This week in the BMJ
Volume 331, Number 7514, Issue of 20 Aug 2005Telephone education reduces readmission for chronic heart failure
Telephone education reduces readmission for chronic heart failure
Telephone intervention by nurses given to people with chronic heart failure reduces hospital readmissions for heart failure. In a randomised controlled trial by the GESICA Investigators (p 425) 760 people received education, counselling, and monitoring by telephone plus usual care, and 758 people received usual care. Patients in the intervention group were significantly less likely to be readmitted to hospital with worsening heart failure (relative risk reduction 29%, P = 0.005) and had a better quality of life than the control group. Mortality was similar in both groups.
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Mobile phones increase risk of having a road crash
Using a mobile phone while driving increases the likelihood of having a road crash. In a case crossover study of 456 drivers who had had a road crash that necessitated hospital attendance, McEvoy and colleagues (p 428) compared a driver's use of a mobile phone at the estimated time of the crash with the same driver's use during a comparable time period. People using a mobile phone up to 10 minutes before a crash were four times more likely to crash (odds ratio 4.1, 95% confidence interval 2.2 to 7.7). The risk was still raised when hands-free phones were used (odds ratio 3.8, 1.8 to 8.0).
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Black people are more likely to survive a stroke than white people
Black people in south London with a first ever stroke are more likely to survive than white people, if they are aged > 65 years and have good mobility before the stroke. Wolfe and colleagues (p 431) assessed survival after stroke and the factors influencing survival in 2321 people with a first stroke from the south London stroke register. Black people had significantly better survival than white people (median 33.7 v 20.0 months), and the trend remained significant after adjustment for age and stratification for socioeconomic status and stroke subtype (hazard ratio 0.72, 95% confidence interval 0.61 to 0.87).
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Cognitive behaviour therapy reduces symptom severity of irritable bowel syndrome
Cognitive behaviour therapy plus the antispasmodic drug mebeverine reduces symptom severity for up to six months in people with irritable bowel syndrome. Kennedy and colleagues (p 435) randomised 149 patients who had not responded to mebeverine to cognitive behaviour therapy delivered by primary care nurses plus mebeverine or to mebeverine alone. The mean reduction in symptom severity score associated with adding cognitive behaviour therapy was 68 points (95% confidence interval 103 to 33) at 1.5 months, but by 12 months the effect was no longer apparent.
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Studies that find publication bias are no more likely to be published than studies that don't
There is no evidence that studies that find publication bias are preferentially published compared with studies that find no publication bias. In a systematic review Dubben and Beck-Bornholdt (p 433) identified studies presenting original data on publication bias. A funnel plot of effect size versus sample size of 26 studies included in the analysis showed no significant asymmetry in the data, indicating no evidence of publication bias. However, because only 26 studies were included, the authors warn that the power to detect asymmetry in a funnel plot is low.
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