The intelligence
Signals
Individual evidence items with national significance, labelled by evidence type and finding status
Signals are individual items from the weekly clinical evidence scan that carry meaning for a national professional audience. Each is labelled by evidence type, finding status, and domain.
Who engages with, and responds to, CBT for psychosis remains largely unpredictable, systematic review finds
A systematic review of 23 studies finds no consistent patient or service-level predictor of engagement with, or response to, cognitive behavioural therapy for psychosis.
Unread 1 minWhich components of talking therapy actually help? Large meta-analysis identifies the ones that work — and two that may not
A Bayesian component-network meta-analysis of individual participant data from 34 randomised trials identifies which specific components of task-shared psychosocial interventions, delivered by non-specialist workers, most improve outcomes for depression and anxiety.
Unread 1 minUK review finds almost no quality-assured patient education materials exist for home intravenous antibiotic therapy
A grey-literature review of 36 candidate resources for outpatient parenteral antimicrobial therapy finds only 9 met basic quality criteria, and just 2 patient-directed resources exist at all, neither formally accredited.
Unread 1 minFive factors predict who reattempts suicide within a year of a first attempt, large Spanish cohort finds
A prospective multicentre cohort study of 1,730 patients across eight Spanish hospitals finds 19.7% reattempted suicide within 12 months, with medication burden, suicidal ideation frequency, prior attempts, childhood emotional neglect and non-suicidal self-injury as independent predictors.
Unread 1 minFirst national survey finds most UK palliative virtual wards still run on phone calls, not technology, and many depend on charity funding
The first UK-wide survey of palliative virtual wards finds only 15% of 22 responding services use remote-monitoring technology, and three-quarters rely on charitable funding, with two services already closed for lack of it.
Unread 1 minFewer than half of older major trauma patients have a documented treatment escalation plan, national UK audit finds
A national point-prevalence audit across major trauma centres and trauma units in England, Wales and Scotland finds only 41% of older major trauma patients had a documented treatment escalation plan, and only a fifth of those were on a palliative or end-of-life care pathway.
Unread 1 minFalls research rarely records the same details twice, systematic review finds, and proposes a standard reporting framework
A systematic review of 75 studies finds fall-circumstance reporting is highly inconsistent and proposes a standardised '6 W's' interview and reporting framework for community-dwelling older adults.
Unread 1 minDigital tools for following up older patients after discharge are feasible and liked, but their effect on readmission remains unproven, systematic review finds
A systematic review of 46 studies finds digital health technologies for post-discharge follow-up of older adults are feasible, well-engaged with and liked by patients, but evidence on whether they reduce rehospitalisation or improve mental health is mixed.
Unread 1 minCochrane review finds little to no evidence that lumbar supports or other assistive devices help chronic low back pain
A Cochrane review of eight randomised trials finds lumbar supports offer little to no benefit alone for chronic low back pain, a small short-term pain reduction only when added to anti-inflammatory drugs, and no eligible evidence exists at all for other mobility or gait assistive devices.
Unread 1 minApathy after hip fracture surgery independently predicts poorer functional recovery, multicentre study finds
A Japanese multicentre prospective study of 65 older adults finds apathy severity after ward transfer independently predicts poorer functional recovery following hip-fracture surgery, distinct from delirium or behavioural and psychological symptoms of dementia.
Unread 1 minA national accessibility mapping method shows hospice access declining sharply outside Germany's cities, and offers a transferable way to measure it
A national study comparing four spatial-accessibility methods across 295 German inpatient hospices finds 90.3% of the population can reach a hospice within 30 minutes by car, but accessibility declines sharply in rural areas once distance-decay is accounted for.
Unread 1 minA five-year, 887-patient study finds high satisfaction with telemedicine-based hospital-at-home care, but does not measure whether it saves clinical resource
A large real-world cohort study of 887 patients over nearly five years finds very high patient satisfaction and perceived safety in a telemedicine-based, virtual-first hospital-at-home programme.
Unread 1 minRural hospice patients in the US receive less intensive support and rely more on unpaid family caregiving than urban peers
A US research letter finds rural hospice patients are more likely to die in nursing homes, rely more heavily on unpaid family caregiving, and receive less intensive paid hospice support than urban patients.
Unread 1 minPlacebo-controlled trial finds no benefit from pilocarpine drops for dry mouth in frail and life-limited patients
A double-blind placebo-controlled trial in the Netherlands finds no significant difference in xerostomia symptoms between pilocarpine drops and placebo in frail or life-limited patients, though the trial was underpowered.
Unread 1 minPeople with opioid use disorder have equivalent palliative care needs but markedly worse access, scoping review finds
A scoping review of 21 studies covering roughly 681,000 participants finds people with opioid use disorder have palliative care needs equivalent to the general population but face fragmented care, unmet pain management and stigma-driven access barriers.
Unread 1 minOnly a quarter of international hospital-at-home admission-avoidance models use validated frailty measures, scoping review finds
A scoping review of 15 international Hospital-at-Home admission-avoidance models finds just four used a validated frailty measure, and communication practice between professionals, patients and carers varied widely.
Unread 1 minMultidisciplinary consensus sets out age-adjusted opioid prescribing standard for chronic pain in older adults
A multidisciplinary clinical consensus sets out age-adjusted opioid selection, dosing and route-of-administration standards for treating chronic pain safely in older adults.
Unread 1 minLarge English trial finds Open Dialogue crisis care cuts psychiatric admission and re-referral, despite no effect on relapse
The first large pragmatic English trial of Open Dialogue crisis care finds no difference in relapse rates but significantly lower psychiatric admission and re-referral, with better patient-rated recovery and satisfaction.
Unread 2 minImplementation capacity, not treatment efficacy, is the primary barrier to delivering high-intensity stroke rehabilitation, international roundtable concludes
A consensus of 16 international experts concludes that delivery and implementation capacity — not the underlying evidence for high-dose, high-intensity rehabilitation — is the primary barrier to delivering it, and names home- and community-based hybrid delivery as essential to closing the gap.
Unread 1 minEmergency-department-embedded geriatric assessment discharges most older patients home with hospital-at-home support rather than admission
A retrospective cohort study of over 8,000 emergency department attendances finds that comprehensive geriatric assessment embedded at first contact converts most encounters into home discharge with hospital-at-home support, rather than admission.
Unread 1 minCompetent initial assessment, not the number of quality indicators reported, predicts OPAT readmission risk, scoping review finds
A scoping review of 18 studies covering over 5,000 patients finds outpatient parenteral antimicrobial therapy readmission risk tracks whether a competent team member performs the initial patient assessment, not how many quality indicators a service reports.
Unread 1 minClinical Frailty Scale predicts outcomes in elderly heart failure patients, meta-analysis confirms
A meta-analysis finds the Clinical Frailty Scale is a validated prognostic tool specifically in elderly heart failure populations, though the finding should not be generalised to non-cardiac frailty pathways.
Unread 1 minBehaviour-change stewardship bundle nearly doubles appropriate-duration antibiotic prescribing in OPAT for urinary tract infection
A quasi-experimental stewardship intervention for patients receiving outpatient parenteral antibiotic therapy for urinary tract infection raised appropriate-duration prescribing from 44% to 83% and cut 90-day recurrence, without increasing readmissions.
Unread 1 minAdjunctive electrical stimulation speeds recovery of oral intake in acute stroke dysphagia, small trial finds
A randomised controlled trial finds adjunctive neuromuscular electrical stimulation produces significantly faster recovery of functional oral intake than swallowing therapy alone in acute and subacute post-stroke dysphagia.
Unread 1 min