What do you think is the biggest medical advance since 1840?

The British Medical Journal has published a supplement on their picks for the top 15 advances in medicine since their launch in 1840. It includes computers, the discovery of DNA, antibiotics, anesthesia, figuring out how germs cause disease and how our body fights off infection, the importance of cleanliness and good hygiene, vaccination, and the risks of smoking, among others. Hey, Rachel - The pill made the list too!

When you read the list, you can't help but think about how lucky we are to benefit from all these advances, and how many lives have been saved or improved because of the changes.

If you're interested in this sort of thing, you have until the end of the day on Sunday to place your vote to help decide which of the 15 is crowned #1.

Related:The Hamilton Spectator did a nice piece on McMaster University's leading role in the development of the evidence-based medicine concept, the idea that clinical practice should be based on clinical expertise, the best relevant scientific research, and the values of the patient, which also made BMJ's list.

Update: And the winner is....
Sanitation, with almost 16% of the vote, followed by antibiotics in 2nd place and anaesthesia a close 3rd.

Richard Smith critique of medical journal publishing

Richard Smith, a former editor of the British Medical Journal, has published a book titled, "The Trouble With Medical Journals" (Amazon record and RSM Press description), based in part on his 13 years of experience as BMJ editor. There's an excerpt from the initial part of the book published in the March 2006 issue of the Journal of the Royal Society of Medicine; this article introduces the series:

"Medical journals, which many imagine to be as dull as telephone directories and twice as obscure, influence the lives of everybody—and not always for the better. Not only do they affect how doctors treat patients and the actions taken by public health authorities, they also influence how we think about birth, death, pain, and sickness. It may therefore make sense for you—the thoughtful but not necessarily expert reader—to pay attention to the ways of medical journals, particularly as many of those ways are deficient and need reform. That is the thesis of this series of articles. "

The full text of other excerpts from the text have been published in the same journal over the last couple of months.

Commentary on the book:
- "Medical Journals Slammed by Former Editor," Life Style Extra (UK)
- "The trouble with medical journals: bias, fraud, and lack of OA," Open Access News
- "How worthy is research?," The Times (UK)
- Royal Society of Medicine press release