My notes block 9

Question 1

What goes into an evidence based decision?

Answer 1

Patient preferences
Available resources
Research evidence
Clinical expertise

Question 2

Why do we need evidence based medicine?

Answer 2

Increasing medical knowledge
Limited time to read
Inadequacy of traditional resources
Disparity between diagnostic skills and up to date knowledge

Question 3

What is the 10/90 gap?

Answer 3

A paradox- 90% of the population only get 10% of the healthcare resources

Question 4

What is the motivation for global health?

Answer 4

Increased awareness of global health disparities and wanting to make a difference

Question 5

What is global health?

Answer 5

The health of the global population, so it involves interdependence, transnational, clinical care, wider aspects of health and all disciplines and sectors

Question 6

How is global health different from international health?

Answer 6

International health is defined by geography, problems and a donor- recipient relationship, whereas global health is a interdependent all working together to improve everyones health

Question 7

What are some pitfalls of global health?

Answer 7

Practical issues, security, ethics, human rights, governance

Question 8

What is the ABCDE method of breaking bad news?

Answer 8

Advance preparation
Build a relationship
Communicate well
Deal with patient reactions
Encourage and validate emotions

Question 9

What is the SPIKES method?

Answer 9

Setting up
Perception
Invitation
Knowledge
Emotions
Strategy and summary

Question 10

What are the top 5 most common cancers worldwide?

Answer 10

Lung
Breast
Colorectal
Stomach
Prostate

Question 11

What are the top 5 most common cancers in the UK?

Answer 11

Breast
Prostate
Lung
Bowel
Malignant melanoma

Question 12

What are the top 5 cancers in men in the UK?

Answer 12

Prostate
Bowel
Lung
Bladder
Kidney

Question 13

What are the top 5 most common cancers in women in the UK?

Answer 13

Breast
Lung
Bowel
Uterine
Malignant melanoma

Question 14

What are the top 5 cancer deaths worldwide?

Answer 14

Lung
Stomach
Liver
Breast
Colorectal

Question 15

What are the top 5 cancer deaths in the UK?

Answer 15

Lung
Colorectal
Breast
Prostate
Pancreas

Question 16

What are the most common childhood cancers?

Answer 16

Leukaemia
Lymphoma
Brain tumours

Question 17

What are the different types of prevention?

Answer 17

Primary- reduce exposure/ stop you getting disease
Secondary- early disease detection
Tertiary- Improve quality of life in someone with disease

Question 18

What are the functions of a clinical record?

Answer 18

Support patient care
Financial planning
Medico-legal documents
Audits
Helps future patient care
Helps monitoring of condition
Helps diagnosis and treatment
Allows for continuity of care

Question 19

What does the Calman-Hine plan involve?

Answer 19

All patients have access to a uniformly high quality of care
Public and professional education to recognise early cancer symptoms
Patients, families and carers should be given clear information about treatment options and outcomes
Development of cancer services should be patient centred
Primary care to be central to cancer care
Psychosocial needs of sufferers need to be recognised
Cancer registration and monitoring of outcomes is essential

Question 20

What are the NHS cancer aims?

Answer 20

Save more lives
Ensure people get right care, support and treatment
Tackle health inequalities- unskilled workers are 2x more likely to die from cancer
Build for future through investing in cancer workforce

Question 21

What did the cancer reform strategy 2007 focus on?

Answer 21

Prevention
Diagnosing cancer earlier
Ensuring better treatment
Living with and beyond cancer
Reducing cancer inequalities
Delivering care in most appropriate setting

Question 22

What is the NAEDI hypothesis?

Answer 22

Hypothesis as to why we have late cancer diagnoses:
Low awareness of symptoms
Difficulty accessing primary care
Negative beliefs about cancer
Low uptake of screening
Barriers to help seeking
Age/ sex/ ethnicity etc.

Question 23

What was Improving outcomes- a strategy for cancer 2011 focused on?

Answer 23

Prevention and early diagnosis
Quality of life and patient experience
Better Treatments
Reducing Inequalities

Question 24

What did reducing inequalities patient survey 2010 show?

Answer 24

Men generally have a more positive experience
White people have a better experience than ethnic minorities
Younger people have worse experience
LGBT have worse experience
Disabled people have worse experience
Rare cancer type have worse experience
No real link between deprivation and patient experience

Question 25

What was the purpose of the independent cancer taskforce 2015?

Answer 25

Spearhead radical upgrade in prevention and public health
Drive national ambition for early diagnosis
Transform approach to support people with cancer
Invest to improve services

Question 26

What is the basic reproductive number? R0

Answer 26

The average number of individuals directly infected by an infectious case during the infectious period in a totally susceptible population

Question 27

What does the basic reproductive number depend on?

Answer 27

Length of time a disease is infectious for
Number of contacts a case has with susceptible hosts
Chance of transmitting infection during an encounter with a susceptible host
Therefore it may differ for different diseases in the same population, or for the same disease in a different population

Question 28

What is the effective reproductive number R?

Answer 28

Actual average of secondary cases per primary case observed in a population

Question 29

How is the effective reproductive number R calculated?

Answer 29

R = R0 X S

Where S is the susceptible population, so in a place with no measures in place then R will be the same as R0, but if some people have been vaccinated then R will be lower than R0