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An overview of B coding of breast core biopsy categorisation and management implications
The United Kingdom National Health Service Breast Screening Programme proposes five B categories for reporting breast screening needle core biopsies. The system is also recommended for symptomatic patients and diagnostic vacuum-assisted biopsies. Usually over 90% of biopsies are categorised as normal (B1), benign (B2) or malignant (B5). B3 is a heterogeneous group including atypical intraductal proliferations, classical lobular neoplasia, papillary lesions, radial scars, cellular fibroepithelial lesions and some rarer lesions. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - December 7, 2023 Category: Pathology Authors: Andrew HS Lee, Sarah E Pinder Tags: Mini-symposium: breast pathology Source Type: research

Protocol for a realist evaluation of Recovery College dementia courses: understanding coproduction through ethnography
Introduction Support following a dementia diagnosis in the UK is variable. Attending a Recovery College course with and for people with dementia, their supporters and healthcare professionals (staff), may enable people to explore and enact ways to live well with dementia. Recovery Colleges are established within mental health services worldwide, offering peer-supported short courses coproduced in partnership between staff and people with lived experience of mental illness. The concept of recovery is challenging in dementia narratives, with little evidence of how the Recovery College model could work as a method of postdiag...
Source: BMJ Open - December 7, 2023 Category: General Medicine Authors: Birt, L., West, J., Poland, F., Wong, G., Handley, M., Litherland, R., Hackmann, C., Moniz-Cook, E., Wolverson, E., Teague, B., Mills, R., Sams, K., Duddy, C., Fox, C. Tags: Open access, Health services research Source Type: research

Randomised controlled trial of automated VR therapy to improve positive self-beliefs and psychological well-being in young people diagnosed with psychosis: a study protocol for the Phoenix VR self-confidence therapy trial
Introduction The confidence of young people diagnosed with psychosis is often low. Positive self-beliefs may be few and negative self-beliefs many. A sense of defeat and failure is common. Young people often withdraw from many aspects of everyday life. Psychological well-being is lowered. Psychological techniques can improve self-confidence, but a shortage of therapists means that very few patients ever receive such help. Virtual reality (VR) offers a potential route out of this impasse. By including a virtual coach, treatment can be automated. As such, delivery of effective therapy is no longer reliant on the availability...
Source: BMJ Open - December 7, 2023 Category: General Medicine Authors: Freeman, D., Freeman, J., Rovira, A., Miguel, A. L., Ward, R., Bousfield, M., Riffiod, L., Leal, J., Kabir, T., Yu, L.-M., Beckwith, H., Waite, F., Rosebrock, L. Tags: Open access, Mental health Source Type: research

Efficiency effects of public hospital closures in the context of public hospital reform: a multistep efficiency analysis
The objective of this study is to examine the effect of closure on competitive hospital performances. Using administrative data from Turkish Public Hospital Statistical Yearbooks for the years 2005 to 2007 and 2014 to 2017, we conducted a three-step efficiency analysis by incorporating data envelopment analysis (DEA) and propensity score matching techniques, followed by a difference-in-differences (DiD) regression. First, we used bootstrapped DEA to calculate the efficiency scores of hospitals that were located near hospitals that had been closed. Second, we used nearest neighbour propensity score matching to form control ...
Source: Health Care Management Science - December 6, 2023 Category: Hospital Management Source Type: research

Cell-free DNA Testing in Lung Cancer Patients Improves National Health Service Real-world Result Turnaround Time and Treatment Initiation for Tumours with Targetable Alterations by 4 Weeks
Clin Oncol (R Coll Radiol). 2023 Nov 21:S0936-6555(23)00450-8. doi: 10.1016/j.clon.2023.11.035. Online ahead of print.NO ABSTRACTPMID:38044195 | DOI:10.1016/j.clon.2023.11.035 (Source: Clinical Lung Cancer)
Source: Clinical Lung Cancer - December 3, 2023 Category: Cancer & Oncology Authors: D M Favara T Verissimo F McCaughan Source Type: research

Hitting the Target: Developing High-quality Evidence for Proton Beam Therapy Through Randomised Controlled Trials
We present a summary of three UK PBT RCTs in progress, including consideration of their key design characteristics and outcome assessments, to inform and support future PBT trial development. The first three UK multicentre phase III PBT RCTs (TORPEdO, PARABLE and APPROACH), will compare PBT with photon radiotherapy for oropharyngeal squamous cell carcinoma, breast cancer and oligodendroglioma, respectively. All three studies were designed by multidisciplinary teams, which combined expertise from clinicians, clinical trialists and scientists with strong patient advocacy and guidance from national radiotherapy research netwo...
Source: Clinical Breast Cancer - December 2, 2023 Category: Cancer & Oncology Authors: E M Hudson F Slevin K Biscombe S R Brown J S Haviland L Murray A M Kirby D J Thomson D Sebag-Montefiore E Hall Source Type: research

