👋 Happy Friday. I heard you were looking for that good stuff 👀… Here’s your fix of the top medical stories from this week :

• 🍿Season Finale of BMA vs GMC: The Semantic Showdown

• 🤰 Anaemia Redefines The Pregnancy Scare

• 💊 Anticoagualants + Ischaemic Stroke? A Truly Bad Idea

• 🤖 AI-Powered Boost For Cancer Detection

• #TheMoreYouKnow: Other Top Stories of The Week

NHS NEWS

🍿Season Finale of BMA vs GMC: The Semantic Showdown

There is an imposter in the Hospital… Can you guess who it is…?

It’s not that 13 year old who impersonated a doctor in Feb(fair play to him, easiest way to bag work experience).

The BMA had argued it’s in fact Physician Associates, who are pretending to be who they are not.

So much so that they’d dragged the GMC to court and sued. Accusing it of committing the gravest of sins…calling PAs ‘medical professionals’ alongside doctors. Gasps in medical blasphemy

The BMA’s legal team was having none of it. Saying the “lack of a clear distinction between the roles undermines public confidence in standards of healthcare.” They may well have been right. I learnt the hard way. I sat in clinic with a PA for six hours, only to find out they couldn’t sign me off 😣.

Finally, the High Court has made their verdict. Judge Justice Lambeth told the BMA to quit their whining! This ‘semantic disagreement’ is like two school children bickering in the playground. 

Mrs Lambeth said:

“The use of shared standards was logical given the overlap in work undertaken by doctors and associates and the need for regulatory concerns affecting all three professions to be considered against the same standards . . . Nor is there anything irrational or inherently confusing about the use of the term ‘medical professionals.’ 

The GMC were very quick to figuratively blow raspberries at the BMA:

‘We welcome Mrs Justice Lambert’s judgment, which dismisses in its entirety the BMA’s claim’ and ‘This comprehensive judgment also finds that there is nothing irrational or inherently confusing about the use of the term “medical professionals” as a collective term in this context.’ Smug indeed.

The BMA said you haven’t seen the last of us ✊. They are considering next steps following the ‘disappointing’ ruling. BMA Chair, Phil Banfield claims the court have “ignored common sense, and the effect will be to perpetuate the patient safety issues caused by the confusion”. 

RESEARCH UPDATE

🤰 Anaemia Redefines The Pregnancy Scare

So. You're Pregnant. Intentionally too :). Congratulations 🥳 
There’s so much to think about…

Who do we call first? The booking visit? Boy or girl? What do I tell work? Vaginal or C-section? Where do we put the cot? Nappies are so expensive! Are the twos so terrible? Where do I send them to primary school? Where will they go to uni?
I hope they don’t become a doctor…

And to top it all off…what do my iron levels look like?

A massive UK-based study has found iron deficiency anaemia in the first 100 days of pregnancy could be breaking your baby's heart. Literally. We're talking about a 47% increased risk of congenital heart defects (CHD) in babies born to mothers with anaemia early in pregnancy.

Let’s look deeper. 

This case-control study was sponsored by the British Heart Foundation and published in BJOG.The study spanned from 1998 to 2020, across 986 general practices in the UK. The study included 2,776 mother-baby pairs where the child was diagnosed with a congenital heart disease (CHD) in the first 5 years of life and 13,880 matched controls(babies without CHD).

Researchers went back through patient records to identify anaemia(Hb <110 g/L) in the first 100 days. They carefully controlled for confounding factors such as maternal age, BMI, socioeconomic status, ethnicity, etc, by conducting conditional logistic regression.

Key findings:

• Prevalence: 4.4% of mothers in the CHD case group had anaemia, compared to 2.8% in the control. Adjusted for confounding, we’re looking at 47% increased odds of CHD. 

• Types of CHD: The most common defects were VSD’s (32%), followed by ASD’s, then patent ductus arteriosus(14%).

• Impact Estimate: Researchers estimates that maternal anaemia may account for around 1 in 20 CHD in the UK.

