When I use a word . . . Medical blue plaques-the Peckham Experiment.

The Pioneer Health Centre in Peckham, also known as the Peckham Centre, running what became known at the Peckham Experiment, was founded in 1926 by two doctors, Innes Pearse (1889-1978) and her colleague George Scott Williamson (1884-1953). It closed down in 1929 and reopened in 1935 in new purpose-built premises. Families paid a shilling a week for membership, which gave them free medical consultations of various sorts and access to a wide variety of recreations, but no medical treatment. The purpose was to observe how their health progressed and to discover what factors were involved in good health and wellbeing. After closing down again during World War II the centre reopened, but was forced to close again in 1950, this time for good, because of lack of funds, due to a complex range of factors. In a 1938 publication, the founders stressed that health and wellbeing were not synonymous; health, they wrote, operates with a cumulative deposit account and wellbeing on a diminishing current account.Two blue plaques commemorate the Pioneer Health Centre: an English Heritage blue plaque at 142 Queen's Road, Peckham, London SE15, the site of the centre's original building, and a plaque put up by the London Borough of Southwark at the site of the second building, now converted to a block of flats, and situated round the corner from the Queen's Road premises, in Frobisher Place, St Mary's Road, Peckham.

When I use a word . . . Medicines regulation-diethylene glycol.

In 1937, when diethylene glycol was used as a solvent in the preparation of a medicinal product, an elixir of sulfanilamide, resulting in deaths, public outcry hastened the promulgation of an act that had been in preparation in the USA for several years, but which had met with opposition from pharmaceutical companies. The 1938 Food, Drug, and Cosmetics Act, as it was known, gave greater powers to the then recently formed Food and Drug Administration (FDA) in regulating the contents of medicinal formulations. Nevertheless, although similar regulatory systems have since been established around the world, episodes of poisoning with diethylene glycol in pharmaceutical formulations, whether deliberately included adulteration or as a contaminant, continue to be reported, generally in developing countries, usually affecting children, and often causing deaths.

When I use a word . . . Medical blue plaques in London.

In 1863 the MP William Ewart suggested that "it might be practicable... to have inscribed on those houses in London which have been inhabited by celebrated persons, the names of such persons." Accordingly, in 1867 the first such inscriptions, which came to be known as blue plaques, were put up by the Society of Arts, commemorating Lord Byron and Napoleon III at places in London where they had lived. The society put up 35 such plaques over the next 35 years when the scheme was taken over by the London County Council, which gave way to the Greater London Council in 1965 and finally English Heritage, in 1986. Among London's 1000 or so blue plaques several medical men and women, doctors, nurses, and other healthcare workers, are commemorated. They include Cecil Belfield-Clarke, Hannah Billig, Richard Bright, Edith Louisa Cavell, Henry Hallett Dale, Charles Darwin, Henry Havelock Ellis, Elizabeth Garrett Anderson, Thomas Hodgkin, William Hunter and his brother John, Joseph Lister, James Mackenzie, Rachel McMillan and her sister Margaret, William Marsden, Florence Nightingale, Ronald Ross, Mary Seacole, Hans Sloane, and George Frederick Still.

A Comparison of Signals of Designated Medical Events and Non-designated Medical Events: Results from a Scoping Review.

INTRODUCTION AND OBJECTIVE: The European Medicines Agency (EMA) maintains a list of designated medical events (DMEs), events that are inherently serious and are prioritized for signal detection, irrespective of statistical criteria. We have analysed the results of our previously published scoping review to determine whether DME signals differ from those of other adverse events in terms of time to communication and characteristics of supporting reports of suspected adverse drug reactions. METHODS: For all signals, we obtained the launch year of medicinal products from textbooks or regulatory agencies, extracted the year of the first report in VigiBase and calculated the interval between the first report and communication (time to communication, TTC). We further retrieved the average completeness (via vigiGrade) of the reports in each case series in the years before the communication. We categorised as DME signals those concerning an event in the EMA's list. We described the two groups of signals using medians and interquartile ranges (IQR) and compared them using the Brunner-Munzel test, calculating 95% confidence intervals (95% CI) and P values. RESULTS: Of 4520 signals, 919 concerned DMEs and 3601 concerned non-DMEs. Signals of DMEs were supported by a median of 15 reports (IQR 6-38 reports) with a completeness score of 0.52 (IQR 0.43-0.62) and signals of non-DMEs by 20 reports (IQR 6-84 reports) with a completeness score of 0.46 (IQR 0.38-0.56). The probability that a random DME signal was supported by fewer reports than non-DME signals was 0.56 (95% CI 0.54-0.58, P < 0.001) and that of one having lower average completeness was 0.39 (95% CI 0.36-0.41, P < 0.001). The median TTCs of DME and non-DME signals did not differ (10 years), but the TTC was as low as 2 years when signals (irrespective of classification) were supported by reports whose average completeness was > 0.80. CONCLUSIONS: Signals of designated medical events were supported by fewer reports and higher completeness scores than signals of other adverse events. Although statistically significant, the differences in effect sizes between the two groups were small. This suggests that listing certain adverse events as DMEs is not having the expected effect of encouraging a focus on reports of the types of suspected adverse reactions that deserve special attention. Further enhancing the completeness of the reports of suspected adverse drug reactions supporting signals of designated medical events might shorten their time to communication and reduce the number of reports required to support them.

Clinical trials of pharmacological interventions for SARS-CoV-2 published in leading medical journals report adherence but not how it was assessed.

AIMS: Adherence to pharmacological interventions in clinical trials is crucial for accurate identification of beneficial and adverse outcomes. The ways in which adherence to interventions should be reported in trial publications are described in the Template for Intervention Description and Replication (TIDieR), a 12-item extension of the Consolidated Standards of Reporting Trials reporting guidelines. The objective of this study was to assess compliance with TIDieR Items 11 and 12 of randomized controlled trials (RCTs) of interventions in SARS-CoV-2 infection published in 5 selected journals during 2021. METHODS: We assessed pharmacological interventions for SARS-CoV-2 infection reported in RCTs published in 2021 in the Annals of Internal Medicine, The BMJ, JAMA, The Lancet and The New England Journal for Medicine for compliance with TIDieR items addressing intervention adherence (Items 11 and 12). We calculated proportional adherence for pharmacological and comparator interventions where available. RESULTS: We found 75 eligible RCTs. Twenty-eight (37%) reported results of SARS-CoV-2 vaccinations. Compliance with Items 11 and 12 could be assessed in 71 of these 75. Of the 71 RCTs, 37 (52%) reported how adherence was assessed (Item 11), and 70 reported adherence rates (Item 12). Only 1 of the 71 RCTs (1.4%, 0-7.6%) fully complied with TIDieR Items 11 and 12. CONCLUSION: Half of RCTs of SARS-CoV-2 pharmacological interventions published in leading medical journals in 2021 complied with reporting of how adherence assessments were made and almost none complied with both TIDieR Items 11 and 12. The implications for interpretation, application and replication of findings based on these publications warrant consideration.

The British Journal of Clinical Pharmacology: The first 50 years.

The British Journal of Clinical Pharmacology celebrates its 50th anniversary of publication in 2023. Here four previous Editors-in-Chief and the current Editor reflect on the Journal's history and the changes that have occurred during that time.