Medical Science: so hard to keep up with

It’s a lot of fun working for a company that has a product that actually does what it says. Sadly, rather a lot of people selling information technology to the National Health Service seem to regard it as a slightly dull but dependable, and above all uncritical, source of funding. You know, they’ll never make your fortune, but you can dump mediocre systems on them and they’ll buy them, not perhaps at the highest of prices but at a price that’s always paid, and with few questions asked.

Sadly, I’ve worked for a few of those companies. I remember being ambushed at one conference at which I was presenting, when a representative of a client hospital asked, in public, why on earth anyone should trust us, given how badly we’d let them down on another product?

Well, it’s a blessed relief to be away from all that unpleasantness. Today I’m working with an evidence-based medicine product that does exactly what it claims to do: provide rapid access to carefully evaluated, up-to-the-minute information reflecting the most recent understanding of medical knowledge.

To take them or not to take them?
The answer may depend on when you ask the question

It’s just as well it does so. One of my colleagues pointed out at a recent presentation that about 15% of all information affecting medical practice changes every year.

Fifteen per cent.

Every year.

That may seem extraordinary, but I have a personal anecdote which seems to confirm it.

A year or so ago, my general practitioner decided that it was time to have my blood tested and assess my level of risk of having a stroke or heart attack in the next ten years or so. You may well guess that at stake was whether or not I should be put on statins. I had wish to start taking those drugs but, then, I had even less wish of suffering a stroke or heart attack.

Well, the results were clear. My risk was above 10%. That was the threshold level. The doctor prescribed statins.

I didn’t take them for long. My digestion turned lousy, I started sleeping badly, I was getting headaches. Classic symptoms.

However, having looked into it a bit – well, to be honest, my wife did – I rather think the reaction was psychosomatic. I was, at the time, working for the worst of the purveyors of dire quality to the health service. My boss had cut me out from doing any actual work on the software, which was good for my conscience but lousy for my long-term employment prospects. It wasn’t a good time, which I think may have contributed to my poor reaction to the medication.

A year or so on, and in a satisfactory job at last, I felt I should take a look again at whether I ought to be taking statins after all. I made contact with the GP again. Once more, he had my blood tested. And, again, the risk of stroke or heart attack was above 10%.

But, lo and behold! Medical science had changed. As he explained to me.

“We used to think the threshold for statins was 20%. Then it was reduced to 10%. But now it’s back up to 20%. And your risk is under 20%.”

So? What did this mean? Could I still live statin-free?

“So,” he went on, “I’ll not be prescribing any medication for now.”

Wonderful! My conscience is clear. I did all that was necessary. And science made the decision for me.

Isn’t it great? But doesn’t it just underline the importance of keeping current? Because how serious your condition is doesn’t just depend on your health – it also, apparently, depends on when you ask the question.