Statistics done wrong: the woefully complete guide

Statistics done wrong by Alex Reinhart is a guide to the  most popular statistical errors and slip-ups committed by scientists every day, both in the lab and in peer-reviewed journals.  Many errors are prevalent in published literature, casting doubt on the findings of thousands of papers, according to the author.  The information presented at this site assumes no previous statistical knowledge and is useful for anyone putting together their own figures, or trying to assess the validity of the work of others.

New Agency for Clinical Innovation website

The ACI and CEC (Clinical Excellence Commission) have developed a new website as a centralised, standardised, first-step resource on ACI and CEC initiatives, programs and projects.

The Excellence and Innovation in Healthcare Portal is now live and can be accessed at http://www.eih.health.nsw.gov.au.  Search for initiatives across Local Health Districts, or by clinical specialties.

Weekend hospital care improvement in the NHS

This report of NHS Services, Seven Days a Week Forum, convened by Professor Sir Bruce Keogh, National Medical Director, addresses the variation in outcomes for patients admitted to hospitals at the weekend across the NHS in England – a problem affecting most healthcare systems around the world.
The report sets out ten new clinical standards all patients should expect from hospital emergency services seven days a week, each supported by clinical evidence and developed in partnership with the Academy of Medical Royal Colleges. The clinical standards cover such areas as the time to first consultant review, mental health, diagnostics and transfer to other care services. 

Reducing inappropriate ED attendances

In this systematic review published in the British Journal of General Practice, the authors reviewed studies published in English between 1986 and 2011, and concluded that telephone triage was the single best-evaluated intervention. "This resulted in negligible impact on [accident and emergency] attendance, but exhibited acceptable patient satisfaction and clinical safety; cost effectiveness was uncertain". The authors found limited evidence that other interventions contributed to reduced ED presentations.

Reducing inappropriate accidentand emergency department attendances: A systematic review of primary careservice interventions is free online.  

Ismail S, Gibbons D, Gnani S. (2013). British Journal of General Practice , 63(617), e813-e820

Trust No Guideline That You Did Not Fake Yourself

An interesting post on the Krafty Librarian blog posted January 21, 2014 relates to fake practice guidelines and doctors with ties to pharma companies writing these guidelines. A number of interesting articles are referenced as well.
Go to Krafty Librarian blog.

Staphylococcus aureus bacteraemia in Australian public hospitals

This AIHW  report presents national information on cases of Staphylococcus aureus bacteraemia (SAB) associated with care provided by public hospitals for the period 1 July 2012 to 30 June 2013.

Australian hospital statistics 2012-13: Staphylococcus aureus bacteraemia in Australian public hospitals. The 25 page report is available freely to download. 

Death Statistics in Australia

The AIHW Deaths snapshot presents the latest data on deaths in Australia including information on age at death, trends over time, causes of death and life expectancy. Looking at how many people die and what caused their death can provide vital information about the health of a population. Examining patterns and trends in deaths can help explain differences and changes in the health of a population, contribute to the evaluation of health strategies and interventions, and guide planning and policy-making.

It shows that chronic diseases-such as heart disease, dementia, cancers and chronic obstructive pulmonary disease-feature much more prominently among people aged 45 and over, and external causes, such as transport accidents and suicide, are the leading causes of death among people aged 1-44. 

"Don’t Rush Me…Go the Full 40"

“Don’t Rush Me…Go the Full 40 Weeks,” is a public health campaign for the US Association of Women’s Health, Obstetric & Neonatal Nurses (AWHONN) that educates women about the physiological benefits of full-term pregnancy for themselves and their baby. Their journal has published a special issue on the topic.  Go the Full 40 aims to:

• Increase the percentage of women who wait for labor to start on its own, thereby reducing overall elective induction and primary cesarean rates.
• Increase awareness among providers and consumers regarding the documented physiologic benefits of term pregnancies that culminate in spontaneous labor.  

You can access this virtual issue of "Nursing for Women's Health" on CIAP or contact your library staff.

Anaesthesia for the Elderly

Anaesthesia, the journal of the Association of Anaesthetists of Great Britain and Ireland has published a free supplement titled Anaesthesia for the Elderly. This 2014 supplement includes critical reviews of subjects relating to anaesthesia and older patients, and also introduces the Association of Anaesthetists of Great Britain and Ireland's updated guideline Perioperative Care of the Elderly.
The articles cover topics such as perioperative pain, patient frailty, ethical and legal aspects, and emergency surgery.

Special Issue: Anaesthesia for the Elderly. January 2014; Volume 69, Issue Supplement s1. Pages 1–98

High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs

The US Institute for Healthcare Improvement (IHI) has published a 34-page white paper based on  the findings of an IHI 90-Day Innovation Project on leadership.
In the white paper the authors discuss three interdependent dimensions of leadership that they consider define high-impact leadership in health care.

The white paper also includes examples from a variety of health care leaders, to help illustrate High-Impact Leadership Behaviors in real-world practice.

Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2013.

Shared Health Information: Toward better, safer care

A short booklet from the New Zealand Ministry of Health showcases examples of information technology innovation and use within the health and disability sector. The book describes the increasing use of connected electronic systems which provide clinicians and consumers with relevant information when it is needed at the point of care and how that can contribute to the safety and quality of care.

