NHS Health Check appears neither equitable nor cost-effective

NHS health checks may be missing the point when it comes to offering the optimal interventions and preventing cardiovascular disease. Carl Heneghan Since 2009 the NHS Health Check programme in England has added considerably to GP workload and has proved to be controversial given the uncertainty about whether it adds value. A Cochrane review found […]

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Overestimation of cardiovascular risk and what to do about it

  A New Zealand study sets new standards for predicting cardiovascular risk and questions the validity of pre-existing risk equations  Carl Heneghan Prevention of cardiovascular disease relies on identifying those most at risk. Most cohorts of patients were established many years ago with patients at higher risk. A recent prospective cohort study done in New Zealand representing primary care […]

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Evidence Watch: Can clinical decision support tools optimise anticoagulant therapy?

  High baseline adherence rates for guidelines recommendations means that a clinical decision support system makes only a small difference in clinical outcomes for atrial fibrillation patients.   Carl Heneghan The evidence for the association of atrial fibrillation with stroke risk is clear. However, there remain persistent levels of under treatment in clinical practice. Clinical decision […]

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Evidence Watch: should ‘rooming in’ be the norm?

  Evidence suggests rooming-in should be the norm in hospitals but what factors will limit uptake  Carl Heneghan Here’s what we selected this week: Daily vs intermittent antituberculosis therapy for pulmonary tuberculosis in patients with HIV a randomized clinical trial. JAMA Internal Medicine, 178(4), 485–493. Bottom line:  HIV-positive patients with pulmonary TB receiving antiretroviral therapy, do […]

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Frailty’s impact on mortality

  A systematic review concludes that frailty is a predictor of mortality, but does it aid decision making in practice? Carl Heneghan A recent systematic review included 18 cohort studies including 65,048 participants. The results suggested that higher Frailty index was significantly associated with higher mortality risk. For every 0.01 increase in the index the […]

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Adverse effects of antidepressants in younger adults

  SSRIs might have higher rates of fracture than tricyclic antidepressants but lower mortality and adverse reactions. Carl Heneghan Antidepressants are commonly prescribed. Yet, in those under 65, there is scant evidence on the risks associated with their use. A recent publication in BMC  looked at these risks in a cohort of 20 to 64-year […]

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