How can we measure the impact of research? What is impact, and how can we show that research leads to measurable outcomes for patients? On 10 May, Médecins Sans Frontières (MSF) held their annual scientific day, and the focus of the day was to try and answer some of these questions. There was also a focus on the role that technology and social media can play in measuring the impact of research. more…

We all know about obesity. We can see fatness. Obesity belongs to all of us, and it’s a global problem. Politicians care about obesity. But who cares about blood pressure? Raised blood pressure may be a bigger risk factor for premature death and suffering than obesity, but people don’t see it. Blood pressure belongs to doctors. Well, it’s time for a revolution. The people must claim blood pressure. more…

Walking up from the station, the Royal Berkshire Foundation Trust has a rather grand frontage. David Oliver, the consultant geriatrician who organised my day, guided me, by phone, round to the modern entrance and bought me a coffee. It was shortly before 8am and, on the hour, we dived into the maelstrom of the clinical decision unit. Over the next two hours I would watch and listen as a team of professionals tackled the problems posed by 17 elderly patients who had been admitted overnight. Only two patients were below the age of 80 and the first person we saw had cancer, heart disease, diabetes, anaemia, falls, and no help at home. more…

The first Core Outcome Measures in Effectiveness Trials (COMET) workshop in Japan took place, in April 2013, at Kyoto University, stimulating debate about how the Japanese research and practice community might engage with this international initiative and make use of core outcome sets. Toshiaki Furukawa (Professor and Chair, Department of Health Promotion and Human Behaviour Professor, Department of Clinical Epidemiology, Kyoto University) and Rintaro Mori (Head, Department of Health Policy National Centre for Child Health and Development, Tokyo), worked with three of the COMET team (Paula Williamson, Liz Gargon, and Mike Clarke) to deliver the workshop. I attended, along with 80 others from across Japan, including researchers, trialists, systematic reviewers, statisticians, healthcare providers, and clinicians. There were small group activities to discuss the problems with outcomes and the need for a more scientific approach to outcomes, how core outcome sets could help, and how we might develop and use core outcome sets in Japan. These discussions were informed by an introduction to the COMET Initiative and their activities. more…

Flying off to Berne to talk about general practice in the future, I met a GP colleague in the airport. A conversation contrasting theory and reality. Asked to talk to Swiss GPs about the best models of European general practice, with particular focus on the UK, I looked back on the effect of the 2004 GP contract, which was designed to help with poor morale and under payment—and introduced radical new changes with a performance related component to income (Quality and Outcomes Framework—QOF) and major changes to out of hours. more…

Readers of the Radio Times can visit locations used in the filming of Sir David Attenborough’s Africa on a tailor made tour offered by the 90 year old UK listings magazine. The Africa trip is one of dozens of destinations listed on RT Travel page and the latest example of how publishers are increasingly thinking like retailers to offer their readers everything from holidays to horticulture. more…

Hardly a new breakthrough, but gadgets relating to health, fitness, and wellbeing are on the increase. Pedometers, sleep monitors, diet apps, and so on, all remain very much in vogue. But, are medical gadgets really the way forward in healthcare? Do we want to be strung up to some monitoring gadget whilst we get on with daily living? Or are they merely a fascination that will pass?

Smartphones are cashing in on the publics want for a “quick fix” with regards to health, targeting its audience with the likes of weight loss apps. The health service may also be wise to embrace these advances. more…

Digital was definitely the catchword at a meeting of UK magazine publishers in London last week. Perhaps more surprising was how often the print medium emerged as a continuing focus in a conference about the rising number of digital platforms and channels.

At this meeting of the Professional Publishers Association’s (PPA), organisers presented the results of their annual bellwether survey, which found that an average 41% of revenue for UK publishers still derived from print, while 40% was from digital. The mood among those surveyed was also markedly buoyant compared to previous years, with respondents becoming more self assured about what lies ahead for publishing. more…

The prime minister has picked a new health advisor, Nick Seddon, who poured cold water on the creation of clinical commissioning groups and appears to be focused on moving NHS management away from public bodies and into the private sector. Whatever the rhetoric might suggest, changing the NHS into a commercial insurance model appears to be the dominant thinking in No. 10.

In July 2010, Nick Seddon, who was then the deputy director of the right wing think tank, Reform, was fairly damming about the white paper which proposed the creation of clinical commissioning groups. He said: more…

JAMA  8 May 2013  Vol 309
1903    When an implanted cardioverter defibrillator goes off inside you, you are sure to feel deeply shocked: whereas, for others, watching you drop dead might be even more shocking. One needs to strike a balance. That was the purpose of the ADVANCE III (Avoid Delivering Therapies for Nonsustained Arrhythmias in ICD Patients III) trial. Essentially this was a gamble on how many ventricular tachycardia beats are allowed to happen before the device fired: with current devices it is usually 18-24, whereas in this trial half the patients got a newly programmed device which counts to 30-40. They stayed alive as much, didn’t have more syncopal episodes, and had a third fewer shocks in the first year.
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