populations

5 07, 2019

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)

2019-07-05T17:19:32+00:00

Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Richard Cookson (2018) Socioeconomic inequality of access to healthcare: Does choice explain the gradient? Journal of Health Economics, 57, 290–314.   This week's blog is brought to you by: Dr Tim Wilson   Bottom Line For planned vascular surgery, there is inequity in NHS provision for people living in the poorest and wealthiest neighbourhoods, representing an addressable cause of lower value.   Authors conclusion Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities of access by socioeconomic status may result from differences in patients’ choices. Using data on non-emergency coronary revascularisation procedures in the English National Health Service, we found substantive differences in waiting times within [...]

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)2019-07-05T17:19:32+00:00
28 06, 2019

Paper of the Week 28th June 2019: The Precision of Evidence Needed to Practice “Precision Medicine”

2019-06-28T12:29:34+00:00

    This weeks Paper of the Week is brought to you by: Professor Sir Muir Gray   Author’s Conclusion “In July 2018, the Journal published the results of TAILORx (Trial Assigning Individualized Option for Treatment).1 This randomized trial conducted by Sparano et al. showed the noninferiority of endocrine therapy to chemoendocrine therapy with respect to invasive disease–free survival among women with hormone-receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative, axillary node–negative breast cancer who had a recurrence score (based on a 21-gene assay) of 11 to 25 (scores range from 0 to 100, with higher scores predicting a higher risk of distant recurrence)… Less than a year later, we are publishing additional results from the same data [...]

Paper of the Week 28th June 2019: The Precision of Evidence Needed to Practice “Precision Medicine”2019-06-28T12:29:34+00:00
21 06, 2019

Paper of the Week 21st June 2019: What Are Polygenic Scores and Why Are They Important?

2019-06-21T09:24:07+00:00

Full reference: Sugrue L.P. and Rahul S. Desikan, R.S JAMA May 14, 2019 Volume 321, Number 18 1820 -1821 This weeks blog is brought to you by: Professor Sir Muir Gray WEB LINK TO PAPER Authors conclusion - Text from the paper chosen by 3VH Value “The value of polygenic risk scores cannot be assessed until the clinical utility has been established through research studies that evaluate their use in clinical practice and therapeutic trials. Companies are already offering these tests directly to consumers at costs ranging from one to a few hundred dollars. As whole-exomesequencing and whole genomesequencing become less expensive and more widely available, it should be possible to compute any polygenic score from an individual’s [...]

Paper of the Week 21st June 2019: What Are Polygenic Scores and Why Are They Important?2019-06-21T09:24:07+00:00
14 06, 2019

Paper of the Week: The health equity measurement framework: a comprehensive model to measure social inequities in health

2019-06-14T11:26:50+00:00

Full reference: Dover D.C. and Belon A.P.(2019) International Journal for Equity in Health 18;36 WEB LINK TO PAPER   This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director   Authors conclusion; Text from the paper chosen by 3VH. This paper presented a complex, overarching measurement framework for health equity.  The HEMF is a synthesis of existing SDOH (Social Determinants of Health) and health system utilisation frameworks and current literature.  Yet, its purpose extends to focus on measurement. It is specifically designed to help identify and measure the interrelationships between political and socio-cultural context, health system-related policies and programs, material and social circumstances, environment, biological and psychosocial factors, perceived and evaluated needs, social location, [...]

Paper of the Week: The health equity measurement framework: a comprehensive model to measure social inequities in health2019-06-14T11:26:50+00:00
7 06, 2019

Paper of the Week: Optimality in cancer redefined for the 21st century

2019-06-07T08:00:07+00:00

This weeks blog is brought to you by: Sir Muir Gray, Founding Director   Authors conclusion “I’ve always had a peculiar fascination for the receiver-operating characteristic (ROC) curve. As a researcher, I appreciate that the area under the curve can be precisely mapped, so that different screening or diagnostic tests can be meaningfully compared. This lovely interweaving of my clinical and academic perspectives took an unexpected turn just over a year ago, when I was diagnosed with breast cancer. I hadn’t reckoned on the price of treatment. The complications. The treatment of complications. The side effects of the treatment of complications. The sepsis. The relapsing, migratory pneumonia from radiation-induced lung injury. The sleep deprivation, agitation, and bone loss [...]