You can view the eBooklet here. (You may need to continue to click Reload)

WA report puts a price on obesity

Overweight patients cost Western Australia’s public hospitals $241 million in 2011 - and that number is expected to soar to $488 million by 2021, according to a new report.
The WA Department of Health study, titled The Cost of Excess Body Mass to the Acute Hospital System in Western Australia 2011, found the top 10 most expensive conditions attributable to excess body mass included osteoarthritis, at the top of the list, costing $84,633,216, with ischaemic heart disease next on $50,510,400.
Diabetic renal dialysis cost $28,385,285, type 2 diabetes reached $16,190,398, gall bladder disease was $13,382,479, obesity - where the primary diagnosis was directly attributed to excess body mass - cost $10,749,139, congestive cardiac failure hit $8,967,621, ischaemic stroke reached $8,708,470, colorectal cancer cost $7,501,672 and breast cancer cost $3,062,834.
The report investigated emergency and inpatient expenditure for 18 conditions, all associated with overweight patients.
The 39 page report is free to read or download online.

New protocol for active surveillance of men with early prostate cancer

Prostate cancer is among the most common cancers in men, making up more than a quarter of diagnoses and accounting four seven per cent of cancer deaths in the UK. Among the updated recommendations, is a new protocol for active surveillance. This is a way of monitoring slow-growing prostate cancers that might never progress or cause any symptoms, and can help avoid or delay treatment such as radiotherapy or surgery which might otherwise be unnecessary.
NICE recommends that doctors should offer active surveillance for men with low-risk localised prostate cancer for whom radical prostatectomy or radical radiotherapy is suitable.
The protocol recommends measuring PSA levels every 3-4 months in the first year of surveillance, and then at increasing intervals if there is no evidence of disease progression.

Australian bites and stings - first aid app

bioCSL has produced a free smartphone app, Australian Bites & Stings: First AidGuide to Australian Venomous Creatures – which hosts up-to-date first aid information for snakes, spiders, marine animals and insects that can be found in Australia.

Advanced care directives - legal aspects

This week's Law Report on ABC's Radio National, Living in the dark on plans for dying, examines problems that are resulting from the fact that there is no national law governing advanced care directives.  Each state in Australia operates with different frameworks and terminology in this complex area of law, which is confusing to both consumers and health professionals.  Ben White, Director of the Health Law Research Centre at QUT said "We are doing a three-year study which is coming towards the end where we surveyed doctors from seven specialties involved in end-of-life decision-making in New South Wales, Queensland and Victoria. Our final analysis isn’t complete, but what does emerge is that there are clear gaps in their legal knowledge."  In NSW and Tasmania, there is no specific law covering written advance directives, which further muddies the issues. Some lawyers in those states assert that these directives are not legally binding, but precedents have proved that they are and the program suggests they all directives be taken very seriously.

Death in a hot climate

With regard to the recent heatwaves in some states of Australia, this article by David Ranson, Forensic Pathologist at Monash University, is a useful summary of  how heat effects the body and how people can die from various heat-associated causes.  Death in a hot climate: southern heatwave takes its toll was published in The Conversation.

Impact of health professional recommendation on weight loss

An article recently published in BMJ Open examines the effect that health professional advice to lose weight has on overweight and obese adults.  'The impact of a health professional recommendation on weight loss attempts in overweight and obese British adults: a cross-sectional analysis' concluded from the results of a British survey that advice to lose weight appears to increase motivation to lose weight, but that only a minority of overweight or obese adults receive such advice. Better training for HPs in delivering brief weight counselling could offer an opportunity to improve obese patients’ motivation to lose weight.

Jackson SE, Wardle J, Johnson F, et al. BMJ Open 2013;3:e003693. doi:10.1136/bmjopen-2013-003693 (Open Access)

Headspace — Australia’s innovation in youth mental health

A recent article in the Medical Journal of Australia  provides the first national profile of the characteristics of young people (aged 12–25 years) accessing headspace centre services — the Australian Government’s innovation in youth mental health service delivery. This paper outlines the findings from research in to the program. It investigates whether headspace is providing early service access for adolescents and young adults with emerging mental health problems. Headspace centres are providing a point of service access for young Australians with high levels of psychological distress and need for care in the early stages of the development of mental disorder.

headspace — Australia’s innovation in youth mental health: who are the clients and why are they presenting?  Debra J Rickwood, Nic R Telford, Alexandra G Parker, Chris J Tanti and Patrick D McGorry Med J Aust 2014; 200 (2): 1-4.

Palliative Care Online Training

  

People across Australia are welcome to register for an online training program which has been developed to help health professionals who provide palliative care to aged persons in the community. The four modules take a total of 6 – 8 hours to complete online. The project is funded by the Department of Health and is developed jointly between SilverChain, AHHA, Just Health Consultants, e3Learning and the DeathTalker, Molly Carlile.

This free online training is available to participants across Australia.

Bell's Palsy guideline

The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell's palsy, to improve the quality of care and outcomes for patients with Bell's palsy, and to decrease harmful variations in the evaluation and management of Bell's palsy. The guideline is intended for all clinicians in any setting who are likely to diagnose and manage patients with Bell's palsy, whether they are adults or children.
The guideline was published as a supplement in the November 2013 issue of Otolaryngology–Head and Neck Surgery and is freely available online.