Confused about Number Needed to Treat?

All you just need is NNT http://www.thennt.com  - the blog that puts "evidence based medicine under the microscope".

With a clear explanation of what Number Needed to Treat actually means (it's a "a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person" BTW), and regular updates of evidence on different therapeutic interventions, NNT is a great site to help you get to grips with this calculation.



Other useful calculators are available at:

• Medcalc 
• - for Odds Ratio, and Relative Risk:   www.medcalc.org/calc/odds_ratio.php 
• UBC Clinical Significance Calculator 
• - for absolute risk reduction, relative risk reduction, odds ratio and NNT http://spph.ubc.ca/sites/healthcare/files/calc/clinsig.html

• Centre for Evicence Based Medicine 
• for more explanations of NNT, likelihood, and other critical appraisal tools http://www.cebm.net/index.aspx?o=1157

NHS Mandate

http://mandate.dh.gov.uk/

The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years was published on 13th November.

The NHS Mandate is structured around five key areas where the Government expects the NHS Commissioning Board to make improvements:

• preventing people from dying prematurely
• enhancing quality of life for people with long-term conditions
• helping people to recover from episodes of ill health or following injury
• ensuring that people have a positive experience of care
• treating and caring for people in a safe environment and protecting them from avoidable harm.

Through the Mandate, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.
The key objectives contained within the Mandate include:

• improving standards of care and not just treatment, especially for the elderly
• better diagnosis, treatment and care for people with dementia
• better care for women during pregnancy, including a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and the postnatal period
• every patient will be able to give feedback on the quality of their care through the Friends and Family Test starting from next April – so patients will be able to tell which wards, A&E departments, maternity units and hospitals are providing the best care
• by 2015 everyone will be able to book their GP appointments online, order a repeat prescription online and talk to their GP online
• putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment
• preventing premature deaths from the biggest killers
• by 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.

http://www.dh.gov.uk/health/2012/11/nhs-mandate/

• The Mandate: A mandate from the Government to the NHS Commissioning Board: April 2013 to March 2015
• The Government’s response to the consultation on the draft mandate to the NHS Commissioning Board
• Equality Analysis
• Reference document for policy impact assessments
• Financial Directions to the NHS Commissioning Board

Watch Jeremy Hunt present the Mandate to Parliament:

 Reaction:

• BBC News - Is the NHS Mandate really that radical?  and NHS Mandate 'a historic moment'
• Nursing Times 
• NHS Commissioning Board 
• BMA  = British Medical Association 
• RCN - Royal College of Nursing
• Guardian -Will the government's mandate put patients at the heart of the NHS?
• Telegraph - Ministers hail first 'contract' with NHS

New online anatomy resource - Instant Anatomy

Struggling to tell where the internal jugular stops and the subclavian begins? Or want a quick podcast of the Myotomes and Dermatomes in the Upper Limb?

Then Instant Anatomy could be the answer.

As well as including clear diagrams, and complementary podcasts, there are MCQs and apps for your smart phone.

Use your RAVEN login to access when you're away from a Cambridge University computer.

https://instantanatomy.co.uk/shib

New look TRIP

TRIP has always been a tremendously useful tool for skimming the cream of the evidence - getting guidelines, summaries of evidence, systematic reviews quickly and easily, but it just got better.

http://www.tripdatabase.com 

As well as covering the same high quality evidence as before, the search results also include videos, images, patient information and more.

The website has had a bit of a makeover, and includes new improved Advanced and PICO search options to help you structure your search better.
Remember? PICO? 

• P - Patient/Problem
• I - Intervention
• C - Comparison
• O - Outcome

It can really help tease your question apart, and help you structure your search. More info....

For a quick introduction to TRIP have a look,

And for more help try: http://www.tripdatabase.com/how-to-use-trip or ask in the Medical Library.

Welcome to our new Clinical Students

We hope you find the next three years rewarding. The library is here to help you get to the information you need - whether it's by providing study space, access to PCs and books, or help to find those journal articles you need.
After all, our future health might depend on it!

Map of Medicine 3.0 - now available

Accessible using your NHS ATHENS login, Map of Medicine is a collection of evidence-based, practice-informed care maps which connect all the knowledge and services around a clinical condition.

http://www.mapofmedicine.com/

It will help you...

• Understand the entire care journey - essential for commissioners to ensure that new services fit seamlessly within existing structures of care.
• Know the skills and capabilities of different care settings - which underpins effective referral management.  
• Understand the care that has been delivered in different settings - which is fundamental to ensuring that individual patients have a positive experience along their entire care journey. 

Need some ideas for a research project?

The James Lind Alliance can help, with the top 10 research priorities, shared by patients, carers and clinicians. http://www.lindalliance.org/top-tens.asp

• Asthma
• Ear, Nose and Throat, Aspects of Balance
• Prostate Cancer
• Schizophrenia
• Stroke in Scotland
• Type 1 Diabetes
• Urinary Incontinence
• Vitiligo

James Lind Alliance http://www.lindalliance.org/

The JLA bring patients, carers and clinicians together to identify and prioritise for research the treatment uncertainties which they agree are the most important.

