Contacts, Help, Advice and Information Network for effective health care, is a network designed to facilitate links between health care professionals, teachers, managers, librarians, specialists, researchers and other professionals working in the NHS family of organizations. It currently has about 2700 members.

It has been established in response to a demand for information from people working in the NHS about 'who is doing what' in evidence based health care and research.

There are no joining requirements other than: 1. You have to be working in the NHS family of organisations; 2. You are willing to share information and experience with other members of the network.

The web address for CHAIN is via the reference below::

Ref: 

The study looked at all original research articles published in Lancet and BMJ during 1999 and 2000. The outcome measures were inclusion of articles in the Lancet or BMJ press releases, and reporting of articles in Times or Sun newspapers.

Of 1193 original research articles, 517 (43%) were highlighted in a press release and 81 (7%) were reported in one or both newspapers. All articles covered in newspapers had been released. The probability of inclusion in press releases was similar for observational studies and randomised controlled trials, but trials were less likely to be covered in the newspapers (odds ratio 0.15 (95% confidence interval 0.06 to 0.37). Good news and bad news were equally likely to be press released, but bad news was more likely to be reported in newspapers (1.74 (1.07 to 2.83)).

Studies of women’s health, reproduction, and cancer were more likely to be press released and covered in newspapers. Studies from industrialised countries other than Britain were less likely to be reported in newspapers (0.51 (0.31 to 0.82)), and no studies from developing countries were covered.

Overall characteristics of articles were more strongly associated with selection for reporting in newspapers than with selection for inclusion in press releases, although each stage influenced the reporting process. Newspapers underreported randomised trials, emphasised bad news from observational studies, and ignored research from developing countries.

This piece is based on a BMJ editorial earlier in the year.

Twenty to 30% of the population in developed countries take a daily vitamin supplement. Does it do them any good? Current estimates of vitamin requirements are based on the amounts needed to prevent deficiency diseases; in most countries deficiency is no longer a major problem. The question is whether higher levels of intake provide health benefits. There are two ways to answer this question: to identify biomarkers of optimum nutritional status, rather than the absence of deficiency; or epidemiological studies to identify nutrients associated with a lower incidence of chronic diseases, followed by intervention studies. Neither approach has yet provided satisfactory answers, and a recent review finds little convincing evidence in favour of supplements.

The benefits of folic acid supplements taken around conception in preventing neural tube defect have been shown convincingly. High intakes of folic acid also reduce plasma homocysteine, a risk factor for cardiovascular disease independent of plasma lipids and other risk factors, and low intakes of folic acid are associated with increased risk of colorectal cancer.

This has led to mandatory fortification of cereal products in the United States and elsewhere. However although folic acid lowers plasma homocysteine, there is no evidence yet from controlled trials whether or not this will reduce cardiovascular disease or cancer. Until the results of intervention trials in progress are available, the benefits of folic acid supplements other than to prevent neural tube defects remain unproved.

The answer to the question of whether we should take a multivitamin tablet every day must be that unless our intake is inadequate as a result of a poor diet then supplements will probably do us no good – apart from folic acid taken periconceptually and, possibly, vitamin D by elderly people.

Several studies have shown that US physicians make greater use of medical technologies than UK physicians. A survey in the BMJ compared rates of referral to specialists in the United Kingdom and the United States.

Among patients who visited their primary care physician, about one in three patients in the United states are referred to a specialist annually compared with one in seven in the United Kingdom. The data do not provide information on whether the US rates are too high or the UK rates are too low. Nevertheless, the twofold difference in referral rates held true for the healthiest as well as the sickest patients.

The low availability of specialists, and resultant long waiting lists in the United Kingdom may be explanation for these differences. The supply of specialists in the United States exceeds that in the United Kingdom by twofold. Just 1% of US patients wait four months or longer for elective surgery compared with 33% of UK patients.

General practitioners believe that waits for appointments with specialists threaten their capacity to deliver high quality care. Absence of waits is likely to have lowered the US physicians’ referral thresholds.

Other possible explanations include a less intensive practice style among UK physicians, the common practice of self referral among US patients (even those in health maintenance organisations), and a broader scope of practice among UK physicians.