A method of decision analysis quantifying the effects of age and comorbidities on the probability of deriving significant benefit from medical treatments.

Background: The external validity, or generalizability, of trials and guidelines has been considered poor in the context of multiple morbidity. How multiple morbidity might affect the magnitude of benefit of a given treatment, and thereby external validity, has had little study.

Objective: To provide a method of decision analysis to quantify the effects of age and comorbidity on the probability of deriving a given magnitude of treatment benefit.

Inadequate resuscitation documentation in older patients' clinical case notes.

This research examined the quality of resuscitation decisions documented in the clinical notes of 99 older patients within 48 h of admission. Only 34 had current documentation that was frequently inconsistent and ambiguous, leaving patients at risk of receiving inappropriate and unwanted resuscitation. Clear guidelines with community input to guide the implementation and documentation of end-of-life decisions are essential.

The first documented case of Candida dubliniensis leptomeningeal disease in an immunocompetent host.

In June 2008, a 25-year-old man presented to the Royal Adelaide Hospital, Australia, with Candida dubliniensis leptomeningeal disease. On examination the patient had focal neurological deficits, both sensory and motor. He tested negative for HIV and had normal T cell subsets.