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Found 471 results
  1. Content Article
    In the area of patient safety, recent attention has focused on diagnostic error. The reduction of diagnostic error is an important goal because of its associated morbidity and potential preventability. A critical subset of diagnostic errors arises through cognitive errors, especially those associated with failures in perception, failed heuristics, and biases; collectively, these have been referred to as cognitive dispositions to respond (CDRs). The author of this paper, published by Academic Medicine, provides an extensive list of CDRs and a list of strategies to reduce diagnostic errors.
  2. Content Article
    Authors of this journal piece, published by The American Journal of Medicine, present a comprehensive review of the available literature and current thinking related to diagnostic error. The review covers the incidence and impact of diagnostic error, data on physician overconfidence as a contributing cause of errors, strategies to improve the accuracy of diagnostic decision making, and recommendations for future research.
  3. Content Article
    Within the research community, there is no consensus on the definition of diagnostic error, in part due to the complexity of diagnosis. This paper, published by Diagnosis, looks at the challenges in defining and measuring diagnostic error.
  4. Event
    until
    A FREE and LIVE virtual event made up of five educational webinars, Tuesday 8th - Thursday 10th September 2020. Co-produced by BD and Health Plus Care. Looking at the blood culture pathway is relevant to all of us right now. The crossover in symptoms between coronavirus and sepsis, means early diagnosis is even more urgent. We are all moving away from the mentality of 'just in time' to 'just in case'. Our speakers have been handpicked for their expertise in diagnostics, in clinical settings, and as known advocates for patient safety. They will examine what methods and best practices are available, as well as reflecting on the current mood and change in priorities within healthcare. This is against a backdrop of UKI guidelines, the UK’s diagnostic strategy and what the future of blood cultures could look like. You will have the chance to hear real life UK customer stories, and our final session will end with a panel discussion chaired by Ed Jones, former Chief of Staff to the UK Foreign Secretary, Jeremy Hunt MP. The panel features Lord O’Shaughnessy, and Dr Ron Daniels, and will tackle the issues around blood cultures and testing in the current COVID-19 climate. Further information and registration
  5. News Article
    Hospitals are not equipped to deal with the surge in screenings and tests as the health service restarts care – leaving patients facing delays in diagnosis and treatment for conditions including cancer, according to medical leaders. As the NHS tries to recover from the worst of the coronavirus crisis, more than a million laboratory samples from cancer screening services are expected in pathology labs, while as many as 850,000 delayed CT and MRI scans need to be carried out. But 97% of labs do not have enough pathologists to carry out the work – with staff already working unpaid hours to tackle the existing backlog – while the number of radiology posts nationally would need to be increased by a third to deal with the rise, experts say. Precautions to protect against the spread of coronavirus also limits the number of scans that can be carried out. The royal colleges of pathologists and radiologists warned that cancers would go undiagnosed and treatments for all patients across the NHS could be further delayed as a result. Read full story Source: The Independent, 27 August 2020
  6. Content Article
    With a lot of medical care on hold during the coronavirus pandemic, Paul Landau, founder and CEO of digital cancer care company Careology, looks at the UK’s ‘next big crisis’.
  7. Content Article
    Although millions of patients with cancer around the world face delays in diagnosis and treatment because of the diversion of resources during the COVID-19 pandemic, there is a growing expectation that telemedicine may play a central role in easing the backlog. This Lancet Digital Health article explores how telemedicine will be key as healthcare systems move forward in tackling the backlog in not only cancer treatment but also diagnosis, and how augmented intelligence (AI) could be used to help to optimise its use.
  8. News Article
    Screening women for breast cancer from their 40s rather than their 50s could save lives without adding to the diagnosis of harmless cancers, a UK study has found. The research was based on 160,000 women from England, Scotland and Wales, followed up for around 23 years. Lowering the screening age could save one life per 1,000 women checked, the scientists say. But experts caution there are many other considerations, including cost. Cancer Research UK says it is still "not clear if reducing the breast screening age would give any additional benefit compared to the UK's existing screening programme". The charity says the priority should be getting cancer services "back on track" for women aged 50-70, after disruption caused by the pandemic. Read full story Source: BBC News, 13 August 2020
  9. Content Article
    In this article, published by The Justice Gap, Theo Huckle QC discusses the issue of people not receiving treatment because of diversion of pre-existing NHS resources to the fight against the COVID-19 pandemic. There are legal issues which arise about the rights of citizens to receive – and continue to receive – treatment from their health service. What are those rights and what right do Governments in the UK or the health Trusts have to reduce services and not treat existing patients because of the current global health crisis?
