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 [...]
The anti-Mullerian hormone (AMH) can be measured by a blood test and gives an indication of the number of oocytes in the ovaries, but not of oocyte quality . Whilst the test is helpful in assisted reproduction as it roughly indicates the potential number of [...]
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 [...]
Analytical performance specifications (APS) based on outcomes refer to how 'good' the analytical performance of a test needs to be to do more good than harm to the patient. Analytical performance of a measurand affects its clinical performance. Without first setting clinical performance requirements, it [...]
Residential aged care facilities (RACF) are sites of high antibiotic use in Australia. Misuse of antimicrobial drugs in RACF contributes to antimicrobial resistance (AMR) burdens that accrue to individuals and the wider public, now and in the future. Antimicrobial stewardship (AMS) practices in RACF, e.g. [...]
In recent years, social media have emerged as important spaces for commercial marketing of health tests, which can be used for the screening and diagnosis of otherwise generally healthy people. However, little is known about how health tests are promoted on social media, whether the [...]
Blood gas analysis is the most commonly ordered test in the intensive care unit. Each investigation, however, comes with risks and costs to the patient and healthcare system. Evidence suggests that many tests are performed with no appropriate clinical indication.
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, [...]
Diagnostic uncertainty, risk perceptions, time constraints, and pressure from resident/family members and nurses have been identified as potential barriers to reducing antibiotic prescribing in residential aged-care facilities. The current study investigated the relationship between nurses’ anxiety, clinical tolerance of uncertainty, and behaviors that favor antimicrobial [...]