Abstract:
:The outlook for patients with lung cancer is poor, so an accurate estimation of prognosis will underpin treatment decisions and allow patients to make personal plans for the future. However, evidence suggests that there is a variation between doctors in their predictions of outcomes and also they tend to be over-optimistic. Two main questions are addressed in this study: whether multidisciplinary team discussion changes prognostic accuracy of individual clinicians; and whether team discussion improves the accuracy of the team's aggregated prediction. A real-time study of 50 newly diagnosed patients discussed by a regional lung cancer team was undertaken. A case pro-forma informed the completion of a pre-discussion questionnaire by each team member, seeking prognostic predictions at specific time points. This was repeated after team discussion. Medical notes were reviewed at 6 months to establish actual survival status. Group discussion did not significantly change the accuracy of survival predictions for any one clinician, but the team as a whole performed better after case discussion. Predictions which the clinicians were more confident about were found to be no more accurate than those where they were less confident. There is a wide variation in the range and accuracy of prognostic predictions made by individual clinicians, with no consistent improvement after team discussion. As such predictions are integral to decision making, further research on decision-making processes of clinical teams is required.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Kee F,Owen T,Leathem Rdoi
10.1136/jech.2005.044917subject
Has Abstractpub_date
2007-04-01 00:00:00pages
308-13issue
4eissn
0143-005Xissn
1470-2738pii
61/4/308journal_volume
61pub_type
杂志文章abstract::It has been claimed that the aggregation of information from several areas of life into a small set of global measures has certain advantages for describing disability. Global measures of disability were constructed from a modified version of an existing health survey instrument and the sickness impact profile (SIP) a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.37.4.296
更新日期:1983-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether methadone maintenance treatment (MMT) is effective in reducing the levels of HIV risk-taking behaviour (borrowing and lending of injection equipment, irregular condom use) among injecting drug users (IDUs), and to identify independent predictors of the borrowing of used syringes. D...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.5.534
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) have a markedly higher overall mortality from coronary heart disease (CHD), as well as many other causes of death like cancer. Since diabetes is a multisystem disease, this fact together with the increased lifespan among individuals with diabetes may also lead to the emer...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2019-213602
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Childhood mortality is a well-known public health issue, particularly in the low and middle income countries. The overarching aim of this study was to examine whether neighbourhood socioeconomic disadvantage is associated with childhood mortality beyond individual-level measures of socioeconomic status in Ni...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-205457
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:To explore risk factors for symptomatic knee osteoarthritis (OAK) in women, which included wearing high heeled shoes. DESIGN:Matched case-control study. Exposure information obtained by interview, included details about past footwear. Self reported weight and height data obtained representing when wome...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.10.823
更新日期:2003-10-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the completion rate, internal reliability, and external validity of a home affluence scale based on adolescents' reports of material circumstances in the home as a measure of family socioeconomic status. DESIGN:Cross sectional survey. SETTING:Data were collected from a school based study in...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.56.8.595
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Two competing hypotheses, cumulative advantage/disadvantage and age-as-leveller, have been proposed to explain the contradictory findings on socioeconomic differences in health over the lifespan. To test these hypotheses, this investigation examined the influence of educational attainment and material condit...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206548
更新日期:2016-11-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to examine disease concurrence, using diabetes mellitus as an ullustrative example. DESIGN:The study involved a general practice morbidity survey, conducted over 12 months in 1981-82. All patients who consulted their general practitioners with a diagnosis of diabetes mellitus (type 1 or typ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.45.1.73
更新日期:1991-03-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the extent to which poorer self assessed health in men in whom an abdominal aortic aneurysm (AAA) is detected at screening is a consequence or a predictor of screening outcome. DESIGN:Prospective study. SETTING:Community based screening. PARTICIPANTS:23 654 men who attended for AAA screeni...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.2003.019307
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Observational studies have linked work-family issues with cigarette consumption. This study examined the 6-month effects on cigarette consumption of a work-family supportive organisational intervention among nursing home workers. METHODS:Group randomised controlled trial where 30 nursing homes across New En...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206953
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:This study contributes robust evidence on the association between mental health and local crime rates by showing how changing exposure to small area-level crime relates to self-reported and administrative data on mental health. METHODS:The study sample comprised 112 251 adults aged 16-60 years, drawn from t...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-213837
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To investigate whether occupational social class and area deprivation are independently associated with the prevalence of cardiovascular disease (CVD) conditions after adjustment for smoking status. DESIGN:Stratified multistage random sample analysed using multilevel logistic regression. PARTICIPANTS:8804 a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2005.034017
