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How many papers, particularly those reporting randomised controlled trials, fully describe what the researchers did? If you knew what the interventions truly comprised you might practise better, give more useful advice to patients, hone the design of your next study, replicate the trial, or decide whether to include the trial in a systematic review.
Nadine Foster and colleagues fill this evidence gap with their multicentre trial of physiotherapy advice, exercise, and true or sham acupuncture for osteoarthritis of the knee. In the full version on bmj.com of the paper we publish this week (doi: 10.1136/bmj.39280.509803.BE) they say what the physiotherapists did: the kind of exercises they used and the sizes, sites, and manipulations of acupuncture needles they inserted. The paper's web extras include the advice leaflet for patients about knee problems (www.bmj.com/cgi/content/full/bmj.39280.509803.BE/DC1) and the illustrated handout showing patients how to do exercises at home (www.bmj.com/cgi/content/full/bmj.39280.509803.BE/DC2).
The third web extra is an invitation to take part in a survey—Paul Glasziou and Sara Schroter want to improve the way the BMJ reports interventions, particularly those consisting of treatments. If you are a clinician who sees patients with painful osteoarthritic knees please click on the trial's web extra marked “take part in our survey” (or go straight to www.bmj.com/cgi/content/full/bmj.39280.509803.BE/DC3) and spend a few minutes reporting whether the extra material posted with Nadine Foster and colleagues' trial is detailed enough to be useful. And if you want to debate with other readers the clinical or wider utility of reporting interventions in this way, do send a rapid response to the paper on bmj.com. Should journals insist on this much detail of every intervention in every trial? Is this better than a note saying that further details are available from the authors, or is it just another example of information overload?
John Russell Silver thinks it's impossible to predict which of the thousands of papers published each year will be important and which will be consigned to the dustbin of obscurity (doi: 10.1136/bmj.39210.408414.AD). He certainly didn't expect his 1966 papers on a previously unreported familial spastic paralysis to be so influential nearly 40 years later or to yield the eponym Silver syndrome. The article arguing whether eponyms should be abandoned (doi: 10.1136/bmj.39308.380567.AD, doi: 10.1136/bmj.39308.342639.AD) prompted me to search, idly, for one including my own name. Groves syndrome describes the hateful patient syndrome, with four subtypes: the dependent clinger, the entitled demander, the manipulative help rejecter, and the self destructive denier. Oh dear.
By the time you read this the summer holiday season will be over for most of the northern hemisphere. I hope it's not too late, though, for the patient waiting to have a break in Spain (doi: 10.1136/bmj.39245.483900.AD). Olimpia Pop admits that “being a psychiatrist . . . I don't find ‘unusual patients' really come as a surprise.” This patient did fit the bill, though: he was a depressed gorilla who was no longer an easy going guy (or should that read Guy), was self harming, and had flummoxed the veterinary team.