effectiveness

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
21 03, 2019

Paper of the Week 21.03.2019: Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years

2019-03-21T16:17:14+00:00

  This week’s paper of the week is brought to you by Professor Sir Muir Gray, 3V's Founding Director. Bottom line, chosen by Muir from the paper Among patients who were scheduled for CABG and had been randomly assigned to undergo bilateral or single internal-thoracic-artery grafting, there was no significant between-group difference in the rate of death from any cause at 10 years in the intention-to-treat analysis. The conclusion is This study shows that in the case of CABG more in healthcare is often no better. Once again Avedis Donabedian’s illustration about optimality has been demonstrated. Implications for value improvement  This is another example of the principle first described by Avedis Donabedian and expressed through his diagrammatic representation [...]

Paper of the Week 21.03.2019: Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years2019-03-21T16:17:14+00:00
2 01, 2019

Paper of the week 02.01.19: Evidence and values in the NHS

2019-01-02T14:14:45+00:00

Reference: Evidence and values in the NHS: choosing treatments and interventions well. Margaret McCartney and Sam Finnikin. Br J Gen Pract 2019;  69 (678): 4-5 This week’s paper of the week is brought to you by Professor Sir Muir Gray, 3V Executive Director. Bottom line (chosen from the paper) But there is a concern that ‘value’ as currently practised may mean monetary cost coming first, and may be used to describe the values of a balanced accounting sheet rather than the personal values of an individual patient. Higher-quality care may happen to be less expensive, but cost should not be the sole arbiter. Yet the opportunity cost of doctors having to explain why CCGs are no longer funding prescriptions for ‘self-limiting’ conditions, rather than doing [...]

Paper of the week 02.01.19: Evidence and values in the NHS2019-01-02T14:14:45+00:00
10 10, 2018

Paper of the week 10.10.18: Paying for Cures: Perspectives on Solutions to the “Affordability Issue”

2018-10-10T13:48:23+00:00

Reference: Paying for Cures: Perspectives on Solutions to the “Affordability Issue” Karlsberg Schaffer K et aljournal This weeks paper of the week is brought to you by Professor Sir Muir Gray, 3V Executive Director. Bottom line ‘We conclude that there is a mismatch between the enthusiasm in the academic literature for developing new approaches and the scepticism of payers that they can work or are necessary. For the foreseeable future, affordability pressures will continue to be handled by aggressive price bargaining, high co-pays (in systems in which this is possible), and restricting access to subgroups of patients. Of the mechanisms we explored, outcomes-based payments were of most interest to payers, but the costs associated with operating such schemes, [...]

Paper of the week 10.10.18: Paying for Cures: Perspectives on Solutions to the “Affordability Issue”2018-10-10T13:48:23+00:00
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