A new review by Mark Mahon and colleagues explores developments in the diagnosis and management of eosinophilic oesophagitis, highlighting promising emerging minimally invasive tests for patients.
Read the full article here: https://bit.ly/3P7Dt6A
Sara Pretorius and colleagues review UK guidelines for individual health conditions and propose improvements to guideline development processes to improve usability of guidelines for clinicians managing patients with multiple long term conditions
https://bit.ly/4slFri8
Read the full research paper in BMJ Medicine bmjmedicine.bmj.com/content/5/1/... and a linked editorial from Barbara Nichol et al bmjmedicine.bmj.com/content/5/1/...
The authors suggest that guideline groups should incorporate multiple long term conditions into evidence review processes, committee design, and guideline structure - but also point out that broader change to education and research is needed.
19 (34%) guidelines featured sections looking at specific coexisting conditions or coexisting conditions generally.
50 (89%) guidelines offered general guidance on tailoring care. However, only 11 (20%) guidelines explicitly referred to multiple long term conditions, and none included a dedicated section on multiple long term conditions or how care should be adapted in this context.
A new study in BMJ Medicine by Sarah Pretorius and colleagues reviewed 56 clinical guidelines developed by NICE. All but one of the NICE guidelines (n=55, 98%) included some advice on managing the index condition in the presence of coexisting conditions.
Estimates of multimorbidity range from 15-43% of the adult population, and most people with one long term condition have more than one. How well do guidelines account for this? How often do they offer specific guidance on how to manage long term conditions that may be affected by comorbidities?🧵
Barbara Nicholl and colleagues reflect on how clinical guidelines largely focus on single diseases and are inadequate for the care required by people with multiple long-term conditions
Read the full Editorial in BMJ Medicine: https://bit.ly/4tWorAy
Read more in the BMJ Medicine methods primer “When means and standard deviations are an incomplete summary of a continuous variable: problems, solutions, and utilising the reference ranges to check normality” by Dan Green and colleagues
bmjmedicine.bmj.com/content/5/1/...
4. Reporting the median and interquartile interval values instead would give a more accurate reflection of the central tendency and spread of the data.
3. This suggests that the data is not normally distributed. In this case most CAPS-5 scores were relatively low with a small number of higher score, resulting in a right skewed distribution (see image)
2. These are implausible because negative values for the scoring tool aren’t possible.
1. The 95% reference range is −9.2 to 35.2.
How did you get on with our stats question? Was it too mean? Here are the answers🧵
In this study Sara Pretorius and colleagues evaluate how UK guidelines for individual health conditions account for coexisting conditions and propose changes to guideline development to improve care for people with multiple long term conditions
https://bit.ly/4sczrYK
Explore our Methods Primers Collection, where all resources in this area are conveniently organized for your reference https://bit.ly/45vZb9G
Answers to follow - or find them now in the BMJ Medicine methods primer by Dan Green and colleagues.
bmjmedicine.bmj.com/content/5/1/...
Question 4. What summary statistics would give a more accurate reflection of the spread of the data?
Question 3. What does it suggest about the data?
Question 2. Why are these implausible?
Question 1. What are the 95% reference range limits?
CAPS-5, a scoring tool to diagnose current and lifetime post traumatic stress disorder, has potential values of 0 to 80. CAPS-5 was completed by 83 individuals; no negative values were possible. The reported mean was 13.0, and standard deviation (SD) was 11.1.
Fancy a stats quiz? Read through the example and answer the questions in the thread below 🧵
New research📢
Geertruida Bekkering and colleagues compare the effectiveness and safety of pharmacological and non-pharmacological smoking cessation interventions in people with severe mental illness.
https://bit.ly/4kHE8Ye
A new Methods Primer by Dan Green and colleagues outlines circumstances where the mean and standard deviation alone are insufficient summary variables, and provides a simple appraisal method for reviewers without raw data
Read in BMJ Medicine now: https://bit.ly/4bJz3w8
Walker and Lee reflect on a study by Faye Cleary and colleagues that presents a new kidney failure risk equation that doesn't need albuminuria testing, saying it has potential to improve health equity but albuminuria testing is important beyond predicting kidney failure https://bit.ly/4bJz3w8
A new study from Faye Cleary and colleagues presents a new risk prediction equation for kidney failure in patients with chronic kidney disease who do not require data for the urine albumin to creatinine ratio
Read the full study here: https://bit.ly/4qtOpsr
Take a look at our open access specialist reviews, in one handy Collection for you to browse anytime https://bit.ly/3YpbpgB
Yuanyuan Zhang and colleagues compare the efficacy and safety of different intensive systolic blood pressure targets versus usual care on cardiovascular and renal outcomes in high risk patients
https://bmjmedicine.bmj.com/content/5/1/e001791
