A culture that values research

In 1995 the extraction of wisdom teeth was among the most common surgical procedures with almost 130,000 operations conducted in England and Wales (Mark Henderson writes).

By 2001 that number had fallen to fewer than 60,000, saving the NHS more than £10 million, and all because doctors and dentists had learnt from evidence.

The impetus for change began with a study led by Professor Shepherd, which systematically compared health outcomes when impacted but uninfected wisdom teeth were removed and when they were left in place.

The research found no benefit to operating on healthy impacted teeth and also that the procedure carried significant risks, such as damage to facial nerves. The British Dental Association and the Royal College of Surgeons advised against the operation and in 2000 the National Institute of Health and Clinical Excellence ruled against the practice.

Professor Shepherd said: “It sounds trivial, but this was the most frequently performed operation in the private sector 10 to 15 years ago, and about the fourth-most-common in the NHS. Research prompted by what we were seeing came to the clear conclusion that it was not right to do prophylactic surgery. That was taken on board and now fewer of those operations take place.

“I feel very proud of what happened and it was the result of the way in which clinical schools in research-intensive universities work. It’s a culture that values research and innovation and integrates that into clinical practice. That’s the ethos we need to introduce into education and criminal justice.”

Writing target ‘beyond infants’

Under-fives are not the only ones struggling with schools’ demands for them to write simple sentences. The Government’s introduction of that target as part of the Early Years Foundation Stage caused an outcry among educationists (Alice Fishburn writes).

The contentious goals that children start to form simple sentences and use “phonic knowledge to write simple regular words” were two of 69 targets that became compulsory for schools last September. The Government’s own Early Education Advisory Group (EEAG) expressed concern that they might demotivate children.

Bernadette Duffy, head of the Thomas Coram Early Childhood Centre and a member of the EEAG, believes that research did not play much of a part in setting the target. “I think it was probably aspirational,” she says. “I don’t think it came from actual solid evidence that the majority of children could achieve that. The evidence has shown that most children can’t.”

Statistics indicate that only a third of children achieve those goals.

A freedom of information request by the Liberal Democrats revealed that the Government had not released all its findings. Research that showed the targets did not “seem crucial” was labelled inconclusive by the Department for Children, Schools and Families.

Dr Richard House, an education expert at Roehampton University, said that if the research had produced the findings the department wanted, it would have been cited as vindication. “It produced exactly the opposite results, so they kicked it into the long grass,” he said.

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