Well I never!

The media have been buzzing this week with news of a study published in the Lancet looking at HRT and cancer. The Scotsman read the article. It was, they said, a “shocking” report showing women on HRT were at “substantially increased risk” of cancer. The figure they quote is a 20% risk increase. Shocking indeed.

A doctor writing in the Telegraph was so shocked that she believes HRT should be banned. It’s a lifestyle drug, she says used by “feisty modern women” hoping to hang on to their sex lives and she wouldn’t recommended it at all, so dangerous is it.

The BBC also read about a 20% increase. They kindly explained that “This translates to one extra case of ovarian cancer for every 2,500 women taking HRT and one extra death from ovarian cancer in every 3,300 users.”

Reuters, it seemed, had read a different report. The study they read was one “suggesting – but not yet proving – that HRT causes breast and ovarian cancer”.

A professor writing in the Telegraph, alongside the sceptical doctor, says risks and benefits should be balanced. The risk is small and some women are “severely disabled” by menopause symptoms.

The headline in the Lancet itself says that 1000 deaths amongst the study cohort since 1991 can be put down to HRT. Just to put that into perspective that works out as one extra death a week over the 16 years of the study.

Is it worth the risk? The BBC tells us that the symptoms of menopause may include aches and pains, insomnia, hot flushes, dry skin, tiredness, bladder problems, depression, panic attacks, poor memory. Oh and there’s osteoporosis too.

So – what’s the moral of the story? Always read with an open mind and never be dazzled by statistics. Look at resources such as CASP to help you read papers critically, and read books like “How to Read Paper” or the recent Guardian Bad Science article on manipulation of statistics.

You can also look at the Hitting the Headlines facility on the National Library for Health. This regular looks at the stories in the headlines and looks at the facts behind them.

Read with your brain fully engaged, and never believe everything you read in the papers!

Alan Johnston

This has always been a work blog, for people in the workplace making use of the library. It's about getting the most out of your library.

Today I'm taking a tiny step away from that remit as I have added the BBC banner reminding people of the plight of Alan Johnston, the journalist who was kidnapped in Gaza on 12th March 2007.

This may appear to have no relevance to libraries, but journalists are gatherers and disseminators of information just as librarians are. Freedom of information is linked to all sorts of other freedoms. And, like many freedoms, we notice them most when they have gone.

I won't write more on this. If you want to know more, click on the banner.

New Look

Dialog Datastar has been tweaking the service it offers. From this Saturday (14th April) you'll see a number of changes when you log into Medline with your Athens password.

The main change will be the wording on the tick boxes below the search box. These will be simplified so that "documents relating to humans", for example, will now just say "humans".

The second big change will be the addition of so-called "Haynes Filters" or Clinical Queries. These are pre-set searches that allow you to search quickly for therapy, diagnosis, aetiology or prognosis.

Don't forget the help function (top of the search page on the dark background) and the search tips (over the search box). The other source of help, advice and guidance is, as ever, your library.

Bye Bye, BMJ, goodbye

Bad news - the subscription that NHS libraries in Essex had to the BMJ journals online has now expired. That means that your Athens password no longer gives you access to the BMJ and related titles.

The BMJ was trailblazer on the internet and was initially all free to view. In recent times libraries have paid for you - the user - to have free access. Budget cuts in 06/07 meant something had to give and the BMJ went out with the bathwater. Many libraries (this one included) still take the paper version, so all is not lost.

Personally I get the table of contents emailed to me weekly. I have to say that although the fillers are often amusing, and the news snippets may be interesting if you haven't already caught them on the BBC or Reuters websites, the actual clinical content seems very thin. This week's issue has just three reviews.

This raises two issues. The first is that free to you doesn't necessarily mean free to all. the resources you have through Athens have been bought and paid for by the NHS so you pay nothing at the point of use. It's amazing how many people seem to think that the world’s knowledge is all on the internet and all free. Next time you download something "free" think of the budgets that have paid for that for you.

The second issue is the way that libraries fall into the habit of stocking "must have” titles. How can you be a real medical/healthcare library and not stock the BMJ, Lancet, New England Journal of Medicine and JAMA? The truth is that none of these is indispensable, and many NHS libraries no longer take them. Good quality evidence turns up in all sorts of places - just relying on a few best sellers is no longer the way forward.

Change of opening hours (again)

Easter is upon us, I am taking leave and another team member has gone off sick, so as of today the opening hours for this week and next are:

Today (Monday 2nd April) - 09.00-17.00
Tuesday - 09.00-17.00
Wednesday - 09.00-17.00
Thursday - 09.00-17.00
Good Friday, weekend, Easter Monday - CLOSED
Tuesday - 09.00-17.00

Hours from Wednesday 11th onwards to be advised, depending on the health of the team!