Financial performance of English NHS trusts and variation in clinical outcomes: a longitudinal observational study.

Objectives: To examine the association between financial performance as measured by operating margin (surplus/deficit as a proportion of turnover) and clinical outcomes in English National Health Service (NHS) trusts.

Setting: Longitudinal, observational study in 149 acute NHS trusts in England between the financial years 2011 and 2016.

Participants: Our analysis focused on outcomes at individual NHS Trust-level (composed of one or more acute hospitals).

Very large treatment effects in randomised trials as an empirical marker to indicate whether subsequent trials are necessary: meta-epidemiological assessment.

Objective:  To examine whether a very large effect (VLE; defined as a relative risk of ≤0.2 or ≥5) in a randomised trial could be an empirical marker that subsequent trials are unnecessary.

Design:  Meta-epidemiological assessment of existing published data on randomised trials.