  10. News Article
    A survey of members of the Royal College of Physicians (RCP) has found that almost two thirds (60%) of doctors worry that patients in their care have suffered harm or complications following diagnosis or treatment delays during the pandemic, while almost all doctors (94%) are concerned about the general indirect impact of COVID-19 on their patients. This is also compounded by the difficulty doctors are finding in accessing diagnostic testing for their patients. Only 29% of doctors report experiencing no delays in accessing endoscopy testing (one of the main diagnostic tests used by doctors) for inpatients, decreasing to just 8% for outpatients. Only 5% of doctors feel that their organisations are fully prepared for a potential second wave of COVID-19 infection, and almost two thirds (64%) say they haven’t been involved in any discussions about preparations for a second wave of the virus. While the government’s promise to roll out flu vaccines to millions more people is welcome, the RCP recently set several more priorities to help prepare the health service for future waves of COVID-19, including the need to ensure the NHS estate is fully able to cope. Only 5% say they wanted an antibody test for COVID-19 but were unable to access one. Of those tested, a quarter (25%) were positive, with little or no difference when it came to gender, between white and BAME doctors, trainees and consultants or between London and the rest of England. Professor Andrew Goddard, president of the Royal College of Physicians, said: “Delays to treatment are so often a major issue for the NHS but as a result of the COVID-19 pandemic, it’s fair to say we’ve reached crisis point. Doctors are, understandably, gravely concerned that their patients’ health will have deteriorated to the point where they will need much more extensive treatment than previously, at a time when NHS resources are already incredibly depleted." “We also cannot underestimate the need to prepare for a second wave of COVID-19 infection, which threatens to compound the situation. Without careful and rigorous preparation, a second wave coupled with the winter flu season, could overwhelm the NHS.” Source: Royal College of Physicians, 5 August 2020
  11. Content Article
    Jerome Groopman is a doctor who discovered that he needed a doctor. When his hand was hurt, he went to six prominent surgeons and got four different opinions about what was wrong. Groopman was advised to have unnecessary surgery and got a seemingly made-up diagnosis for a nonexistent condition. Groopman, who holds a chair in medicine at Harvard Medical School, eventually found a doctor who helped. But he didn't stop wondering about why those other doctors made the wrong diagnoses. You can listed or read his interview from the link below.
  12. Content Article
    In this case study, Angela gives us a first person account of her life, detailing her family history, life with her husband, her interests and her healthcare, including her recent diagnosis of dementia. Nicola, who has supported Angela with her diagnosis, reflects on the importance of telling Angela about the diagnosis and the support needed moving forward.
  13. Content Article
    This article from Susan Carr discusses how fear is keeping patients from getting the care they need. The author highlights the importance of recognising that rebuilding trust in the system disrupted by COVID-19 will take time and the role of leaders to anchor this effort.  
  14. Content Article
    In this article for Stylist, Sarah Graham, founder of the Hysterical Women blog, looks at the statistics around gender and heart attacks and gender. She highlights the worrying disparities and argues that sexism plays a dangerous role. The term Yentl Syndrome is used to describe the different ways men and women are treated after heart attacks.
  15. Content Article
    The aim of this study from H R Guly was to describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist. In total 57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius. Guly concluded that training for junior doctors in A&E departments should be improved—especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.
  16. News Article
    About 3,500 people in England may die within the next five years of one of the four main cancers – breast, lung, oesophageal or bowel – as a result of delays in being diagnosed because of COVID-19, say the researchers in the Lancet Oncology journal. “Our findings demonstrate the impact of the national Covid-19 response, which may cut short the lives of thousands of people with cancer in England over the next five years,” said Dr Ajay Aggarwal from the London School of Hygiene & Tropical Medicine, who led the research. Routine cancer screening was suspended during the lockdown, the authors said. So was the routine referral to hospital outpatient departments of people with symptoms that could be something else but also might possibly be cancer. Only those deemed to need emergency care by the GP or those who go to A&E are being picked up. Inevitably, those are people with more advanced cancers. If cancer is picked up at an earlier stage, successful treatment and survival are much more likely. “Whilst currently attention is being focused on diagnostic pathways where cancer is suspected, the issue is that a significant number of cancers are diagnosed in patients awaiting investigation for symptoms not considered related to be cancer. Therefore we need a whole system approach to avoid the predicted excess deaths,” said Aggarwal. Read full story Source: The Guardian, 20 July 2020
  17. News Article
    A former senior NHS official plans to sue the organisation after he had to pay a private hospital £20,000 for potentially life-saving cancer surgery because NHS care was suspended due to COVID-19. Rob McMahon, 68, decided to seek private treatment after Worcestershire Acute Hospitals NHS trust told him that he would have to wait much longer than usual for a biopsy. He was diagnosed with prostate cancer after an MRI scan on 19 March, four days before the lockdown began. McMahon was due to see a consultant urologist on 27 March but that was changed to a telephone consultation and then did not take place for almost two weeks. “At that appointment, the consultant said: ‘Don’t worry, these things are slow-growing. You’ll have a biopsy but not for two or three months.’ I thought, ‘that’s a long time’, so decided to see another consultant privately for a second opinion.” A PET-CT scan confirmed that he had a large tumour on both lobes of the prostate and a biopsy showed the cancer was at risk of breaking out of the prostate capsule and spreading into his body. He then paid to undergo a radical prostatectomy at a private Spire hospital. “This is care that I should have had on the NHS, not something that I should have had to pay for myself. I had an aggressive cancer. I needed urgent treatment – there was no time to waste,”, he said. “With the pandemic, he added, “it was almost like a veil came down over the NHS. He worked for the NHS for 17 years as a manager in hospitals in London, Birmingham and Redditch, Worcestershire, and was the chief executive of an NHS primary care trust in Leicester.” Mary Smith of Novum Law, McMahon’s solicitors, said: “Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19." Read full story Source: The Guardian, 11 July 2020
  18. Content Article
    Early clinical experiences have demonstrated the wide spectrum of COVID-19 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions. This article, published in the BMJ, summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. 
