{ "format" : "linked-data-api", "version" : "0.2", "result" : {"_about" : "http://eldaddp.azurewebsites.net/answeredquestions.text?date=2015-07-01&answeringDeptId=17&uin=HL1034&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "definition" : "http://eldaddp.azurewebsites.net/meta/answeredquestions.text?date=2015-07-01&answeringDeptId=17&uin=HL1034&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "extendedMetadataVersion" : "http://eldaddp.azurewebsites.net/answeredquestions.text?date=2015-07-01&answeringDeptId=17&uin=HL1034&_metadata=all&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "first" : "http://eldaddp.azurewebsites.net/answeredquestions.text?date=2015-07-01&_page=0&answeringDeptId=17&uin=HL1034&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "hasPart" : "http://eldaddp.azurewebsites.net/answeredquestions.text?date=2015-07-01&answeringDeptId=17&uin=HL1034&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "isPartOf" : "http://eldaddp.azurewebsites.net/answeredquestions.text?date=2015-07-01&answeringDeptId=17&uin=HL1034&max-answer.questionFirstAnswered.=2018-09-13T11%3A16%3A38.953Z", "items" : [{"_about" : "http://data.parliament.uk/resources/386925", "AnsweringBody" : [{"_value" : "Department of Health"}
      ], "answer" : {"_about" : "http://data.parliament.uk/resources/386925/answer", "answerText" : {"_value" : "<p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p><p> <\/p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p><p> <\/p><p> <\/p><p> <\/p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p><p> <\/p><p> <\/p><p> <\/p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p><p> <\/p><p> <\/p><p> <\/p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p><p> <\/p><p> <\/p><p> <\/p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p><p> <\/p><p> <\/p><p> <\/p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p><p> <\/p>"}
        , "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
        }
        , "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
        , "attachment" : {"_about" : "http://data.parliament.uk/resources/386925/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
          , "title" : "BSCH Guidance"}
        , "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
        , "groupedQuestionUIN" : [{"_value" : "HL1032"}
        , {"_value" : "HL1033"}
        , {"_value" : "HL1035"}
        , {"_value" : "HL1036"}
        , {"_value" : "HL1042"}
        ], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
        , "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:41.947Z", "_datatype" : "dateTime"}
        ]}
      , "answeringDeptId" : {"_value" : "17"}
      , "answeringDeptShortName" : {"_value" : "Health"}
      , "answeringDeptSortName" : {"_value" : "Health"}
      , "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
      , "hansardHeading" : {"_value" : "Vitamin B12"}
      , "houseId" : {"_value" : "2"}
      , "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
      }
      ], "questionText" : "To ask Her Majesty\u2019s Government what steps they are taking to ensure that a reliable test to assess the vitamin B12 status of the United Kingdom population is made available as a means to prevent serious and irreversible neurological damage before any mandatory fortification of flour with folic acid is introduced.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
      , "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
      }
      , "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
      ], "uin" : "HL1034"}
    ], "itemsPerPage" : 10, "page" : 0, "startIndex" : 1, "totalResults" : 1, "type" : ["http://purl.org/linked-data/api/vocab#ListEndpoint", "http://purl.org/linked-data/api/vocab#Page"]}
}