GlossaryPod – Overuse and Underuse
ruth brice2021-04-30T08:26:12+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 [...]
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 [...]
Reference: Has the Long Term Plan forgotten we are all going to die? (Bleakley T., Smith R., Taylor R) 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 "One certainty is that there will be a lot of dying in the next 10 years as the baby boomers become the dying boomers... Increasingly, people endure slow deaths of frailty, often with dementia in the final years. Increased life expectancy is generally regarded as a cause for celebration, but many people fear dependency and dementia more than they fear death... Between a quarter and a third of health-care expenditure is for care [...]
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. [...]
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, [...]