Follow them on Twitter: @LindAlliance


The UK Database of Uncertainties about the Effects of Treatments
As part of the process of identifying treatment uncertainties, the JLA works closely with an online resource called the UK Database of Uncertainties about the Effects of Treatments (UK DUETs).
UK DUETs has been established to publish uncertainties about the effects of treatment. This means these uncertainties cannot currently be resolved by referring to reliable up-to-date systematic reviews of existing research evidence.

Bank Holiday Monday

The Library will be open 9:00am till 6:00pm Monday 27th August 2010.

Guidance on your smart phone - does that make you 'appy?

NICE have made an app of their guidance which is availble for iPhones and Android

image from NICE

• Android users: download the NICE Guidance app here

• iPhone users: download the NICE Guidance app here 

You get offline access to all of NICE's guidance products, organised by clinical or public health topic, and the app allows you to search, browse and explore all of NICE's current guidance.

More details... 

SIGN (Scottish Intercollegiate Guidelines Network) have also made their guidelines (over 120 of them) available   

• iPhone + iPad users down load from here      
• Android can use the Android Market here

SIGN have also launched Patient apps - focusing on  Autistic Spectrum Disorder, Asthma and Diabetes. The app focuses on
The app describes:

image from SIGN

• what the condition is;
• how it is diagnosed;
• what can help. 

These Patient apps are also available for iPhone + iPad and Android.

The new age of photocopying and scanning!

Hurrah - we've very pleased to be able to offer a new, improved photocopy and scanning service in the Medical Library.

As well as reducing the prices of photocopying, and offering colour copying, library users are able to scan documents to send as a PDF by email.
The credit purchased for printing is now networked, and so is valid for use photocopying and scanning and printing.

The lovely new Multi-Function Device (MFD) is installed in the Wolfson Computer Room.

Just login with the same username and password you use on the PCs.

Costs:

Printing and Photocopying  (A4)

Mono (black + white) duplex (double sided)      8p per sheet of paper
Mono                                                                5p per sheet of paper
Colour  duplex                                                 26p per sheet of paper
Colour                                                               14p per sheet of paper

Photocopying (A3 paper):

Mono duplex                                                     16p per sheet of paper
Mono                                                                 10p per sheet of paper
Colour  duplex                                                   52p per sheet of paper
Colour                                                                28p per sheet of paper

Scanning to create a PDF which is sent by email:

                                                                                       3p per page scanned

 Photocopy Cards

If you have a stash of photocopy cards, the card operated photocopier will still be available for use for a few weeks.
If you would like to transfer the credit from these cards to your library card account, photcopy card units will be refunded at 5p per 2 units on the card, and this balance will be added to your networked account. Please ask staff at the Library Issue Desk. 

National Health Profiles and other public health intelligence tools

Public Health Observatories in England have compiled useful resources.

National Health Profiles give a snapshot overview of health for each local authority in England. They are produced annually by the Public Health Observatories in England working in partnership and are commissioned by the Department of Health.
Available here




Directory of Public Health Intelligence Tools: are available

These tools include......

• 2012 Cardiovascular Disease Profiles for England
  
  The profiles allow comparison across regions and local areas against a number of indicators, including: incidence, mortality, treatments and costs. They are available for every Primary Care Trust in England, along with s ...
  
• Community Mental Health Profiles Profiles for every local authority in England giving an overview of mental health risks, prevalence and services at a local, regional and national level.
  
• Disease Prevalence Estimates
  Updated modelled estimates of the prevalence of five long-term conditions with significant impact on the health and wellbeing of the population are now available to inform commissioning of services, and to support case f ...
  
• End of Life Care PCT Profiles Profiles with over 40 end of life care indicators for each PCT in England relating to population; deaths; place of death; cause of death; deaths in hospital; care homes; and end of life care spend.
  
• Excess Winter Deaths Information about excess winter deaths in the South West.
  
• Health inequality indicators for local authorities and primary care organisations
  
• Health Profiles 2012 The profiles contain a summary of information on the health of the people in every local authority area and some factors that may influence their health.
  
• Health Impact Analysis Gateway
  
• Local Alcohol Profiles for England (LAPE) Local Alcohol Profiles for England 2011 (LAPE), produced by the North West Public Health Observatory on behalf of the Public Health Observatories in England.The profiles contain 25 alcohol-related indicators for every lo ...
  
• Local Authority Child Health Profiles 2012 How healthy are children and young people in your area? View key child health indicators and compare performance locally, regionally and nationally.
  
• Local Tobacco Control Profiles Revised and updated January 2012 - The profiles bring together a detailed picture of the burden of smoking-related disease, costs and action for every local authority and primary care trust in England.
  
• Mortality among inpatients with diabetes This work analyses mortality among inpatients with diabetes. The study used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality. It also identifies trust level variatio ...
  
• National General Practice Profiles
  Revised and updated December 2011 - The profiles are designed to support GPs, clinical commissioning groups and PCTs to ensure that they are providing and commissioning effective and appropriate healthcare services for t ...
  
