Sociology/public health

Question 1

Name three strategies to resource allocation

Answer 1

equal access to treatment 
rationing according to clinical need 
maximising health gains QALY
discriminating according to age 
taking individual responsibility into account 
ration according to ability to pay 
singling out certain types of excluded treatment 
dilution of care 
random allocation

Question 2

what is the theory underlying cost-effectiveness and QALYs

Answer 2

consequentialism (utilitarianism)

Question 3

QALY equation

Answer 3

quality of life x life expectancy (before and after), then cost it

Question 4

low cost per QALY can be defined as what

Answer 4

efficient

Question 5

what are NICE’s four technology appraisal recommendations:

Answer 5

1. recommended for use in NHS
2. restricted use to certain categories of patients
3. use confined to clinical trials
4. not be used in NHS

Question 6

what does Scotland have as opposed to the NICE technology appraisals serve

Answer 6

scottish medicines consortium
- more transparent, less likely to be lobbyed
(can be accepted, accepted with restriction, or not recommeded)

Question 7

4 parts of Wilson and Junger’s 1968 screening chat

Answer 7

d1. disease (natural history understoof, latent or early symptomatic stage)
2. test (should be a test)
3. treatment (should be accepted treatment for patients with disease that is accessible)
4. process (cost of case finding should be economically balanced

Question 8

harms of cancer screening

Answer 8

system without negative feedback 
anxiety 
ethics 
false positive/negative
measurements (what defines cancer) 
informaed consent