Evidence
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Quality improvement collaboratives can improve clinical processes and patient outcomes

Quality improvement collaboratives (QICs) were largely effective across a wide range of healthcare problems and settings. Of the 64 studies included in this systematic review, 53 showed improvement in some of the healthcare processes and patient outcomes that they investigated. A small number of studies also showed that collaboratives were cost-effective, and the improvements were ...

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Being overweight or having diabetes are both linked to cancer

For western high-income countries such as the UK, an estimated 15% to 16% of cancers could be avoided by preventing diabetes, obesity or excess weight (defined as a Body Mass Index [BMI] greater than 25). A high BMI was responsible for almost twice as many cancers as diabetes. Around 5.6% of cancers globally in 2012 ...

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Delayed umbilical cord clamping reduces hospital mortality for preterm infants

Delays to clamping the umbilical cord of about a minute can reduce hospital mortality for preterm infants by around 32%. Delayed clamping also reduced the proportion of infants needing a blood transfusion by 10%. This review adds more precise data on survival from new trials including a large Australian trial (over 1,600 babies) to a ...

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Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation

In people with atrial fibrillation needing anticoagulant treatment, deaths were fewer in those who had direct acting oral anticoagulants compared with warfarin. The picture is less clear for the risk of stroke and complications such as bleeding in the brain or gut. Apixaban had the best efficacy and safety profile and was cost-effective compared with ...

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Self-testing kits increase overall HIV testing uptake in men who have sex with men

Frequency of HIV testing in men who have sex with men may be increased by one additional test in a six month period when self-testing kits are used. Self-testing kits allow people to collect their finger-prick or saliva sample, perform the test and interpret the result themselves. This global study found that first-time testers made ...

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Social exclusion heightens risk of death across many health conditions

Socially excluded men have a mortality rate that is nearly eight times higher than the average for other men, and it is almost 12 times higher for excluded women. These health inequities in outcomes exist across a wide range of health conditions, particularly in infectious diseases and mental health. These findings suggest the need for ...

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Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis

The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours compared to a bolus or less than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics ...

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Study raises questions about NHS “weekend effect”

The increased mortality observed if patients are taken to hospitals at weekends also affects night admissions and can be explained in part by the severity of illness. Five linked NIHR-funded studies reviewed mortality and time and day of admission to hospital, largely using routine England-wide data. Fewer people are admitted from A&E at the weekend. ...

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Early use of tranexamic acid reduces bleeding more effectively

In people bleeding after trauma or giving birth, tranexamic acid within an hour of the start of bleeding increases the chances of survival by 72% compared with a placebo. Overall the trial data showed that at least six deaths from bleeding complications were prevented for every 1,000 people treated and potentially more if treatment is ...

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Parental training improves a child’s disruptive behaviours regardless of socio-economic disadvantage or ethnicity

Children from low-income families, or with an unemployed or single parent, benefitted as much as did economically advantaged groups from parental training. The Incredible Years programme worked better for children with more severe behaviour problems or a parent with depression. This NIHR-funded review pooled individual-level data for pre-school and primary aged children with persistent disruptive ...

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