• Small Area Indicators for Joint Strategic Needs Assessment
  Indicators at middle layer super output area level and higher geographies for use in joint strategic needs assessment, published by the Public Health Observatories in England
  
• Spend and Outcomes Tool - updated March 2012 This tool enables Primary Care Trusts (PCTs) to gain an overview of spend and outcomes across all programmes of care. The tool has been updated with spend and outcome data for 2010/11 and shows the position for PCTs. Fac ...
  
• Teenage Pregnancy Atlases, Forecasts and other Resources
  
• The European Health Profile Tool Comparisons of demographic, morbidity, risk factors and mortality indicators across regions of Europe plus information on health care systems and financing.
  
• Welcome to the Sexual Health Balanced Scorecard

2011 Journal Citation Reports now available

The ISI Web of Knowledge have released the 2011 edition of the Journal Citation Reports. These contain data on the impact factors of more than 1600 journals.

 To access the JCR, you'll need a RAVEN login off campus, or an NHS ATHENS login.

Go to http://wok.mimas.ac.uk, login, and click to access Journal Citation Reports.

Contact the medical library if you need any help getting the impact factors that are important to you.

BNF App

Now the BNF can be at your finger tips all the time, with the new app launched by NICE, but you'll need your NHS ATHENS login to get access even once you've downloaded it.

 

Read all about it, via NICE

 

Download the app for Android
Download app the for iPhone

Users will need to enter their NHS Athens user name and password to activate the app and download the content. Eligible professionals who do not yet have an NHS Athens password can register for free online or directly from their smartphone by following the instructions displayed in the Apple App Store and Google Play Store, or the app itself.

New look for NHS databases for literature searching

All change! 

The databases available using your NHS ATHENS logins via NHS Evidence have had a face-lift!

As from Wednesday 30th May 2012, there'll be a new look to the databases. You still access the databases via NHS Evidence, but there's a new colour scheme and some improved functionality.

To help with the transition, we've provided a guide to searching with the new look databases -and the opportunity to come for a refresher session on searching these databases - places are limited, so please book by contacting Isla by email or phone (01223) 336750

• Wednesday 30th May: 12noon- 1pm
• Wednesday 30th May: 1pm - 2pm
• Monday 4th June: 12noon - 1pm
• Monday 11th June: 12noon -1pm
• Monday 11th June: 2pm -3pm

 Alternatively, book an individual Information Clinic with Isla.

Holiday Monday and Tuesday

The Library will be open 9.00am till 6.00pm on Bank Holiday Monday and Jubilee Tuesday
- 4th and 5th June.

New Evidence updates - outcome in head & neck cancer / familial breast cancer

New style Evidence Updates from NHS Evidence help health and social care professionals keep up-to-date with new research, and support them in making evidence-based decisions in a focused and time-efficient manner.  

While Evidence Updates do not replace current accredited guidance they do highlight new evidence that might generate a future change in practice.

See the list of latest Evidence Updates

Two new Evidence Updates have been published this month.

• ‘Improving outcomes in head and neck cancers: Evidence Update May 2012’ focuses on a summary of selected new evidence relevant to NICE cancer services guidance Improving outcomes in head and neck cancers’ (2004).
• ‘Familial breast cancer: Evidence Update May 2012’ focuses on a summary of selected new evidence relevant to NICE clinical guideline 41 ‘The classification and care of women at risk of familial breast cancer in primary, secondary and tertiary care’ (2006).

Engaging patients in research - live discussion

"What are patients' perceptions of research, and
how can we improve their involvement?"

Join the live debate on Guardian Healthcare Network Zone:

Noon till 2pm Thursday 24th May 2012

follow the live debate on the Guardian pages or follow @GdnHealthcare

The panel includes Joann Leeding: "communications manager in the research and development team at Cambridge University Hospitals NHS Foundation Trust. Her role involves informing the public about biomedical research taking place on the campus, organising patient and public awareness events and recruiting members of the public to ethics panels." 

NHS Information Strategy

The Department of Health today launched an new NHS Information Strategy  - The power of information – which sets a ten-year framework for transforming information for the NHS, public health and social care.

The full strategy is available here.

Taking the hassle out of healthcare

View more documents from Department of Health

Comment and Responses come from:

• The Kings Fund and Veena Raleigh
• The Guardian's Dick Vinegar
• The Guardian's Government Computing section
• eHealth Insider 
•  BBC
• The Telegraph Health section
• The Telegraph Political section 
• Pulse presents a round up of reaction

Goodbye Anne, and happy retirement

We're very sorry today to see Anne Collins retire from the Medical Library after 16 years as Deputy Medical Librarian. She's a fantastic colleague, and we'll miss her very much.

Sunday Opening

As is traditional at this time of year, the Medical Library has a temporary period of Sunday opening:
So from Sunday May 6th till Sunday June 10th (inclusive), we'll be open 2pm till 6pm.

Best of luck to all students with exams coming up.