“Not long ago—and you can’t even believe these numbers—one in 10 000 children have autism . . . And now it’s one in 36. There’s something wrong,” Donald Trump told the US Congress on 4 March. Since he took office for the second time in January 2025 autism has been on the agenda for both Trump and Robert F Kennedy Jr. The US health secretary has controversially spoken out on the issue, linking childhood vaccines to autism and advocating alternative, often unproved, treatments. In a press event on 18 April Kennedy said that people with autism “will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go on a date, many of them will never use a toilet unassisted.” In March Kennedy’s Department for Health and Human Services (HHS) announced that the Centres for Disease Control and Prevention (CDC) will conduct a large study to investigate a possible link between vaccines …

Clinical research is being contaminated by flawed or biased evidence, which negatively impacts daily evidence based clinical practice, write Fuchen Liu and colleagues As clinicians, we navigate complex decision making in our daily clinical practice. These decisions are based on our expertise, guided by clinical guidelines, and grounded in the most up-to-date evidence. An important part of evidence based medicine involves critically appraising emerging evidence from clinical trials and systematic reviews to provide valuable insights that inform clinical decision making. Research by our team published in The BMJ explores the potential contamination of evidence by problematic trials within the evidence ecosystem.1 Through this work, we aimed to understand how flawed or biased trials could distort the broader body of evidence. This project offered a sobering realisation: evidence contamination is an escalating issue that undermines the reliability of current evidence. This growing challeng

A “culture of blame” often discourages NHS doctors and other staff from speaking up about the effects of fatigue on the safety of patients, a report has warned. The Health Services Safety Investigations Body (HSSIB) said that fatigue among healthcare staff contributed directly and indirectly to patient harm but was not routinely captured or considered in patient safety event reporting or learning reviews. In a report detailing the findings of its investigation into the issue,1 the agency warned that fatigue in healthcare was often misunderstood and viewed as a staff wellbeing issue rather than a critical patient or staff safety risk. The report’s authors found, through interviews, site visits, and data analysis, that healthcare staff in England were wary of speaking up for fear of disciplinary …

Judith Steel was pivotal in enabling women with diabetes to have safe pregnancies and give birth to healthy babies. She recognised that the increased rates of obstetric complications and congenital abnormalities in women with diabetes and their babies were not an inevitable consequence of the disease—they could be mitigated through control of blood sugar, not only during but also pre-pregnancy. In 1976 Steel and obstetrician Frank Johnstone set up what is thought to be the first pre-pregnancy diabetes clinic at the Simpson Memorial Pavilion in Edinburgh. Because it was recognised that early gestation was the time when congenital abnormalities occurred, targeting women before they became pregnant was key. Women between the ages of 14 and 40 were invited to attend a clinic where pregnancy and the importance of control of diabetes through medication and diet were discussed. A paper on the first five years of the clinic highlighted the difficulties women faced—motivation was initially high

US citizens seeking information about covid-19 on the government’s official covid websites are now redirected to a page asserting that the coronavirus was leaked from a lab in Wuhan, China, and condemning the former US covid adviser Anthony Fauci. The Covid.gov website used to offer US citizens information on how to stay safe from the novel coronavirus and help people stay up to date with their vaccinations. But as of 18 April, visitors to the page found the usual information replaced by a landing page with an image of Donald Trump over a backdrop of the words “LAB LEAK.” “By nearly …