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Highlights

Frequent self-monitoring of blood glucose in patients with type 2 diabetes not using insulin was associated with unfavorable estimates of cost-effectiveness, say Cameron and colleagues. They carried out an incremental cost-utility analysis using a model based on the United Kingdom Prospective Diabetes Study. Reducing the frequency of self-monitoring to one to two times a week from seven or more times, or a decrease in the price of test strips, could improve the cost-effectiveness of routine self-monitoring in this group, the authors add. See Research, page 28

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Mortality declined overall among people with diabetes from 1994 to 2005, but the drop was substantially greater in the highest income group than in the lowest income group. Lipscombe and colleagues come to this conclusion in their population-based retrospective cohort study of people with diabetes aged 30 years or older in Ontario. See Research, page E1

Use of blood glucose test strips

Self-monitoring of blood glucose among older patients with diabetes has increased by over 250% during the past 12 years in Ontario, finds a cross-sectional analysis by Gomes and colleagues. They report that almost half of these patients were at low risk of drug-induced hypoglycaemia. According to the authors, more selective monitoring could reduce the number of test strips dispensed to 74.5 million from 117 million. See Research, page 35

Pandemic H1N1 influenza in children

Children with pandemic H1N1 (2009) influenza are significantly older than children with seasonal influenza. O’Riordan and colleagues found this and other differences in their study based on a review of charts of children with pandemic H1N1 infuenza admitted to a large pediatric hospital. See Research, page 39

Registry of systematic reviews

Straus and Moher call for a registry of systematic reviews. Such a registry may reduce publication bias, enhance transparency and avoid duplication of effort, say the authors. See Commentary, page 13

Asthma unresponsive to usual care

In patients with asthma who do not respond to usual care, physicians need to confirm the diagnosis, check inhaler technique and compliance, explore potential triggers and comorbidities and exclude rare syndromes. These are some of the key messages listed by Chapman and McIvor in their review of asthma. See Reviews, page 45

Role of the medical expert witness

The overriding duty of any expert witness in court is to provide impartial testimony, regardless of who retained the witness, say Iacobucci and Hamilton. See Analysis, page 53

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A 28-year-old woman who used cocaine daily presented with fever, chills, sore throat and cough, and had an absolute neutrophil count of less than 100cells/mm³. Levamisole, an increasingly common contaminant in cocaine, was detected in her urine. Another patient with levamisole-induced neutropenia is also described. See Practice, page 57

Conflict of interest

Allegations of conflict of interest are among controversies swirling around the latest revision process for the Diagnostic and Statistical Manual of Mental Disorders. See News, page 15 and page 16

Liverpool Care Pathway

The protocol known as the Liverpool Care Pathway has been lauded as an evidence-based framework for delivering appropriate end-of-life or palliative care to the terminally ill, and slagged as a self-fulfilling proposition that should be known as the "Liverpool Death Pathway."See News, page 17

Related Articles

Registering systematic reviews

Sharon Straus and David Moher
Can. Med. Assoc. J. 2010 182: 13-14. [Full Text] [PDF]

This Article Figures Only Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager PubMed PubMed Citation Related Collections Related Articles

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