diagnosis

26 04, 2019

Paper of the Week: 26th April 2019: Shared Decision Making and the Importance of Time

2019-04-26T12:46:40+00:00

  For many professionals, and almost all patients , the value of time is more precious than money Full reference: Pieterse A.M., Stiggelbout A.M.,  Montori V.M. JAMA. Published online April 19, 2019. doi:10.1001/jama.2019.3785 This weeks Paper of the Week is brought to you by Sir Muir Gray, Founding Director. WEB LINK TO PAPER Authors conclusion “health care professionals, patient advocates, health care systems, and policy makers need to recognise that time is not simply a resource, its minutes indifferent and interchangeable like dollars or euros. A minute spent in providing information may turn out to be less important than a minute spent waiting silently for patient questions, or a minute responding emphatically to angst and loss, or a [...]

Paper of the Week: 26th April 2019: Shared Decision Making and the Importance of Time2019-04-26T12:46:40+00:00
11 04, 2019

Paper of the Week: 11.04.2019: Breast Cancer Treatment, what to start, what to stop?

2019-04-11T17:36:53+00:00

Full Reference: Overall Survival with Fulvestrant plus Anastrozole in Metastatic Breast Cancer, Rita S. Mehta, Et al, N Engl J Med 2019; 380:1226-1234, DOI: 10.1056/NEJMoa1811714 Web link to Paper  This week’s blog is brought to you by: Dr Tim Wilson Authors conclusion In this trial, we found that combination therapy with anastrozole plus fulvestrant significantly prolonged, as compared with treatment with anastrozole alone, the primary and secondary end points of progression-free survival (P=0.007) and long-term overall survival (P=0.03) when used as first-line therapy for hormone-receptor–positive metastatic breast cancer in postmenopausal women. 3VH - Implications for value Another promising treatment emerges for breast cancer. Not a cure, but one that prolongs survival from 42 to 49.8 months in women [...]

Paper of the Week: 11.04.2019: Breast Cancer Treatment, what to start, what to stop?2019-04-11T17:36:53+00:00
10 01, 2019

Paper of the week 10.01.19: International variation in radiation dose for computed tomography examinations

2019-01-10T12:00:47+00:00

Reference: International variation in radiation dose for computed tomography examinations: prospective cohort study. Rebecca Smith-Bindman et al BMJ 2019;364:k4931 This week’s paper of the week is brought to you by Professor Sir Muir Gray, 3V Executive Director. Bottom line The authors conclusion was that: Variation was chiefly driven by how machines were used, rather than by patient or machine manufacturer or model.       Implications for value improvement  This is an example of what has been called a ‘one tailed curve’ namely a distribution curve where we are clear about what is good and what is not good. In this case lower doses are better than higher doses because there is no evidence that the higher dose improves outcome. [...]

Paper of the week 10.01.19: International variation in radiation dose for computed tomography examinations2019-01-10T12:00:47+00:00
21 12, 2018

Paper of the week: Temporal trends in use of tests in UK primary care

2018-12-21T10:47:25+00:00

This weeks paper of the week focuses on 'Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests'. Listen to the podcast to hear author Jack O'Sullivan talk about this paper with 3V's Dr Tim Wilson Reference: O’Sullivan Jack W, Stevens Sarah, Hobbs F D Richard, Salisbury Chris, Little Paul, Goldacre Benet al. Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests BMJ 2018; 363 :k4666 3V's Bottom Line There has been an 8% per annum increase in testing in UK primary care. Some of this increase will represent better monitoring or attempts to make earlier diagnoses. But some may represent overuse of testing, and certainly the impact of the increase is not just in the cost of testing, [...]

Paper of the week: Temporal trends in use of tests in UK primary care2018-12-21T10:47:25+00:00
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