GIRFT - Ear,Nose and Throat Surgery

Ear,Nose and Throat Surgery
GIRFT 1 November 2019

• The GIRFT review of ENT services visited 126 units across the country. This report highlights a significant degree of unwarranted variation in a number of key areas in delivery of ENT surgery and suggests how the many examples of good practice in the delivery of ENT services could be adopted in order to improve patient care and outcomes.
• The report makes 23 recommendations ranging from increasing day case surgery, networks for out-of-hours provision, improve the procurement of devices and consumables, consider including Patient Reported Outcome Metrics (PROMs) for ENT and head and neck surgery and implement the GIRFT 5 point plan for reducing litigation costs.

Factors influencing men’s choice of and adherence to active surveillance for low-risk prostate cancer: a mixed method systematic review.
Eur Urol. v74(3), p261-280 September 2018; doi: 10.1016/j.eururo.2018.02.026.

• The recent ProtecT trial demonstrated that there was no difference in 10-year survival rates between men with low risk localised prostate cancer who were allocated to active surveillance and those who chose radical treatment.
• However, patient uptake of and adherence to active surveillance is generally low in clinical practice. This research suggests that efforts by clinicians to explain the choices available might help improve understanding, uptake or adherence. This will aid patients in making more informed decisions, potentially lessening the side effects experienced by some men.

Abstract

New data links route to cancer diagnosis and treatment

New data links route to cancer diagnosis and treatment
Public Health England 15 August 2018

• Data from PHE shows that patients diagnosed through screening, GP referral or 2-week referrals likely to have more treatment options.
• The data illustrates how the way that cancer patients are diagnosed may affect their treatment options.Those diagnosed through screening were likely to have the most treatment options available and receive treatments aimed at curing the cancer, in particular surgery to completely remove the tumour. 
• The national data links individual patients’ route to diagnosis, including screening, GP referrals, and emergency presentations, with the treatment patients go on to receive.

NHS England procurement notices for specialised services

NHS England 2019/21 Specialised Services Contract Procurement
Official Journal of the European Union, 14 August 2018

• NHS England has published prior information notices in the for specialised services contracts across the country. The tenders are split into 20 different lots, across four regions, and total £7.6bn for the South of England, £10.8bn for London, £9.4bn for the Midlands and East and £862m for the North of England.
• Expressions of interest must be received by 14 September 2018.

DeepMind AI system ‘able to identify eye diseases and make referrals’

Clinically applicable deep learning for diagnosis and referral in retinal disease
Nature Medicine (2018) 13 August 2018

• This research uses a novel deep learning architecture to a clinically heterogeneous set of three-dimensional optical coherence tomography scans from patients referred to a major eye hospital (Moorfields Hospital, London). 
• The research demonstrates performance in making a referral recommendation that reaches or exceeds that of experts on a range of sight-threatening retinal diseases after training on only 14,884 scans. 
• See commentary DeepMind AI system ‘able to identify eye diseases and make referrals’, Digital Health 14 August 2018.

Abstract

National Bowel Cancer Audit: The feasibility of reporting patient outcome measures…

National Bowel Cancer Audit: The feasibility of reporting patient outcome measures…

HQIP 9 August 2018

• A feasibility study linking the NHS England National Cancer PROM’s to the National Bowel Cancer Audit (NBOCA) data to establish the feasibility of the PROMs as part of the national clinical audit. This was assessed according to:
• i) the characteristics of responders compared to all eligible patients
• ii) the representativeness of the responders at different points along their pathway from diagnosis
• iii) hospital trust variation in response rate, and
• iv) the validity of the measures in comparison to NBOCA measures.

Ortus-iHealth app trial at St Bartholomew's Hospital

Virtual advice app trialled at St Bartholomew’s Hospital
Digital Health 8 August 2018

• A new app, Ortus-iHealth, that provides care advice for heart and cancer patients is being trialled at St Bartholomew’s Hospital. 
• The app helps patients and their clinicians connect through virtual appointments by computer or mobile phone, rather than requiring them to travel in for a face-to-face consultation.
• See also Virtual clinic app underway at St Bartholomew’s Hospital

Paediatric critical care in practice (PCCP)

Paediatric critical care in practice (PCCP)
Healthy London Partnership 2 August 2018

• An online portal of resources designed for London’s health professionals to use to develop their knowledge and achieve the quality of care set out in the London’s Paediatric Critical Care: Level 1 and 2 Standards.

