The precision of health state valuation by members of the general public using the standard gamble.

Background: Precision is a recognised requirement of patient-reported outcome measures but no previous studies of the precision of methods for obtaining health state values from the general public, based on specific health state descriptions or vignettes, have been carried out. The methodological requirements of policy makers internationally is driving growth in the use of methods to obtain utilities from the general public to inform cost per quality-adjusted life-year (QALY) analyses of health technologies being considered for adoption by health systems.

Methods: The precision of five comparisons of the outcomes of treatments, based on health state descriptions, was assessed against the results of clinical trials which showed a statistically and clinically significant improvement using an internet panel of members of the UK general public.

A pilot Internet "value of health" panel: recruitment, participation and compliance.

Objectives: To pilot using a panel of members of the public to provide preference data via the Internet

Methods: A stratified random sample of members of the general public was recruited and familiarized with the standard gamble procedure using an Internet based tool. Health states were periodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained); Participation (a) the proportion of people trained who provided any preferences and (b) the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed).

Clinical features of prostate cancer before diagnosis: a population-based, case-control study.

Background: Even in areas where screening is available, many prostate cancers are diagnosed after the symptoms begin. However, the risk posed by particular symptoms is largely unknown, especially in unselected populations such as primary care.

Aim: To identify and quantify the features of prostate cancer before diagnosis, both individually and in combination.

High incidence of mesothelioma in an English city without heavy industrial use of asbestos.

Background: Mesothelioma rates are increasing in the industrialized world, related to occupational asbestos exposure. The highest rates have been reported from areas with specific industries such as shipbuilding or mining. Lower rates have been reported from areas without such industries.

Screening for Hepatitis C in injecting drug users: a cost utility analysis.

Background: Hepatitis C is a major public health problem of increasing importance among injecting drug users, among whom screening has been proposed. We therefore estimated the cost utility of screening for hepatitis C infection among people with a history of injecting drug use in contact with drug misuse services.

Methods: A spreadsheet-based model of screening using ELISA followed by polymerase chain reaction tests and treatment using combination therapy with interferon alpha and ribavirin was developed.

Six month outcomes after emergency admission of elderly patients to a community or a district general hospital.

Background: Emergency admissions account for 40% of National Health Service bed usage. Recent policy is to increase the role of intermediate care, which includes the use of community hospitals (CHs). However, the proposed expansion presumes that CH care is as effective as acute hospital care.

The quality of record keeping in primary care: a comparison of computerised, paper and hybrid systems.

Background: Computerised record keeping in primary care is increasing. However, no study has systematically examined the completeness of computer records in practices using different forms of record keeping.

Aim: To compare computer-only record keeping to paper-only and hybrid systems, by measuring the number of consultations and symptoms recorded within individual consultations.

Systematic review of the use and value of computer simulation modelling in population health and health care delivery.

Background: The objective of the review was to evaluate the extent, quality and value of computer simulation modelling in population health and health care delivery.

Methods: A narrative systematic review was carried out of world literature from 1980 to 1999, searching Medline, INSPEC, Embase, HealthSTAR, Science Citation Index, CINAHL, MathSci, INFORMS Online and SIGLE databases, and researchers in the field were contacted. Papers were included if they contained a computer simulation model of individuals in a stochastic system and the topic or setting related to population health or health service delivery.

Screening for hepatitis C in genito-urinary medicine clinics: a cost utility analysis.

Background/aims: To estimate the cost utility (cost per QALY) of screening for hepatitis C (HCV) infection in people attending genito-urinary medicine clinics in England.

Methods: An epidemiological model of screening and diagnosis was combined with a Markov chain model of treatment with combination therapy to estimate cost utility. Parameters for the model were informed by literature review, expert opinion and a survey of current screening practice.

Do community based self-reading sphygmomanometers improve detection of hypertension? A feasibility study.

Background: Hypertension is a major risk factor for stroke and ischaemic heart disease. Most hypertension is detected opportunistically by general practitioners. Those who rarely use medical services are less likely to have their blood pressure (BP) measured.

Patient, hospital, and general practitioner characteristics associated with non-attendance: a cohort study.

Studies examining characteristics of non-attendance at hospital outpatients have given inconsistent results. We examined a cohort of 1972 referrals from 26 general practitioners, with complete follow-up. Five factors were found to be significantly associated with non-attendance: male sex, younger age, longer interval between referral and appointment, higher Jarman score and patients of a high-referring general practitioner.