GlossaryPod – Variation
ruth brice2021-04-23T07:43:41+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 [...]
This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director. Authors conclusion Cost-conversation practice certainly will not make us perfect, given the logistical and informational barriers that exist. However, it will move us closer to the kind of patient-centered care that characterizes the ideals of our profession. Text from the paper chosen by 3VH (this may, or may not be the ‘conclusion’) Out-of-pocket expenditures have increased rapidly in the United States over the past decade. In 2018, 29% of people with private insurance were enrolled in high-deductible health plans, compared with just 4% in 2006. Out-of-pocket costs are high for many publicly insured people, too. Medicare beneficiaries with cancer who do not [...]
Warraich, H. J., & Meier, D. E. (2019). Serious-Illness Care 2.0 — Meeting the Needs of Patients with Heart Failure. New England Journal of Medicine, 380(26), 2492–2494. https://doi.org/10.1056/NEJMp1900584 WEB LINK TO PAPER This week's paper of the week is brought to you by Dr Tim Wilson, Managing Director Authors conclusion Heart failure is the most common cause of hospitalizations among elderly Americans, and despite much medical and scientific progress, it remains a source of substantial suffering, expense, and caregiver burden. Palliative care can improve quality of life, symptoms, and functioning for people with serious illnesses, and a recent observational study in patients with heart failure showed that enrollment in home hospice was associated with fewer emergency [...]
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 [...]
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 [...]
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 [...]
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, [...]
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 [...]
Full reference: MA. Published online April 15, 2019. doi:10.1001/jama.2019.4310 This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director Authors conclusion “The rationale for using HbA1c level as a surrogate for diabetes outcomes is predicated on the assumption of its direct correlation with outcomes that patients ultimately value, including clinical microvascular disease (eg, ESKD and need for dialysis, blindness, neuropathic pain, amputation), macrovascular disease (eg, myocardial infarction, stroke, painful neuropathy), quality of life, and death. Yet, the strength of this relationship has been called into question. Meta-analyses revealed a null association between intensive glycemic control and these patient-important outcomes, with the sole exception of a 10% to 15% relative risk reduction of nonfatal myocardial [...]