All tests ‘(…) do harm; some do good as well, and, of these, some do more good than harm at reasonable cost.’ - Muir Gray and Angela Raffle. Medical tests are widely and increasingly marketed directly to consumers via traditional and social media. Such tests may [...]
Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis [...]
The primary objective was to determine the population prevalence of glenohumeral joint imaging abnormalities in asymptomatic adults. We systematically reviewed studies reporting the prevalence of X-ray, ultrasound (US), computed tomography, and magnetic resonance imaging (MRI) abnormalities in adults without shoulder symptoms.
Different methods to quantify the carbon impact of health care produce different answers. The top-down method, environmentally extended input output (EEIO) analysis, uses financial data to track money flows of products and services between sectors within an economy. Knowing both the direct emissions of each [...]
Digital breast tomosynthesis (DBT) may improve sensitivity in population screening. However, evidence is currently limited on the performance of DBT in patients at a higher risk of breast cancer. This systematic review compares the clinical effectiveness and cost-effectiveness of DBT, digital mammography (DM), and ultrasound, [...]
Clinical care indicators for low back pain can be used to monitor healthcare practices and consequently be used to evaluate success of strategies to improve care quality. The aim of this study was to identify the clinical care indicators that have been used to measure [...]
This study aims to evaluate the efficacy and cost-effectiveness of sonothrombolysis delivered pre and post primary percutaneous coronary intervention (pPCI) on infarct size assessed by cardiac MRI, in patients presenting with STEMI, when compared against sham procedure. More than a half of patients with successful [...]
Occasions of low-value care (LVC) are those that confer little or no benefit to the patient or where harm (including lost treatment opportunity and financial cost) exceeds likely benefit. While it is easy to conceptualise health care as either low or high value, the reality [...]
Strategies to enhance clinicians’ adherence to validated imaging decision rules and increase the appropriateness of imaging remain unclear. The objective of this study is to evaluate the effectiveness of various implementation strategies for increasing clinicians’ use of five validated imaging decision rules (Ottawa Ankle Rules, [...]
Film mammography has been replaced by digital mammography in breast screening programs globally. This led to a small increase in the rate of detection, but whether the detection of clinically important cancers increased is uncertain. We aimed to assess the impact on tumor characteristics of [...]