Hitting the Target: Developing High-quality Evidence for Proton Beam Therapy Through Randomised Controlled Trials
We present a summary of three UK PBT RCTs in progress, including consideration of their key design characteristics and outcome assessments, to inform and support future PBT trial development. The first three UK multicentre phase III PBT RCTs (TORPEdO, PARABLE and APPROACH), will compare PBT with photon radiotherapy for oropharyngeal squamous cell carcinoma, breast cancer and oligodendroglioma, respectively. All three studies were designed by multidisciplinary teams, which combined expertise from clinicians, clinical trialists and scientists with strong patient advocacy and guidance from national radiotherapy research netwo...
Source: Clinical Genitourinary Cancer - December 2, 2023 Category: Cancer & Oncology Authors: E M Hudson F Slevin K Biscombe S R Brown J S Haviland L Murray A M Kirby D J Thomson D Sebag-Montefiore E Hall Source Type: research

Preconceptual administration of doxycycline in women with recurrent miscarriage and chronic endometritis: protocol for the Chronic Endometritis and Recurrent Miscarriage (CERM) trial, a multicentre, double-blind, placebo-controlled, adaptive randomised trial with an embedded translational substudy
This study will aim to determine if preconceptual administration of doxycycline, in women with recurrent miscarriages, and CE, reduces first trimester miscarriages, increasing live births. Methods and analysis Chronic Endometritis and Recurrent Miscarriage is a multicentre, double-blind adaptive trial with an embedded translational substudy. Women with a history of two or more consecutive first trimester losses with evidence of CE on endometrial biopsy (defined as ≥5 CD138 positive cells per 10 mm2) will be randomised to oral doxycycline or placebo for 14 days. A subset will be recruited to a mechanistic substudy in wh...
Source: BMJ Open - December 1, 2023 Category: General Medicine Authors: Odendaal, J., Black, N., Bouliotis, G., Guck, J., Underwood, M., Fisher, J., Quenby, S. Tags: Open access, Obstetrics & Gynaecology Obstetrics and gynaecology Source Type: research

P021 Appropriateness of two-week wait head and neck cancer referrals to a District General Hospital
The objective of this research was to analyse the two-week wait head and neck cancer referrals to a District General Hospital, and to identify the prevalence of oral cancer in these referrals amongst other conditions. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 1, 2023 Category: ENT & OMF Authors: Hannah Hook, Hannah Hook, Gabriele Baniulyte, Michael Esson, John Bowden Source Type: research

72. A quality improvement project analysing the environmental and financial impact of unnecessary preoperative investigations
In 2019 NHS Scotland became the first National Health Service in the UK to commit to becoming a net-zero organisation by 2040. In Aug 2021, routine GP blood tests were halted in E&W due bottle shortages. Considering this, routine bloods should be rationalised. This could benefit the patient, hospital and environment. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 1, 2023 Category: ENT & OMF Authors: Marc Chan, Marc Chan, Conor Davidson, Oliver Rideout, Nida Ilahi, Eiling Wu, Mark Ansell, David Laraway Source Type: research

P10 Impact of the COVID-19 Pandemic on Cancer Screenings in Portugal and Years of Life Lost Due to Delayed Diagnoses
This study aimed to evaluate the impact of the COVID-19 pandemic on cancer screening programs carried out by the Portuguese National Health Service (NHS), and to estimate the consequences on cancer morbidity and mortality. (Source: Value in Health)
Source: Value in Health - December 1, 2023 Category: International Medicine & Public Health Authors: D. Mendes, D. Figueiredo, C. Alves, A. Penedones, B. Costa, F. Batel Marques Source Type: research

EE117 Cost-Effectiveness of Empagliflozin in Patients Affected By Chronic Kidney Disease in Italy
Chronic Kidney Disease (CKD) is a prevalent condition associated to a great clinical and economic burden. The phase III randomized controlled trial EMPA-KIDNEY found empagliflozin, a sodium glucose co-transporter 2 inhibitor, to be effective in reducing CKD progression and cardiovascular mortality in both diabetic and non-diabetic patients with CKD. The study aims to assess the cost-effectiveness of empagliflozin in patients affected by CKD in stages II-IV from the Italian National Health Service (NHS) perspective. (Source: Value in Health)
Source: Value in Health - December 1, 2023 Category: International Medicine & Public Health Authors: A. Di Costanzo, A. Uster, C. Vassallo, F. Fiorentino Source Type: research

EE172 An Early Economic Analysis of the Costs and Benefits of Medical Alert Assistance Dogs (MAADS) in the Management of Emergency Episodes for People with Postural Tachycardia Syndrome (POTS) Using Real-World Evidence (RWE)
The objective of this analysis was to estimate the cost-effectiveness of MAADs, in addition to standard of care (SoC), in the management of emergency episodes for people with PoTS versus SoC alone from the perspective of the National Health Service (NHS). (Source: Value in Health)
Source: Value in Health - December 1, 2023 Category: International Medicine & Public Health Authors: E. Ryczek, H. Baker, A. Bentley, E. Thurgar Source Type: research