I read yet again that the BNF are refusing to change treatment guidelines because treatment has to be based on scientific evidence.
How I so wish the BNF and their ilk would put forward the scientific evidence which supports the guidelines they CURRENTLY provide - because I have yet to find it - and that includes asking the BNF for it.
How on earth can they say that new guidelines can only be formulated on scientific evidence when the old guidelines don't have any scientific evidence?
The only scientific evidence they do have is that injections of b12 will reverse serum b12 levels quite easily (reticulocyte counts usually improve after 6 days) - who cares!
Oh, I know, the scientists who, for decades, have been mistaking this neurological condition for a haematological one.
I think also that I would like to come out and say a word in defence of doctors here - If you go onto the BMJ Vitamin b12 Hunt article and check out the CME section - although it only shows a few comments made by doctors, the roll on and roll off, you can clearly see that many doctors are now starting to 'get it.' But the one thing they are asking for is clearer instruction on how to treat in primary care.
What appears to be happening is that although bodies such as NICE, BNF, NEQAS etc have had this information thrust under their noses (unless they've been living under a rock for the past 3 months) they are still sticking with their abstention from responsibility pose.
In short they are leaving doctors with the sticky end!