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Public Health Screening Shared decisions

Screening Creep and the harm done

  I have been pretty vocal on ever creeping of proposals to screen for things a long way beyond National Screening Committee recommendation in the past. Lung cancer is the focus of this one. I wrote a lot on this a year or so ago in response to the planned rollout in G Mancs Carl […]

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Public Health Screening Shared decisions

Lung cancer screening

I’ve written a little on this already I know a thing or two about screening. It’s not like other healthcare, there’s an ethical issue of inviting people who think they are well……for a test that may have good and bad downstream consequences. It’s ethically not the same as offering someone with symptoms a test. I […]

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Accountable Care Health Care Public Health Healthcare Reform population health Prevention Public Health Shared decisions STP

Population health, population health care, population managemen

More than 30 years ago Rose set out the importance of focusing on population factors and not just individuals. We’ve not really made good on the hypothesis yet. Population health is still all the rage, if not properly defined. I’ve had a few gos at defining. Firstly trying to distinguish “public health” and “population health”. […]

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Health Care Public Health Shared decisions Value

Robotic prostatectomy. £60m capital cost on gizmo idolatry

I’ve previously had my rant about the ProtecT study. This broadly backs up earlier studies e.g. The PIVOT study suggesting radical prostatectomy doesn’t beat watchful waiting in terms of overall survival for localised prostate cancer. Surgery can do harm, watchful waiting will not. This is a development based on the hot of the press study […]

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Shared decisions

A Public Health perspective on Delayed Transfers Of Care

Warning – this is a geeky data focused blog thinking about “what’s a public health perspective” on delayed transfers of care. Last winter, Sheffield was in detention. That we could do better is undisputed (and undisputable). There’s a real tangible, measurable human harm. Sheffield DID do a lot of work on this from spring onwards. […]

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Clinical Health Care Public Health Screening Shared decisions Value

A prostate cancer bumper edition

ICYMI here’s a suite of studies – principally the ProtecT and linked study. I’m told this is the most expensive trial ever. Which concluded that no difference in prostate specific cancer survival between three arms – active surveillance, radiotherapy, surgery. (Remember we know that robotic surgery is no better than standard surgery – study earlier […]

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Shared decisions Uncategorized

Meshing together personal and population approaches – reaching the impossible dream

Meshing together personal and population approaches – reaching the impossible dreamHere’s a conundrum. I don’t know the answer. I don’t actually think there is an answer, certainly not a neat pithy one.Personalisation and person centred is the future. No questions there.However, there is also great gain that can be had from systematic application of a […]

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Health Care Public Health Shared decisions

Can anyone suggest resources to help authors incorporate values/shared decision-making in guidelines? Or examples of it done well? #sdm

Can anyone suggest resources to help authors incorporate values/shared decision-making in guidelines? Or examples of it done well? #sdmWas the q I was asked on TwitterI don’t know the answer, but I can’t summarise my view into 140 chars.So I wrote a bit moreSorry this is not perfect prose 1) Opening thoughtsa) Applications of shared […]