13 02, 2020

A Prescription for Longevity in the 21st Century

2020-02-13T13:10:34+00:00

Paper of the Week: 13th February 2020 This week’s blog is brought to you by: Professor Sir Muir Gray, Founding Director Full reference and title from the journal: A Prescription for Longevity in the 21st Century Renewing Purpose, Building and Sustaining Social Engagement, and Embracing a Positive Lifestyle Pizzo P.A. (2020), JAMA. Published online January 9, 2020. doi:10.1001/jama.2019.21087 Authors conclusion An assessment of an individual’s sense of purpose, social engagement, and lifestyle choices constitute a triad associated with longevity and should be part of the health assessment. Furthermore, a plan should be developed between the physician and patient about how purpose, community, and wellness will be fostered and enhanced…. While these associations are not new, their benefits for [...]

A Prescription for Longevity in the 21st Century2020-02-13T13:10:34+00:00
5 02, 2020

Rising to the challenge of multimorbidity

2020-02-05T11:55:30+00:00

Paper of the Week: 5th February 2020 This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Whitty C.J.M.et al 2020, BMJ 2020;368:l6964 doi: 10.1136/bmj.l6964 (Published 6 January 2020) Link to paper: https://www.bmj.com/content/bmj/368/bmj.l6964.full.pdf The paper’s bottom line “Cluster medicine the shift includes moving from thinking about multimorbidityas a random assortment of individual conditions to recognising it as a series of largely predictable clusters of disease in the same person….Continued increases in healthy longevity depend on this different model. Clustering of diseases, and how we might better tackle management of coexisting physical and mental health problems, should be embedded into medical training and continuous” 3vh bottom line The Third Dimension [...]

Rising to the challenge of multimorbidity2020-02-05T11:55:30+00:00
30 01, 2020

The 21st Century is the century of networks: are clinical networks the future way to organize healthcare?

2020-01-30T11:11:23+00:00

Paper of the Week: 30th January 2020 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Managing the performance of general practitioners and specialists referral networks: A system for evaluating the heart failure pathway. SabinaNutiaFrancescaFerréaChiaraSeghieriaElisaForesiaTherese A.Stukelb Health Policy Volume 124, Issue 1, January 2020, Pages 44-51 Web link to paper https://www.sciencedirect.com/science/article/pii/S0168851019302581 Authors conclusion The aim of this paper is to identify and evaluate the performance of naturally occurring networks of GP's and hospital-based specialists providing care for congestive heart failure (CHF) patients in Tuscany, Italy. They demonstrate the existence of informal links between GP's and hospitals based on patterns of patient flow. An integrated approach to evaluation and performance management that [...]

The 21st Century is the century of networks: are clinical networks the future way to organize healthcare?2020-01-30T11:11:23+00:00
21 01, 2020

The Top Ten from the NEJM in 2019

2020-01-21T11:11:44+00:00

Paper of the Week: 21st January 2020 This week’s blog is brought to you by: Dr Muir Gray This is a free pdf with the full articles and accompanying editorials https://cdn.nejm.org/pdf/Notable-Articles-of-2019.pdf Authors conclusion We know that physicians need the best information in order to advise patients and to identify these vaping-related illnesses. In early September, we published a report on pulmonary illness related to e-cigarette use in Illinois and Wisconsin. The 53 cases described in this report had patterns of pneu­monitis that included acute eosinophilic pneumonia, organizing pneumonia and lipoid pneumonia, among others. Products that contained THC were the most commonly reported e-cigarette product exposure. 2019 will be remembered for emergence of vaping-related disease and this article was [...]

The Top Ten from the NEJM in 20192020-01-21T11:11:44+00:00
13 01, 2020

‘Scan because you can’, and ‘boys and toys’. Answering the question of why we persist with low value care.

2020-01-13T15:21:19+00:00

Paper of the Week: 13th January 2020 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Biases distorting priority setting: BjørnHofmann Health Policy, Volume 124, Issue 1. January 2020. Pages 52-60. Link to paper click here Authors conclusion: Despite vast challenges and extensive efforts, the outcomes of practical priority setting are scarcely documented. Why is this so? This is the key question of this study. That is, why are the outcomes of priority setting so poorly documented, e.g. in reducing low-value care, when the principles, regulations, and tools for priority setting are fairly well developed? The author looks briefly at some rational explanations for the discrepancy between theoretical efforts [...]