Machine learning for clinical decision-making in cystic fibrosis care

New research shows machine learning could significantly augment clinical decision-making in cystic fibrosis care

Alan Turing Institute 

• New research published in Scientific Reports (see below), demonstrates that machine learning methods can predict with a 35% improvement in accuracy whether a cystic fibrosis (CF) patient should be referred for a lung transplant, in comparison to existing statistical methods. It is the first machine learning study to make use of a dataset representing 99% of CF patients living in the UK, the CF Registry.
• The research,has been generated through a partnership between The Alan Turing Institute and the Cystic Fibrosis Trust.

Reference: Prognostication and Risk Factors for Cystic Fibrosis via Automated Machine Learning Ahmed M. Alaa & Mihaela van der Schaar .
Scientific Reports vol8, Article number: 11242, 26 July 2018

Symbitron project - a wearable, assistive exoskeleton

Symbitron project - a wearable, assistive exoskeleton
EU CORDIS June 2018

• The Symbitron project - started in the Netherlands in 2013 and involving an international project team from Switzerland, Italy, Iceland and the UK - has been working to restore partial movement in those with spinal cord injury. 
• It has done this by designing a unique wearable, assistive exoskeleton that helps to activate the neuromuscular system, which is believed to improve motor recovery. Inspired by how the body itself works, this safe, personalised man-machine interface is responsive to both the user and the environment.

Commissioning and delivery toolkit for cancer as a long-term condition

Commissioning and delivery toolkit for cancer as a long-term condition
Healthy London June 2018

• Resources for London STPs to use to commission and deliver the 4 Point Cancer Care Reviews Model in primary care for people living with and beyond cancer. It triggers the support patients reportedly need following a diagnosis of cancer, to self-manage to the best of their ability.

Robotic system for joint fractures

Robotic surgery breakthrough
EPSRC 29 June 2018

• A ground-breaking system that enables surgeons to put joint fractures back together using a minimally invasive approach which combines state-of-the-art 3D imaging, pattern recognition and robotic surgery has been developed at the University of Bristol.

Sleep positioning systems for children and adults with a neurodisability: A systematic review

Sleep positioning systems for children and adults with a neurodisability: A systematic review
British Journal of Occupational Therapy 1–10, 21 June 2018

• Sleep positioning systems are often prescribed as part of a 24-hour postural management programme. for children and adults with neurodisabilities. A review of the literature identified 14 studies of sleep positioning systems. All were small and most were of low quality. While no harm was found, inferences of benefits cannot be made from the literature.
• The results of this review will inform a new evidence based guide for therapists prescribing sleep positioning systems for patients with neurodisabilities. It is hoped that this guide will help to outline the potential benefits and risks associated with the systems in practice as far as possible.

Read more here: : Clinician-led research to inform new guidance for therapists, CLARHC South West Peninsula, 26 June 2018

Abstract

Predicting risk of unplanned hospital readmission in survivors of critical illness

Predicting risk of unplanned hospital readmission in survivors of critical illness: a population-level cohort study
Thorax Online First: 05 April 2018. doi: 10.1136/thoraxjnl-2017-210822

• A cohort study of ICU survivors (n=55,975) found that pre-existing illness indices are better predictors of readmission than acute illness factors and identifying additional patient-centred drivers of readmission may improve risk prediction models. 
• Study: Edinburgh, UK

Abstract

Accelerating the translation of early detection and diagnosis research in cancer

Accelerating the translation of early detection and diagnosis research in cancer
Cancer research UK, Academy of Medical Sciences

• Summary of a workshop held by the Academy of Medical Sciences and Cancer Research UK, 7 February 2018
• "A system change is needed to ensure better development, evaluation, translation and implementation of early detection and diagnosis (EDD) tests. Delegates advocated the value of developing a roadmap for translation of EDD research that incorporates these factors and particularly addresses evidence and clinical needs at the various stages in translation."