Paper of the Week: Optimality in cancer redefined for the 21st century2019-06-07T08:00:07+00:00
10 05, 2019

Paper of the Week: 10th May 2019: Better payment systems can support, but not replace, culture change

2019-05-10T08:24:07+00:00

  Full reference: Maryland’s Experiment With Capitated Payments For Rural Hospitals: Large Reductions In Hospital-Based Care. Jesse M. Pines, Sonal Vats, Mark S. Zocchi, Bernard Black. (2019) HEALTH AFFAIRS . Vol. 38, NO. 4 Link to Paper This week’s blog is brought to you by: Dr Tim Wilson, Managing Director Authors conclusion Inpatient admissions and outpatient services fell sharply at [study] hospitals, increasingly so over the period that [capitated payment] was in effect. Emergency department (ED) admission rates declined 12 percent, direct (non-ED) admissions fell 23 percent, ambulatory surgery center visits fell 45 percent, and outpatient clinic visits and services fell 40 percent. However, for residents of [capitated payment] counties, visits to all Maryland hospitals fell by lesser amounts and Medicare spending increased, [...]

Paper of the Week: 10th May 2019: Better payment systems can support, but not replace, culture change2019-05-10T08:24:07+00:00
27 03, 2019

Paper of the Week 27.03.2019: Toward Precision Policy — The Case of Cardiovascular Care

2019-03-27T16:12:11+00:00

This week’s paper of the week is brought to you by Professor Sir Muir Gray, 3V’s Founding Director. Author’s conclusion “If we are serious about improving quality of care and patient outcomes — whether mortality, readmissions, or patient centered [clinical] outcomes such as freedom from angina or heart failure symptoms — we have a responsibility to ensure that policies are grounded in evidence. We believe it’s imperative that before policies are implemented widely, rigorous studies be conducted to determine whether they achieve their goals. In addition to taking an evidence- first approach to policy implementation, we can better target policies toward specific diseases… As we move toward precision medicine and the delivery of diagnostic and therapeutic advances individualized [...]

Paper of the Week 27.03.2019: Toward Precision Policy — The Case of Cardiovascular Care2019-03-27T16:12:11+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
14 03, 2019

Paper of the Week 14.03.2019: Digital Smoking Cessation

2019-03-14T11:01:16+00:00

  Reference: Tang, J., & Liao, Y. (2018). Effectiveness of a text messaging-based smoking cessation intervention (Happy Quit) in China: a randomised controlled trial. The Lancet, 392, S6.  https://doi.org/10.1016/S0140-6736(18)32635-7 This week’s paper of the week is brought to you by Dr Tim Wilson, 3V’s Managing Director. Bottom line, chosen by Tim from the paper “a mobile phone-based text messaging intervention (Happy Quit), with either high-frequency or low-frequency messaging, is effective to Chinese cigarette smokers. It should be considered for inclusion in smoking cessation services. … One limitation is that we could not prevent participants from using other smoking cessation services.” Smoking cessations services are generally going to be a higher value intervention, so finding lower cost ways of [...]

Paper of the Week 14.03.2019: Digital Smoking Cessation2019-03-14T11:01:16+00:00
7 03, 2019

Paper of the Week 07.03.2019: Future Directions in Valuing Benefits for Estimating QALYs: Is Time Up for the EQ-5D?

2019-03-07T12:21:36+00:00

Reference: Brazier J. E. et al (2019  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 This raises the issue of what is meant by “well-being.” A broad conception of well-being is how well an individual’s life is going on. Subjective well-being (SWB) has been described or categorised into 3 types: hedonism (well-being increases when an individual experiences more pleasure and/or less pain), flourishing theories (well-being increases when an individual fulfils their nature as a human being, or “flourishes”), and life evaluation or life satisfaction (well-being increases when an individual positively assesses his or her life). The notion of SWB is [...]

Paper of the Week 07.03.2019: Future Directions in Valuing Benefits for Estimating QALYs: Is Time Up for the EQ-5D?2019-03-07T12:21:36+00:00
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