prescribing will rarely be answered in one concise little paper, but Bandolier found several that help. From Finlay McAlister, David Sackett and co in Canada come some typically thoughtful pieces on how we might think about class effects, and what we should have in mind when faced with equivalence trials. Both of these relate directly to prescribing policies.

Then there's a superb randomised trial and commentary about using different SSRIs for depression in general practice, and finally some British health economists highlight important thinking about the cost-effectiveness of trying to change professional behaviour. Powerful stuff when combined. Oh, and there's terrific information from Northern Ireland and Liverpool that helps to tell us how many cases of Perthes' disease to expect in a PCO.

Responding to questions asked by professionals is the most rewarding thing Bandolier does. Please keep them coming in 2002.


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