References
RESEARCH ROUNDUP

Abstract
George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
In this editorial, Southport-based GP Dr David Unwin (2024) recalls the ineffective ‘standard advice’ he gave to his patients on weight loss, eg ‘eat less, move more’, ‘everything in moderation’, calorie counting as part of a low-fat diet. Then 11 years ago ‘an angry patient asked me why I had never discussed reducing dietary carbohydrates as a way to lose weight and improve blood sugar.’ Since implementing this approach with prediabetic and type 2 diabetes patients, Unwin's team have achieved significant improvements.
Unwin also notes that while randomised controlled trials (RCTs), systematic reviews and meta-analyses of RCT are at the top of the evidential hierarchy, ‘[i]t has become obvious to me that we should question the utility of this model … particularly in the world of nutrition and health.’ Unwin believes that without clinical expertise, medical practice risks becoming tyrannised by evidence, since even good external evidence may be inapplicable to or inappropriate for an individual patient. Without the best current evidence, Unwin contends, practice risks becoming outdated, to the detriment of patients. While it is necessary to have evidence-based practice – derived from RCTs, for example – Unwin argues that ‘practice-based evidence’ is also needed. Clinicians have a lot of data, Unwin asserts, especially around weight and other measures of metabolic health: ‘Our computer systems make it more accessible than ever before, let us use it!’
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