Abstract:
OBJECTIVE:To evaluate whether follow up of patients with inflammatory bowel disease is better through open access than by routine booked appointments. DESIGN:Pragmatic randomised controlled trial. SETTING:Two district general hospitals in Swansea and Neath, Wales. PARTICIPANTS:180 adults (78 with Crohn's disease, 77 ulcerative or indeterminate colitis, 25 ulcerative or idiopathic proctitis) recruited from outpatient clinics during October 1995 to November 1996. INTERVENTION:Open access follow up according to patient need. MAIN OUTCOME MEASURES:Generic (SF-36) and disease specific (UK inflammatory bowel disease questionnaire UKIBDQ) quality of life, number of primary and secondary care contacts, total resource use, and views of patients and general practitioners. RESULTS:There were no differences in generic or disease specific quality of life. Open access patients had fewer day visits (0.21 v 0. 42, P<0.05) and fewer outpatient visits ( 4.12 v 4.64, P<0.01), but some patients had difficulty obtaining an urgent appointment. There were no significant differences in specific investigations undertaken, inpatient days, general practitioner surgery or home visits, drugs prescribed, or total patient borne costs. Mean total cost in secondary care was lower for open access patients (P<0.05), but when primary care and patient borne costs were added there were no significant differences in total costs to the NHS or to society. General practitioners and patients preferred open access. CONCLUSIONS:Open access follow up delivers the same quality of care as routine outpatient care and is preferred by patients and general practitioners. It uses fewer resources in secondary care but total resource use is similar. Better methods of ensuring urgent access to outpatient clinics are needed.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Williams JG,Cheung WY,Russell IT,Cohen DR,Longo M,Lervy Bdoi
10.1136/bmj.320.7234.544keywords:
subject
Has Abstractpub_date
2000-02-26 00:00:00pages
544-8issue
7234eissn
0959-8138issn
1756-1833journal_volume
320pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:To examine the associations of a vegetarian diet and dietary fibre intake with risk of diverticular disease. DESIGN:Prospective cohort study. SETTING:The EPIC-Oxford study, a cohort of mainly health conscious participants recruited from around the United Kingdom. PARTICIPANTS:47,033 men and women living in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d4131
更新日期:2011-07-19 00:00:00
abstract:OBJECTIVES:To assess whether and how investigators of placebo controlled randomised trials inform participants of their treatment allocation at trial closure and to assess barriers to feedback. DESIGN:Postal survey with a semistructured questionnaire. PARTICIPANTS:All investigators who published a placebo controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7376.1329
更新日期:2002-12-07 00:00:00
abstract:OBJECTIVE:To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. DESIGN:Multicentre retrospective case-control study. SETTING:79 emergency departments of hospitals associated with the Pediatric Emergency...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f4836
更新日期:2013-08-12 00:00:00
abstract:OBJECTIVE:To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. DESIGN:Pooled analysis of in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.d3036
更新日期:2011-05-24 00:00:00
abstract:OBJECTIVE:To determine whether in a patient with spontaneous pneumothorax the presence or absence of a pleural leak can be shown at the time of manual aspiration by use of a marker gas. Also, to find out if the technique can predict whether manual aspiration will be successful, hence avoiding the need for intercostal t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6771.262
更新日期:1991-02-02 00:00:00
abstract:OBJECTIVE:To assess whether sleep apnoea syndrome is an independent risk factor for hypertension. DESIGN:Population study. SETTING:Sleep clinic in Toronto. PARTICIPANTS:2,677 adults, aged 20-85 years, referred to the sleep clinic with suspected sleep apnoea syndrome. OUTCOME MEASURES:Medical history, demographic da...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.320.7233.479
更新日期:2000-02-19 00:00:00
abstract:OBJECTIVE:To determine prevalence of HIV infection and drug injecting behaviour among inmates of Glenochil Prison on a specified date a year after an outbreak of hepatitis B and HIV infection. DESIGN:Cross sectional: voluntary, anonymous HIV salivary antibody surveillance and linked self completion questionnaire on ri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6975.293
更新日期:1995-02-04 00:00:00
abstract:OBJECTIVES:To evaluate the cardiac safety of central nervous system stimulants in children and adolescents. DESIGN:Population based retrospective cohort study. SETTING:Automated healthcare claims data from 1,219,847 children and young people eligible for 28 state Medicaid programmes from 1999 to 2006 linked to the So...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e4627
更新日期:2012-07-18 00:00:00
abstract::Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (deri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.j1710
更新日期:2017-05-03 00:00:00
abstract:OBJECTIVE:To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN:Prospective audit of referrals from a group practice over one year. SETTING:Six handed practice in a southern coastal town. SUBJECTS:All patients referred during the study period for whom a copy o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6701.722
更新日期:1989-09-16 00:00:00
abstract:OBJECTIVE:To review the evidence base from randomised controlled trials of combined cardiac resynchronisation therapy and implantable cardioverter defibrillator therapy in left ventricular impairment and symptomatic heart failure. DESIGN:Bayesian network meta-analysis. DATA SOURCES:Medline, Embase, and Cochrane datab...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39343.511389.BE
