Skip to main content

Posts

Showing posts from December, 2015

Bariatric surgery - Should we prioritise patients with type 2 diabetes?

The results of recent research studies illustrate the importance of prioritizing obese people with type 2 diabetes mellitus when it comes to selecting patients for bariatric surgery. For example, the number of people eligible for bariatric surgery in England far exceeds the bariatric surgery capacity of its National Health Service. If the aim of bariatric surgery is to reduce mortality and morbidity among obese patients, then the focus should be on selecting patients for surgery based on the presence of the conditions that have the greatest detrimental effect on health status. It may therefore be appropriate to reconsider the importance of body mass index alone as a predictor of mortality and put more emphasis on the presence of comorbidities when assessing eligibility for bariatric surgery. Given the significant benefits for people with type 2 diabetes that bariatric surgery offers and the resulting major improvements in their health status, there is a strong case that type 2 diabet…

Moving forwards with research on the “weekend effect”

Two articles published in The BMJ in 2015 on the “weekend effect” have sparked considerable debate in The BMJ and on social media. A number of previous studies have reported that hospital mortality is higher for patients admitted at weekends than for patients admitted on other days of the week. This higher mortality for patients admitted at weekends has also been found in studies carried out in other countries as well as in England’s NHS. However, the key question which this prior research has not answered is whether the higher mortality is “avoidable” and not simply due to the patients who are admitted on weekends having more complex health needs and a poorer health status than patients admitted on weekdays.

You can read the full article on BMJ Blogs.

Sharing images of patients electronically

In a recent article in a medical magazine, I and two other commentators discuss issues around the electronic sharing of images of patients that clinicans should be aware of.

The very high use of information technology in modern society has resulted in the practical uses of sending and sharing information electronically rapidly outstripping published guidance in this area. For example, many NHS organisations have draconian policies about sending patient information by email – in some cases describing sending information by unencrypted email as similar to ‘sending it on a postcard’. No empirical evidence is ever presented in such guidance that sending information electronically is any less secure than sending it by post or telephone. Guidance from such organisations has also yet to catch up with the now near-ubiquitous access to smartphones, high-speed Internet connections and high-resolution cameras in our society. In my opinion, it is acceptable for the photo to be stored on your pho…