  19. Content Article
    This short film was created by patients who are experiencing long-lasting and debilitating symptoms of COVID-19, to raise awareness of their ongoing issues, also known as 'Long COVID'.
  20. Content Article
    The results of this study, published in the Journal of Translational Medicine, confirm previous work that demonstrated an abnormal response to exercise in fatigued ME/CFS patients.
  21. Content Article
    "Over half of the disease burden in England is deemed preventable", says this report, "with one in five deaths attributed to causes that could have been avoided". It notes however, that progress has stalled on reducing the number of people with preventable illness and that compared to other high-income countries, we are underperforming. The authors call for a paradigm shift in prevention policy, from interventions that "blame and punish" to those that "empathise and assist". Regressive taxes and bans have not, they say, delivered the transformation required. Key to any new prevention strategy is the online information environment. Over 60% of British adults use the internet to check symptoms or self-diagnose, with the NHS website considered to be the most trustworthy. There is also, however, a "pernicious prevalence of false information". Polling shows that less than half of the population believe obesity is linked to cancer (misinformation), while over a third either agree that vaccinations can cause autism, or say they don't know (disinformation).
  22. Content Article
    This article from Perlin et al. discusses how a 173-hospital system used technology as a strategy to reduce sepsis-related mortality system-wide by real-time dissemination of basic laboratory and clinical data to alert teams to patients exhibiting signs of sepsis risk.
  23. Content Article
    This ‘Erice Call for Change’ is a report from a group of experts, patients and patient representatives who met in Erice in September 2019 following previous similar meetings after the original Erice Declaration (1996). The aim of the meeting was to discuss the challenge of causal complexity and individual variation in modern healthcare. The group’s concern was the impact that new clinical decision-making tools, based on statistical correlations in large databases, could have on individual patient care if they replace other types of clinical investigation and knowledge. The group calls for a change in the approach to the care of the individual patient, and indicates some specific challenges to overcome for such changes to happen.
  24. News Article
    Waiting times for tests and treatment not related to COVID-19 are likely to increase significantly in the second half of 2020 because of the fallout from the pandemic, the head of NHS England has acknowledged. Giving evidence to the Commons health select committee on 30 June, NHS England’s chief executive Simon Stevens said that contrary to some commentary, the NHS’s overall waiting list actually dropped by over half a million people between February and April 2020 because fewer people were coming forward for treatment. But, he added, “As referrals return we expect that will go up significantly over the second half of the year.” Stevens said that there were 725 000 fewer elective admissions to NHS hospitals during March and April, but that number has begun to recover significantly. “As we speak, we think we’re now somewhere north of 55% of pre-covid-19 elective activity levels,” he said. He added that he hoped the NHS would return to around three quarters of normal activity levels by July or August. Stevens told MPs that the NHS would pursue a range of measures to increase capacity over the coming months, including extending the deal with the private sector to use its facilities, and repurposing some of the Nightingale hospitals for diagnostic testing. Read full story Source: BMJ, 1 July 2020
  25. News Article
    Almost half a million people are waiting at least six weeks for tests which could diagnose cancer – up from just 30,000 before lockdown, new analysis shows. Ministers have been urged to urgently bring forward plans to tackle the backlog of patients waiting for care, with calls for weekly testing of staff to keep coronavirus infections off the wards. Cancer charities fear there will be an extra 18,000 deaths a year because those with symptoms are not receiving prompt diagnosis and treatment. Read full story (paywalled) Source: The Telegraph, 23 June 2020
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