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Community Post
Patients wanted to help review information documents
RHarrison posted a topic in Data and insight
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Hi there, I represent a team of researchers in Reading, who are submitting ethical approval for a project investigating pain research and knee surgery. Part of this process is receiving feedback from an NHS ethics committee and addressing this for the benefit of the science, patients and clinicians involved. One suggestion they have made is that we involve patients within the review of our information sheets, which detail the procedures (both medical & research) that they may consent to. There is no requirement of expertise or experience from any patient who wishes to be involved, we are just very eager to make sure our information is clear, free of jargon and doesn't come across as confusing or intimidating. The committee have indicated this is an optional recommendation, but it is one that I am very keen to engage with. As it's optional, we are unable to shift our deadline for this, and I would unfortunately need the documents reviewed and submitted by Thursday 26th November. If this is something that anybody would be willing to help us with, I'd be very grateful. One information sheet is 2 pages, and the other is 7 pages, if this offers a good idea of how much time it may require. My hope it it would take no more than 30 minutes. If you are able to volunteer your time, please contact me on rich.harrison@reading.ac.uk, and I will forward you the documents for your review. Once again, thank you in advance! Richard -
Content ArticlePatients have better outcomes with female surgeons, a study from Wallis et al. has found. In a cohort study of 1 million patients, those treated by a female surgeon were less likely to experience death, hospital readmission, or major medical complication at 90 days or 1 year after surgery. This association was seen across nearly all subgroups defined by patient, surgeon, hospital, and procedure characteristics.
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Content ArticleThe early use of automated external defibrillators (AEDs) improves outcomes in out-of-hospital cardiac arrest (OHCA). This study in the journal Heart investigated AED access across Great Britain according to socioeconomic deprivation. The authors found that in England and Scotland, there are differences in distances to the nearest 24/7 accessible AED between the most and least deprived communities. They concluded that equitable access to ‘out-of-hours’ accessible AEDs may improve outcomes for people with OHCA.
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Content ArticleThis study in the Journal of Medical Virology aimed to assess the extent and the disparity in excess acute myocardial infarction (AMI)-associated mortality during the pandemic, focusing on the outbreak of the Omicron strain. Using data from the US Centers for Disease Control and Prevention's (CDC's) National Vital Statistics System, the authors found that excess death, defined as the difference between the observed and the predicted mortality rates, was most pronounced for the 25–44 years age group. Excess deaths ranged from 23%–34% for the youngest compared to 13%–18% for the oldest age groups. The trend of mortality suggests that age and sex disparities have persisted even through the Omicron surge, with excess AMI-associated mortality being most pronounced in younger-aged adults.
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Content ArticleThe aim of this study from Hutchinson et al. was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department.
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Content ArticleMost people experience a diagnostic error at least once in their lifetime. Patients’ experiences with their diagnosis could provide important insights when setting research priorities to reduce diagnostic error. The objective of this study from Zwaan et al. was to engage patients in research agenda setting for improving diagnosis. Patients were involved in generating, discussing, prioritising, and ranking of research questions for diagnostic error reduction.
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Content ArticleThe aim of the Long Covid webinar held on 5 July 2023 was to discuss where we are now with Long Covid clinics and research. The presentation videos from the webinar can be accessed from the link below.
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Content ArticleAll health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were (1) to analyse the association between IHA and the development of subsequent AEs; and (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. It found that patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns.
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Content ArticleDifferent communities have different needs when it comes to vaccination. Research can show us how to engage with different groups effectively. The latest Collection from the National Institute for Health and Care Research (NIHR) brings together examples of NIHR research on how to increase vaccine uptake.
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Content ArticleIn a new Lancet Respiratory Medicine Series about Long Covid, Sally J Singh and colleagues discuss the origins of respiratory sequelae and consider the promise of adapted pulmonary rehabilitation programmes and physiotherapy techniques for breathing management. Pratik Pandharipande and colleagues review the epidemiology and pathophysiology of neuropsychological sequelae of COVID-19-related critical illness, highlighting the combined threat of long COVID and post-intensive care syndrome (PICS), and outline potential mitigation strategies. Finally, Matteo Parotto and colleagues discuss pathophysiological mechanisms of diverse, multisystem sequelae in adult survivors of critical illness, including longitudinal effects of endothelial and immune system dysfunction, and consider the challenges of providing appropriate care and support for patients.
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Content ArticleThe Trinity Challenge is a coalition of partners united by the common aim of developing insights and actions to contribute to a world better protected from global health emergencies. They focus on three core activities which will improve the use of data and analytics and our understanding of human behaviour in response to health emergencies: Set a new global challenge to the world Facilitate unique collaborations amongst the coalition to improve outcomes Strengthen the data, analytics and learning ecosystem for global public health.
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Content ArticleThe aim of the study was to explore the factors that affect the safety attitude and teamwork climate of Cyprus maternity units and Cypriot midwives. The study found that the safety climate in the maternity settings was negative across all six safety climate domains examined. The higher mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. It could be suggested that younger midwives need more support and teamwork practice, in a friendly environment, to enhance the safety and teamwork climate through experience and self-confidence.
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Content ArticlePatient satisfaction surveys rely largely on numerical ratings, but applying artificial intelligence (AI) to analyse respondents’ free-text comments can yield deeper insights. AI presents the ability to reveal insights from large sets of this type of unstructured data. The authors’ analysis here presents AI-enabled insights into what different racial and ethnic groups of patients say about physicians’ courtesy and respect. This analysis illustrates one method of leveraging AI to improve the quality and value of care.