‘Scan because you can’, and ‘boys and toys’. Answering the question of why we persist with low value care.2020-01-13T15:21:19+00:00
6 01, 2020

Papers of the decade in JAMA

2020-01-07T09:42:10+00:00

Paper of the Week: 6th January 2020 This week’s blog is brought to you by: Professor Sir Muir Gray and Dr Joe McManners These articles have been selected by our editors as the most important published by JAMA between 2010 and 2019. Click below to read them for free.  The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Mervyn Singer, MD, FRCP; Clifford S. Deutschman, MD, MS; Christopher Warren Seymour, MD, MSc; et alManu 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) Paul A. James, MD; Suzanne Oparil, MD; Barry L. Carter, PharmD; et al Antibiotic Therapy vs Appendectomy [...]

Papers of the decade in JAMA2020-01-07T09:42:10+00:00
20 12, 2019

Society wants fair, not utilitarian, approaches to value

2019-12-20T07:38:19+00:00

Paper of the Week: 20th December 2019 This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: Funding orphan medicinal products beyond price: sustaining an ecosystem , Author- De Sola-Morales, Oriol, The European Journal of Health Economics (2019) 20:1283–1286 Web link to paper: https://doi.org/10.1007/s10198-019-01047-0 Authors conclusion: “it is not the individual price that matters, but whether the overall budget impact is perceived as acceptable and that manufacturers have an accept- able profit.” 3V bottom line: Ideally, a decision whether a treatment or intervention should be used in a health system is largely be driven by value and values. In the case of effective but expensive treatments for rare conditions, societal [...]

Society wants fair, not utilitarian, approaches to value2019-12-20T07:38:19+00:00
10 12, 2019

What happens when you lose access to Primary Care?

2019-12-10T15:16:27+00:00

Paper of the Week: 10th December 2019 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Association Between a Temporary Reduction in Access to Health Care and Long-term Changes in Hypertension Control Among Veterans After a Natural Disaster Aaron Baum, PhD; Michael L. Barnett,MD, MS; Juan Wisnivesky,MD, DrPH; Mark D. Schwartz, MD. JAMA Network Open. 2019;2(11):e1915111. doi:10.1001/jamanetworkopen.2019.15111 (Reprinted) November 13, 2019 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755309 Authors conclusion: The authors used the temporary closure of a primary healthcare facility as a natural experiment to examine the association between a temporary decrease in health care access and long-term control of hypertension, diabetes, and hypercholesterolemia. The period of decreased access to healthcare services was associated [...]

What happens when you lose access to Primary Care?2019-12-10T15:16:27+00:00
2 12, 2019

Resources the same size as the annual GDP of Holland are wasted every year in the US health system, but there are solutions.

2019-12-10T15:17:12+00:00

Paper of the Week: 2nd December 2019 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Waste in the US Health Care System; Estimated Costs and Potential for Savings William H. Shrank, MD, MSHS1; Teresa L. Rogstad, MPH1; Natasha Parekh, MD, MS2 JAMA. 2019;322(15):1501-1509. https://jamanetwork.com/journals/jama/article-abstract/2752664 Authors conclusion: In this review, based on 6 previously identified domains of health care waste, the authors estimate the cost of waste in the US health care system to between $760 billion to $935 billion, this is approximately 25% of total US health care spending. The projected potential savings from interventions that reduce waste, (excluding savings from administrative complexity), range from $191 billion to $282 billion, representing a potential 25% reduction in the [...]

Resources the same size as the annual GDP of Holland are wasted every year in the US health system, but there are solutions.2019-12-10T15:17:12+00:00
18 11, 2019

Can equity be measured as accurately as quality?

2019-11-18T11:02:01+00:00

Paper of the Week: 18th November 2019 This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Whitehead J. et al (2019), How can the spatial equity of health services be defined and measured? A systematic review of spatial equity definitions and methods, Journal of Health Services Research & Policy Vol. 24(4) 270–278, DOI: 10.1177/1355819619837292. https://journals.sagepub.com/doi/abs/10.1177/1355819619837292?journalCode=hsrb Authors conclusion There appeared to be general agreement that spatial equity is difficult to define…Although a wide variety of methods were used, the Gini coefficient was identified as the most common method of spatial equity analysis. 3V bottom line Equity is difficult to measure accurately but it should be included in every report [...]

Can equity be measured as accurately as quality?2019-11-18T11:02:01+00:00