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:It is important to understand the local burden of non-communicable diseases including within-country heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors. METHO...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-205988
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. METHOD:A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech-2011-200689
更新日期:2012-08-01 00:00:00
abstract::Birthweight and gestational age are the two most commonly used continuous variables in perinatal research. Dichotomous outcomes derived from these two variables include low birthweight, preterm birth and small for gestational age, each extensively used as perinatal and population health indicators within public health...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2011-200772
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:An association between socioeconomic status (SES) and the incidence of type 2 diabetes mellitus (T2DM) has been found for younger and middle-aged individuals, but studies of this relationship in elderly populations are rare. METHODS:In a population-based cohort in southern Germany (KORA S4/F4: 1223 subjects...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.094086
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:People living in highly walkable neighbourhoods tend to be more physically active and less likely to be obese. Whether walkable urban design reduces the future risk of diabetes is less clear. METHODS:We used inverse probability of treatment weighting to compare 10-year diabetes incidence between residents l...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-210510
更新日期:2019-04-01 00:00:00
abstract::A retrospective questionnaire and interview study of 10 year survivors of uncomplicated myocardial infarction examined smoking, diet, exercise, weight, medication, and treatment since discharge from hospital in 1973-4 and made comparisons with controls (using the same questionnaire) and with normal populations (as rep...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.2.103
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Several studies have found that an increased level of ambient particulate matter (PM) smaller than 2.5 microns (PM2.5) is associated with an increased risk of OHCA. We investigated the relationship between air pollution levels and the...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-202955
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to estimate the health and social costs of tobacco use in Ontario, Canada. DESIGN:This was a cost-benefit analysis based on cross sectional data in 1988, stratified by age and sex, using an attributable risk model. The total cost of the consequences of tobacco use in the society includ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.1.81
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:The aetiology of age-related sarcopenia is not known. OBJECTIVES:To investigate if risk of developing sarcopenia differs by gender and to identify gender-specific risk factors of incident sarcopenia in a large population-based cohort of older English adults. METHODS:The sample (n=3404; age 63.4 (SD 7.7) ye...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211258
更新日期:2019-01-01 00:00:00
abstract::Records in the obstetric wards and nurseries of 18 hospitals were reviewed and studied epidemiologically, covering about 210,000 deliveries and 1000 cases of neural tube defects (NTD). All live and still births occurred in the period 1970-84. Following the NTD classification used by Koch (1984), our case series consis...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.41.3.259
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Reliable data on clinical biomarkers are necessary in order to assess the health risks of populations and especially in assessing long-term trends related to disease incidence. METHODS:Ten European laboratories participated in a two-phase quality control exercise of total cholesterol (TC) and high-density l...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-210763
更新日期:2018-07-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN:Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.1.35
更新日期:2000-01-01 00:00:00
abstract::The comparison of trends in ischaemic heart disease (IHD) mortality in different social classes is confounded by historical changes in diagnostic techniques and statistical classification, and possibly by different standards of diagnostic accuracy in the different social classes. The problems can be circumvented by ta...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.33.1.74
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Despite the implementation of policy interventions to address open drug consumption, public injecting continues to occur in many urban settings. This study sought to examine public injecting among a community-recruited cohort of injecting drug users (IDUs) in Vancouver. METHODS:The prevalence and correlates...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2007.069013
更新日期:2009-01-01 00:00:00
abstract:STUDY OBJECTIVE:To study municipal variations in children's injury risk and to assess the impact of safety promotion measures in general municipal, preschool, school, and leisure activity settings, on injury outcome. DESIGN:A cohort study based on individual data on children's consumption of hospital care as a result ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.57.9.724
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:It has been hypothesised that dehydration in infancy could permanently increase sodium retention, raising blood pressure in later life. In this study, the association between gastrointestinal tract infection in infancy, a clinically relevant exposure often accompanied by dehydration, and raised blood pressur...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech.2009.090894
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:In a participatory approach to health and development interventions, defining and measuring community mobilisation is important, but it is challenging to do this effectively, especially at scale. METHODS:A cross-sectional, participatory monitoring tool was administered in 2008-2009 and 2009-2010 across a re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2012-201065
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Tobacco smoke pollution (TSP) has major negative effects on infant health. Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies' TSP exposure, and to establish variables related to greater exposure. METHOD:A multicentre, ope...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/jech-2014-204708
更新日期:2015-03-01 00:00:00