Medical Centre

Electronic healthcare records (EHRs) are increasingly being used to collect and store data on patient care. This data can be used for a variety of purposes, such as improving clinical care, conducting research, and monitoring population health. However, it is important to be aware of potential biases in EHR data, as these can lead to inaccurate or misleading results..  The reliability of diagnostic codes in primary care EHRs is a subject of ongoing debate and a topic we investigated in paper published in BMJ Open .  These codes not only guide clinical decisions but also shape healthcare policies, research, and even financial incentives in the healthcare system. A recent retrospective cohort study explored whether the frequency of these codes for long-term conditions (LTCs) is influenced by various factors such as financial incentives, general practices, patient sociodemographic data, and the calendar year of diagnosis. The study comes at a crucial time, shedding light on signi...

I am sometimes asked by junior researchers or by the public how the academic publication process works. The academic peer review timeline varies depending on the journal, but it typically takes several months (sometimes even longer) from submission to publication. 1. Submission : You submit your paper to the journal. Make sure your paper is well-written, checked for spelling and grammatical errors, follows the journal's style and formatting requirements, and that you submit your paper to a journal that is a good fit for your work. 2. Initial screening : An editor at the journal reviews your paper to make sure it is within the scope of the journal & meets the journal's style and formatting requirements. Some articles are rejected at this stage, without external peer review (particularly, by larger journals). For example, articles may be rejected if they are outside the scope of the journal, if they are poorly written or have major methodological flaws, or do not include the...

The COVID-19 pandemic had profound effects on many aspects of life, from healthcare to lifestyle habits. One of the most impacts has been the mental and physical well-being of individuals, particularly those who are older. Our study published in PLoS One aimed to quantify the relationship between shielding status and loneliness at the start of the pandemic and how these factors affected physical activity (PA) levels throughout the period. Conducted in London, the study surveyed 7748 cognitively healthy adults aged 50 and above from April 2020 to March 2021.  Methods The study used the International Physical Activity Questionnaire (IPAQ) short-form to assess the physical activity levels of participants before the pandemic and six more times over the next 11 months. Linear mixed models were used to explore the relationship between shielding status and loneliness at the onset of the pandemic with physical activity over time. Key Findings Loneliness and Physical Activity The study rev...

You will often see the NNT mentioned in clinical guidelines; and when different health interventions are being prioritised or assessed for their clinical effectiveness and cost effectiveness. For example, the NNT was used to inform decisions to recommend statins for people with an elevated risk of cardiovascular disease. The NNT is a measure used to quantify the effectiveness of an intervention or treatment. It is the average number of patients who need to be treated with a particular therapy for one additional patient to benefit. How is NNT calculated? In mathematical terms, the NNT = 1/[Absolute Risk Reduction] Where Absolute Risk Reduction (ARR) = Control Event Rate (CER) - Experimental Event Rate (EER) Control Event Rate (CER): The rate of an outcome in a control group. Experimental Event Rate (EER): The rate of an outcome in an experimental group treated with the intervention. For example, consider a drug that reduces the risk of heart attack from 4% to 2%. The ARR i...

It's that time of year when students are starting to enrol in higher education courses at universities and colleges. Every year, when marking essays and dissertations, I encounter numerous errors in students' writing.  What are these errors, and how can you avoid them to make your dissertation more readable? Here are my top 10 tips for improving your academic writing: 1. Plan Your Outline Most importantly, spend time planning the outline of your essay or dissertation. For dissertations, this means thinking about chapter headings and subsections for each chapter. Decide on the key tables, figures, and graphs you need to include to complement the main text. These visual elements should add value; they shouldn't merely repeat what's already said but should provide a different perspective or clearer illustration of your points. 2. Avoid Complexity Many students assume that longer words are "more scientific" and thus preferable to shorter ones. For example, they mi...

What steps can primary care providers take to maximise the uptake of flu vaccination? The NHS is now offering free vaccination to eligible patients in England but careful planning is needed to ensure the flu vaccine programme is implemented effectively and achieves a high uptake. In this post, I list some of the key steps in implementing flu vaccination in your practice. This guidance can also be used by primary care providers in other countries. Give one member of the practice team responsibility for leading the vaccination programme, supported by the wider practice team. Ensure staff are informed about the programme; including start dates, who is eligible and the benefits of vaccination for the individual patient, their family and society. Prepare FAQs to common questions from patients. These are usually available on government websites such as those published by NHS England and the UKHSA. Ensure staff know where to look for these FAQs, which ar...

What is the difference between Absolute Risk Reduction (ARR) and Relative Risk Reduction (RRR) ? This is a common question from students and clinicians. Understanding these concepts is crucial for interpreting research findings, especially in clinical and public health settings. Absolute Risk Reduction (ARR) refers to the difference in outcomes between a control group and a treated group in a clinical trial or an public health study. Formula: ARR = CER - EER Where: CER is the Control Event Rate (rate of event in the control group) and EER is the Experimental Event Rate (rate of event in the experimental group). Example: Imagine a trial in which 10% of patients in the control group have an adverse event, and only 5% in the treatment group experience the same. ARR = 10% - 5% = 5% This means that the drug reduces the absolute risk of an adverse event by 5%. In total, 20 people need to be treated to prevent one event (the Number Needed to Treat, NNT ). Relative Risk Reducti...

  1. Advice on school attendance for children with URTIs or anxiety School absence has increased since the start of the Covid-19 pandemic. The Chief Medical Office has recently written to schools about the importance to children’s health and wellbeing of regular attendance at school. GPs and other primary care staff should advise families that pupils should not stay off school with mild upper respiratory tract infection symptoms or anxiety. Full letter:  https://www.gov.uk/government/publications/letter-to-school-leaders-on-mild-illness-and-school-attendance/letter-to-school-leaders-on-mild-illness-and-school-attendance Our view is that NHS professionals should encourage school attendance among their patients. But their role is limited in comparison to the role for schools, parents and carers. 2. Flu vaccine Autumn-Winter 2023-24 The flu vaccine programme for this Autumn and Winter is starting. The groups eligible for flu vaccination in the 2023 to 2024 flu season include: all...