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Qual Saf Health Care 2002;11:118 doi:10.1136/qhc.11.2.118
  • Commentary
  • Surgery for glue ear

Impact of national guidelines on use of surgery for glue ear in England

  1. D Keeley
  1. Correspondence to:
 Dr D Keeley, General Practitioner, Thame, Oxon OX9 3JZ;
 yc23{at}dial.pipex.com

    Change in practice follows Effective Health Care bulletin—post hoc or propter hoc?

    A significant proportion of medical activity is based on custom and practice rather than on sound evidence of effectiveness. It is a matter of concern worldwide to understand how best to encourage doctors to stop doing things that don't work. The paper by Black and Hutchings1 in this issue of QSHC offers a fascinating account of the time trends in rates of surgery for glue ear and the possible impact of the 1992 Effective Health Care bulletin which outlined the reasons to doubt the effectiveness of this common surgical procedure.2

    Rates of …

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