Monthly Archives: March 2013

The challenges of becoming culturally competent

We are all aware of the aspiration for health care services to be both respectful of and responsive to the diverse needs of patients. We are also all aware of how far short we fall of this goal on many occasions. Last week I attended an inspirational meeting of the EACH project (Embedding Community Ambassadors …read more

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You can’t always get what you want…

There has been a flurry of interest in the recent Patient Association report “Primary Care: Access Denied?”, based on a survey of members and supporters of that association: see for example the write up from BBC News. Patients need to understand that if they want GPs to be available round the clock, they will be …read more

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What does the future of primary care hold?

Domhnall MacAuley paints a bleak picture of the future of primary care in the UK. One in which our experience will be dominated by discontinuity of care, and doctors with no real sense of personal responsibility for their patients. How might we do better than this? 1. Redefine the ‘new professionalism’ Personal responsibility for patients …read more

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How many levels in multi-level modelling? An example from a recent CCHSR paper

A previous blog by Gary Abel here discussed the interpretation of random effects used to account for clustering (i.e. non-independence) of observations within organisations such as general practices or hospitals. We can also use another common term to describe this use of random effect variables, which is ‘multi-level modelling’. For example, patient observations are usually …read more

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You mean, I have to write something too? Early lessons in research group blogging

Welcome, welcome. Come on in, let me show you around. It’s all rather shiny and new at the moment, our blog. Over here, we’ve got our lovely statisticians, Gary and Katie, helping the rest of us to try and understand tricky things like joint tests and correction for attenuation. Over there is the Prof giving …read more

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When less is more: Responding to overtreatment

There is much about medicine that is good. But as Fiona Godlee points out, it is possible to have too much of a good thing. Evidence for potential harms of overtreatment, both to individual patients and to society, should not be ignored. All treatments have the potential to do harm, as well as good. Yet …read more

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Why don’t doctors believe patient surveys?

Recent work by CCHSR shows that GPs find a whole range of reasons for doubting the results of patient surveys.

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What is so special about random effects?

Nothing! Apologies for the rather glib answer, but this blog is not aimed at my fellow statisticians for whom issues around power, parsimony, computational efficiency, and distributional assumptions keep them awake at night. Nor should these issues be ignored when we are thinking about the design of a study or the analysis methods to use. …read more

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Social media and patient experience

Research from Oxford University on a rise in emergency admissions in children, mostly due to common viral infections, caught the interest of national media; and a media request was made to Mumsnet posters for examples of when this had happened. The response from posters on Mumsnet was a robust defence of the work of general …read more

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.