Medicine Central
Clinical evidence moves faster than guidelines. Our medical team filters, curates, reports and educates on what has changed and how it impacts primary care practice. Providing you a trusted central reference point you can come back to, so you're always current.
Editor's picks
For someone who needs help with every basal insulin dose, this means 52 assisted injections a year instead of 365.
The trial aimed to recruit more than 25,000 people. The pandemic left it with 4,633. That limits how much its results can tell us.
Recurrent UTI drives a large share of antibiotic use in women. The alternatives vary a lot in how much evidence backs them.
Type 2 Diabetes
Diagnostic criteria, risk tools, annual care processes and referral pathways.
Chronic Kidney Disease
CKD staging, eGFR monitoring, renal protection and referral pathways.
Obesity
BMI classification, weight management tiers, risk stratification and referral pathways.
Cardiovascular Health
CVD risk assessment, hypertension management, lipid modification and referral pathways.
Asthma
Diagnostic criteria, risk stratification, annual review checklist and referral pathways per NG245.
COPD
Diagnosis, severity staging, smoking cessation, annual review and referral pathways per NG115.
CKD is common, but progression is not inevitable.
A prespecified exploratory analysis of the FIND-CKD trial reports slower eGFR decline with finerenone in chronic kidney disease due to glomerular diseases.
A study of 1.4 million women in England shows that pregnancy records should be part of heart health discussions, not just antenatal notes.
Iatrogenic menopause is associated with a higher risk of cardiovascular disease, while menopause before 45 is associated with higher cardiovascular and all-cause mortality.
A UK observational study of more than 8,000 women found substantial six-month weight loss and high retention in a structured digital-first GLP-1 programme. It is promising implementation evidence, but not a comparison with NHS or face-to-face care.
Dr Saira Bano explains why BMI is a starting point—not the whole assessment—and how waist-to-height ratio, HbA1c, blood pressure, lipids and cardiovascular risk help build a clearer metabolic picture in primary care.
In focus
From semaglutide to tirzepatide: the evidence on weight management medications is moving fast. Our clinical team breaks down what the latest trials mean for prescribing in primary care.
Read the GLP-1 coverage
Children who met criteria for a psychiatric disorder in 2017 were more likely to see difficulties worsen over three years than earlier cohorts. A new England study underlines the importance of prevention, early identification and effective support.
Around a quarter of patients presenting to primary care with mental health difficulties meet criteria for personality disorder, yet only 1 to 1.5% have a coded diagnosis. A new qualitative study explores what that gap looks like from the patient side.
A London study of nearly 159,000 patients indicates the programme might do more than just spot high blood pressure early.
Dr Fatima Tahir explains the safeguards that underpin clinical trials in general practice, from ethical review and informed consent to Good Clinical Practice and ongoing safety monitoring.
Sixteen months after it reached the UK market, the live chikungunya vaccine has been withdrawn.
Finding a cancer and changing its outcome are not the same thing. The largest trial of a multicancer blood test shows why.
A large US matched cohort found lower recorded cerebrovascular, hospital-use and mortality outcomes among people with OSA exposed to GLP-1 receptor agonists. The finding is promising, but observational and not a replacement for standard OSA care.
Across 19 papers published since 2022, a consistent picture emerges on MART versus conventional ICS/LABA plus SABA. The headline benefit is concentrated in exacerbation prevention - but the size of the gain depends heavily on baseline exacerbation risk.
Why Medicine Central
Medicine Central is curated especially for UK primary care, with contributions from guest expert clinicians.
Peer-reviewed sources only, with study design and limitations reported alongside the headline.
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Key publications in 50 words
Across 14 placebo-controlled trials in 76,969 adults with type 2 diabetes, SGLT2 inhibitors reduced first heart-failure admission or cardiovascular death by 23% (HR 0.77) and composite kidney events by 31% (HR 0.69). Kidney outcome definitions differed across trials, so the kidney estimate needs cautious interpretation.
In over 400,000 UK Biobank participants, replacing creatinine with cystatin C reclassified 15% to a more advanced CKD stage. People with four or more long-term conditions had over four-fold higher odds of a large negative eGFR difference. This observational study does not show that cystatin C testing improves outcomes.
In a Lambeth primary-care cohort of 158,645 eligible adults, attending at least one NHS Health Check was associated with lower all-cause mortality (adjusted HR 0.68). The largest ten-year absolute risk difference was in people aged 70 to 74. As an observational study, it cannot rule out residual confounding.
The NHS-Galleri randomised trial found no reduction in stage III or IV cancer after three annual multicancer blood-test rounds (IRR 1.03, 95% CI 0.92 to 1.14). The stage IV estimate was lower but borderline. Grail, the test manufacturer, funded the study; longer follow-up is planned.
Pregnancy complications can flag future cardiometabolic and renal risk. In 1.4 million women in England, pre-eclampsia and gestational hypertension were linked to over threefold higher later hypertension, while gestational diabetes was linked to nearly sevenfold higher type 2 diabetes. These are associations, not causes; closer monitoring may partly explain them.
This week's edition
This week's key publications, each summarised in 50 words by our clinical team.
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