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Content ArticleInvestigations suggest that, in some fields, at least one-quarter of clinical trials might be problematic or even entirely made up. This article in Nature looks at the findings of researchers who have been studying clinical trials and calling for greater regulatory scrutiny. It particularly examines the work of John Carlisle, NHS anaesthetist and editor at the journal Anaesthesia, who scrutinised over 500 studies with randomised controlled trials, over a period of three years. Carlisle found that 26% of the papers had problems that were so widespread that the trial was impossible to trust, either because the authors were incompetent or because they had faked the data. He called these ‘zombie’ trials because they had the semblance of real research, but closer scrutiny showed they were masquerading as reliable information.
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Content ArticlePeople dying in UK hospitals without specialist palliative care input frequently have “significant and poorly identified unmet needs,” finds a UK-wide evaluation—the first of its kind—published online in the journal BMJ Supportive & Palliative Care. In response to the perceived unmet needs of people dying in hospitals, the Association of Palliative Medicine coordinated the first ever prospective evaluation of end of life care against set standards in 88 hospitals across the UK: Seeking Excellence in End-of-life Care UK or SEECareUK. Palliative care specialists assessed how well the holistic needs of 284 adult patients nearing death, but not referred to palliative care services, were being met on one single day between 25 April and 01 May 2022. Patients in emergency care departments or intensive care units weren’t included. Nearly all (93%) of those assessed had demonstrable unmet need, with this deficit more apparent in district general hospitals than it was in teaching hospitals or cancer centres. It is estimated that 1 in 10 patients admitted to UK hospitals will die during their inpatient stay. As specialist palliative care teams often function as a consult service, referral from the managing team is required. But complexities around recognising that a patient is dying and the stigma associated with palliative care mean these referrals are frequently not made, say the researchers of this study.
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Content ArticleThe author of this blog published by Sling the Mesh, writes that ever year new healthcare treatments are launched underpinned by flawed, mischievous, flimsy and fraudulent scientific evidence – also known as cheating. They look at different types of cheating and argue that cheating helped push surgical mesh implants as ‘gold standard’.
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Content ArticleToo many women are dying from disadvantage in one of the poorest parts of England, according to ground breaking new research which serves as an urgent wake-up call for levelling up efforts. The report by Agenda Alliance and Changing Lives, Dismantling disadvantage has found that in 2021 a woman in the North East of England was 1.7 times more likely to die early as a result of suicide, addiction, or murder by a partner or family member than in the rest of England and Wales. Today’s new research was conducted to better understand the lives and needs of disadvantaged women in the North East, including Newcastle, coastal areas and Gateshead and Sunderland; some of the poorest regions in the country. Working with women with lived experience at every stage, the study involved 18 in-depth interviews, 47 survey responses; focus groups; data analysis and multiple meetings with affected women, practitioners and policy makers.
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Content ArticleErrors in patient identification have implications for patient care and safety, payment, as well as data sharing and interoperability. Different patient identification techniques ranging from unique patient identifiers and algorithms to hybrid models have been implemented worldwide. However, no current patient identification techniques have resulted in a 100% match rate. This study by Riplinger et al. identified some of the challenges associated with improper patient identification. The literature review showed six common patient identification techniques implemented worldwide ranging from unique patient identifiers, algorithmic approaches, referential matching software, biometrics, radio frequency identification device (RFID) systems, and hybrid models. The review revealed three themes associated with unresolved patient identification: 1) treatment, care delivery, and patient safety errors, 2) cost and resource considerations, and 3) data sharing and interoperability challenges.
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Content ArticleUsing new technologies in the NHS could bring multiple benefits. They could save healthcare professionals’ time, increase the number of people a skilled professional can support, and enable more sustainable workforce models. At the same time, they can promote safer and more personalised care. The National Institute for Health and Care Research (NIHR) have published their latest Collection brings together NIHR research demonstrating how digital technology can improve care while reducing the demands on staff.
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Content ArticleFollowing an extensive process of internal and external engagement, the Medicines and Healthcare products Regulatory Agency has published their corporate plan for the next 3 years. Their priorities are: Maintain public trust through transparency and proactive communication Enable healthcare access to safe and effective medical products Deliver scientific and regulatory excellence through strategic partnerships Become an agency where people flourish alongside a responsive customer service culture.
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Content ArticleThe Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest database of patient safety event reports in the US. In addition to over 4.5 million acute care reports, the PA-PSRS database contains more than 396,000 long-term care healthcare-associated infection (HAI) reports. This study in Patient Safety aimed to look at trends in HAIs in long term care using data from the PA-PSRS database. The study found that there was an increase in the total number and rate of infections reported to PA-PSRS in 2022.
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Content ArticleWhat exactly is machine learning and how is it being used in healthcare? Are machines always better than a person? How do we know? In this interview, Patient Safety managing editor, Caitlyn Allen asks these questions of artificial intelligence healthcare researcher Dr Avishek Choudhury.
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Content ArticleIn this blog, Kath Sansom, founder of campaign group Sling the Mesh, outlines her concerns about three new mesh products for muscle and tendon injuries that have been given near automatic approval by the US Food and Drug Administration (FDA). She highlights that although the manufacturers claim the products have caused no sensitivity issues and no adverse responses in animals, there is no data on the potential long term impact of the mesh devices. Highlighting the knowledge that we now have about the potential for surgical mesh to cause severe injury and side-effects, Kath raises concerns about the lack of regulatory rigour and the potential for these degradable devices to cause fibromyalgia and other systemic issues. Read more about the approval of products for shoulder soft tissue repair
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Content ArticleThere are reports of increasing incidence of paediatric diabetes since the onset of the COVID-19 pandemic. This study by D'Souza et al. compares the incidence rates of paediatric diabetes during and before the COVID-19 pandemic. The study found that incidence rates of type 1 diabetes and diabetic ketoacidosis at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.
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Content ArticleTrust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic injustice has received limited treatment in bioethics. In this paper, Buchman and colleagues examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. They critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. They also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration.
