Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New system developed to monitor deaths in general practice

28.07.2003


Researchers from Imperial College London have developed a system using statistical control charts to help monitor mortality rates in general practice.

Although the system, details of which are published online today in The Lancet, was developed as a practical response to monitoring issues raised by the Harold Shipman case, it can also be used to monitor variations in the quality of care between GPs and practices.

Dr Paul Aylin, one of the paper’s authors, from Imperial College London comments: “Following the Shipman affair it became clear that no method existed to monitor mortality rates in general practice.



“One use of this system would be to help stop a repeat of the Shipman affair, but tools such as this could also help in monitoring the performance of GPs and their practices by continuously keeping track of mortality rates.

“We envisage these methods being used as a governance tool for monitoring performance since they enable a first-pass analysis of the data and can highlight units with an unusual outcome. We caution however, that the charts themselves cannot shed light on the reasons for apparent poor performance.

“Excess mortality will not necessarily mean bad practice or even criminal behaviour. Excess mortality could result from many different situations. For example, practices involved in terminal care for cancer patients or treating patients in a number of nursing homes. The system can also be used to help spot GPs or practices with particularly low mortality rates, which may be indicative of good practice.
“Any GPs or practices that are seen as having unusual mortality patterns could be investigated further through audit. This process could be improved by the collection of additional information on the death certificate.”

Dr Nicky Best, an author of the paper, from Imperial College London comments: “If the NHS is to deliver high quality cost effective care leading to improved health through guidance, audit and best practice, it needs high quality and timely information. Any method, for analysing and comparing performance, no matter how sophisticated, will founder if this is unavailable.”

The researchers collected data from more than 1000 GPs (including Shipman) or practices over five health authority areas between 1993 and 1999, linking information from death certificates and patient lists. From this they were able to work out how many patients died per GP or practice.

In order to calculate a figure from which abnormal mortality rates could be established, local reference rates were derived from the age and year specific mortality rates for the relevant Health Authority.

The researchers then plotted the mortality figures by year on to a graph using a CUSUM (Cumulative Sum) method. This allowed the researchers to monitor the mortality figure year on year, highlighting any unusual trends in mortality. If the cumulative difference between the observed mortality and the reference rates exceeded a pre-defined threshold, this signalled a warning that the mortality rates for the GP or practice in question warranted further investigation.

Tony Stephenson | alfa
Further information:
http://www.imperial.ac.uk

More articles from Health and Medicine:

nachricht Penn studies find promise for innovations in liquid biopsies
30.03.2017 | University of Pennsylvania School of Medicine

nachricht 'On-off switch' brings researchers a step closer to potential HIV vaccine
30.03.2017 | University of Nebraska-Lincoln

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

'On-off switch' brings researchers a step closer to potential HIV vaccine

30.03.2017 | Health and Medicine

Penn studies find promise for innovations in liquid biopsies

30.03.2017 | Health and Medicine

An LED-based device for imaging radiation induced skin damage

30.03.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>