The ASCO Post
Interview with: Camilla Zimmermann, MD, PhD
We asked patients and their caregivers in both cohorts what they thought the role of their oncologist was.
Wednesday, January 25, 2017
Canadian Study Looks at an Integrated Palliative Care Model
The ASCO Post
Interview with: Camilla Zimmermann, MD, PhD
OA: What have we learnt after 15 years of research into the ‘weekend effect’?
BMJ Quality and Safety
Published Online First 30 November 2016
It is now 15 years since Bell and Redelmeier published their landmark study demonstrating higher mortality for people admitted
to hospital during weekends compared with during the week.1
Examining the records of 3.8 million patients admitted over a 10-year
period to emergency departments in Ontario, Canada,
this ‘weekend effect’ existed over a range
of acute conditions, including 23 out of the 100 leading causes of
death.
Since that paper in 2001, over 100 studies have explored the weekend effect, across a range of patient populations and health
systems.2
Surprisingly, despite this large number of studies, there remains
ongoing debate about whether the weekend effect exists,
and if so, what causes it. For example,
one recent and highly influential study found higher rates of
in-hospital death following
admission on Saturday or Sunday compared
with Wednesday admissions (HR 1.10 for Saturday and 1.15 for Sunday).3.....
Summary
Untangling the evidence for
the weekend effect has proven extremely difficult, and it therefore
comes as no surprise that
it has generated controversy in some
settings. Messy, conflicting evidence is, however, less the exception
than the norm when
it comes to questions about healthcare
quality, and meaningful progress can be made even for these knotty types
of problems
through the use of quality improvement
methods. Actively looking for temporal variation in quality of care,
patient safety
and outcomes should help ensure that
potentially important, systematic inequalities in quality do not persist
unnoticed.
Aerobic Exercise and Cancer-Related Fatigue in Adults: A Reexamination....
abstract:
Aerobic Exercise and Cancer-Related Fatigue in Adults: A Reexamination Using the IVhet Model for Meta-analysis | Cancer Epidemiology, Biomarkers & Prevention
Background: Although the results of a
recent meta-analysis using the traditional random effects model yielded a
statistically significant standardized mean difference (SMD) reduction
in cancer-related fatigue (CRF) as a result of aerobic exercise, a
recently developed inverse heterogeneity (IVhet) model has been shown to
be more valid than the traditional random effects model. The purpose of
this study was to compare these previous meta-analytic results using
the IVhet model.
Conclusions: Insufficient evidence currently exists to support the use of aerobic exercise for reducing CRF in adults.
Impact: Additional studies are needed to determine the certainty of aerobic exercise on CRF in adults. Cancer Epidemiol Biomarkers Prev; 26(2); 1–3.
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