This has the potential to be a very high impact bit of research.  Heart defects are the most common birth defects, with 13 babies with CHD born a day. An estimated 25% of pregnant women in the UK have anaemia. A lot could be fixed with a bit of ferrous sulphate.

But let’s not get ahead of ourselves. Ultimately, it’s just an observational study. We can see the link, but we cannot prove the cause. Correlation ≠ causation. We need more research for that. 

Regardless, encouraging more iron in GPland or clinics never hurts.

RESEARCH UPDATE

💊 Anticoagualants + Ischaemic Stroke? A Truly Bad Idea

Okay, so picture this: you’re the stroke consultant. You have a patient with recurrent ischaemic stroke. You’ve already covered them with clopidogrel. What more can you do 🤔? Your apixaban is collecting dust because the patient doesn’t have AF. 

So the medical student on the ward asks “Hey, what if we gave this patient an anticoagulant anyway?”

How do we tell them that's a dumb ass idea, with professional and academic finesse? We are the consultant after all.

We might start by quoting the latest meta-analysis by Adamou et al. (2025), published in the International Journal of Stoke. 

This review aimed to assess if adding an oral anticoagulant to standard antiplatelet therapy could further reduce the risk of stroke recurrence in patients who otherwise don’t need it(no AF, DVT or PE history).

They had screened over 1,850 RCT’s and whittled it down to just 4 eligible studies. The inclusion criteria was RCTs comparing oral anticoagulants + antiplatelet vs antiplatelet alone. From those 4 studies, 6,893 patients were included. The outcomes studied were: Recurrence of ischaemic stroke, major haemorrhages and the net clinical benefits. 

Key findings:

• Ischaemic stroke recurrence: No significant difference between combination therapy and antiplatelet alone (OR 0.89, 95% CI 0.68–1.17).

• Covert brain infarcts (Detecting on MRI):  No significant difference(OR 1.06, 95% CI 0.86-1.31)

• Major Haemorrhages: Significantly higher risk with combination therapy compared to antiplatelet alone(OR 2.21 95% CI 1.25-3.90).

• Net clinical benefit: There was none (OR 1.12 95% CI 0.88-1.43)

The student is staring at you in awe of your scientific swagger. 

You conclude by saying, ‘whilst it may look appealing to intensify treatment in the face of persistent recurrence, the study shows the importance of adhering to evidence-based practice.’

Satisfied, you lean back and sip your lukewarm coffee.

NHS/MED-TECH NEWS

🤖 AI-Powered Boost For Cancer Detection

A new blood test that leverages AI is being funded by NHS England to detect cancer earlier with a 99% accuracy.

Enter miONCO-Dx. This is a multi-cancer early detection test from Xgenera; a Southampton uni spinout lab. The test only needs 100mL of blood to detect 12 cancers with the highest mortality and prevalence.  

The test trained an AI model to not only detect if cancer’s present, but to tell where it is. A place where the current golden child of cancer detection, Galleri, falls short. 

In an early analysis of 20,000 people, it detected the 12 cancers with a 99% accuracy. This information made the Health Secretary sit up and put down £2.4 million to run a new clinical trial on 8,000 people. 

The Department of Health and Social Care describe this as “a formal and significant step towards bringing the test closer to patients by ensuring it is fit for purpose in the NHS.”

This new study aims to evaluate the useability, accuracy and cost-effectiveness of the test to be used with the NHS. 

Xgenera co-founder Dr Andy Shapnis said “The hope is that if the test is shown to be successful in the early diagnosis of the 12 cancers we have currently identified biomarkers for, then it could be expanded to look at over 50 other cancers in the future”

If all goes according to plan this could have significant implications for cancers like bowel cancer. Which has a 90% survival rate in stage 1 and 10% in stage 4. So godspeed Xgenera 🫡

OTHER NEWS YOU SHOULD KNOW

• The GP Bribe: Plans for GP service expansion and reduced waitlists

• Lab-grown liver organoids with therapeutic potential

• NHS Scotland lost over £200 million in legal compensation

• Ozempic Baby: Fact or Fiction?

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