更新日期:2007-11-03 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and costs of a multifaceted flexible educational programme aimed at reducing antibiotic dispensing at the practice level in primary care. DESIGN:Randomised controlled trial with general practices as the unit of randomisation and analysis. Clinicians and researchers were blinded ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.d8173
更新日期:2012-02-02 00:00:00
abstract::The studyA Rodger, V Cambiano, T Bruun, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393:2428-38.This project was funde...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.l4915
更新日期:2019-08-27 00:00:00
abstract:OBJECTIVES:To gain insight into people's thoughts on stroke and to inform the development of educational strategies in the community. DESIGN:Focus group discussions: two groups of people who had a stroke and their carers, and two groups of members of the general public. SETTING:New South Wales, Australia. PARTICIPAN...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.324.7345.1065
更新日期:2002-05-04 00:00:00
abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7295.1154
更新日期:2001-05-12 00:00:00
abstract:OBJECTIVE:To assess the ability of ultrasonography to identify reflux nephropathy in children after urinary tract infection. DESIGN:Ten experienced radiologists performed a total of 240 ultrasonographic examinations of kidneys in a one day study. The examiners were unaware of the results of previous radiological and c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6949.235
更新日期:1994-07-23 00:00:00
abstract::A doctor who performed an abortion in Poland faces two years in prison and the loss of his medical license for up to 10 years if he is found guilty of violating the new abortion laws introduced in 1993 after a lengthy campaign by the Catholic church and the Christian Democratic Union party. The new laws permit aborti...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.310.6994.1556a
更新日期:1995-06-17 00:00:00
abstract:OBJECTIVES:To identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with ant...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.l6461
更新日期:2019-12-11 00:00:00
abstract:OBJECTIVES:To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.320.7245.1303
更新日期:2000-05-13 00:00:00
abstract:OBJECTIVES:To explore general practitioners' reasons for recent changes in their prescribing behaviour. DESIGN:Qualitative analysis of semistructured interviews. SETTING:General practice in south east London. SUBJECTS:A heterogeneous sample of 18 general practitioners. RESULTS:Interviewees were able to identify bet...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7036.949
更新日期:1996-04-13 00:00:00
abstract:OBJECTIVES:To examine how insurance companies assess proposals for life assurance from applicants with raised cholesterol concentrations and to determine the excess mortality rating applied. DESIGN:Survey of 49 companies underwriting term life assurance. SETTING:United Kingdom. SUBJECTS:Four fictional men aged 30 se...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6781.891
更新日期:1991-04-13 00:00:00
abstract:OBJECTIVES:To determine the prevalence of workplace bullying in an NHS community trust; to examine the association between bullying and occupational health outcomes; and to investigate the relation between support at work and bullying. DESIGN:Questionnaire survey. SETTING:NHS community trust in the south east of Engl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7178.228
更新日期:1999-01-23 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract:OBJECTIVE:To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN:Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING:Obstetric department and neonatal department...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39405.539282.BE
更新日期:2008-01-12 00:00:00
abstract:OBJECTIVE:To evaluate the impact and cost effectiveness of a programme to transform adult critical care throughout England initiated in late 2000. DESIGN:Evaluation of trends in inputs, processes, and outcomes during 1998-2000 compared with last quarter of 2000-6. SETTING:96 critical care units in England. PARTICIPA...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4353
更新日期:2009-11-11 00:00:00
abstract:OBJECTIVES:To examine a possible effect on labour of training the muscles of the pelvic floor during pregnancy. DESIGN:Randomised controlled trial. SETTING:Trondheim University Hospital and three outpatient physiotherapy clinics in a primary care setting. PARTICIPANTS:301 healthy nulliparous women randomly allocated...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38163.724306.3A
更新日期:2004-08-14 00:00:00
abstract:OBJECTIVE:To compare characteristics of patients and outcomes after elective surgery in independent sector treatment centres (ISTCs) and NHS providers. DESIGN:Follow-up study with outcomes reported by patients three to six months after surgery. SETTING:25 ISTCs and 72 NHS providers in England. Population Consecutive ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d6404
更新日期:2011-10-19 00:00:00
abstract::Doctors and other health professionals in developing countries are missing out on relevant information about health. A lot of the information they need is available in the developed countries, and those who have it are happy to share it with them. But transporting information, like food or medicines, from one part of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6959.939
更新日期:1994-10-08 00:00:00
abstract:OBJECTIVE:To investigate any long term effects of traumatic birth and obstetric procedures in relation to suicide by violent means in offspring as adults. DESIGN:Prospective case-control study. SETTING:Stockholm, Sweden. SUBJECTS:242 adults who committed suicide by violent means from 1978 to 1995, and who were born ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7169.1346
更新日期:1998-11-14 00:00:00
abstract:OBJECTIVES:To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. DESIGN:Feasibility study. SETTING:Seven paediatric intensive care units in England. PARTICIP...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38404.650208.AE
更新日期:2005-04-16 00:00:00