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.
Telerehabilitation matches in-person stroke therapy for arm recovery only when dose is matched, systematic review finds
A systematic review of four randomised trials finds telerehabilitation is non-inferior to conventional in-person stroke rehabilitation for arm motor recovery only in the one trial that matched therapy dose between arms, with smaller, non-dose-matched trials showing mixed results.
Unread 1 minSix mechanisms determine whether mobile health improves home-based palliative care, realist review finds
A realist review of 126 studies identifies six mechanisms through which mobile health interventions improve home-based palliative care outcomes, and cautions that mHealth must be tailored to local infrastructure and technology competence rather than treated as a substitute for workforce capacity.
Unread 1 minRural palliative care access breaks down as a pathway and workforce problem, not simply a shortage of beds, systematic review finds
A mixed-methods systematic review of 34 studies finds rural palliative care access breaks down cumulatively across recognition, entry, reach and continuity stages, with distance, workforce shortages and weak specialist-generalist referral links driving the biggest barrier.
Unread 1 minPeople with ADHD have significantly poorer outcomes from standard NHS talking therapies, large cohort study finds
A retrospective cohort of over three million adults using NHS Talking Therapies in England finds people with diagnosed ADHD have significantly poorer recovery and higher deterioration rates than a matched comparison group, despite both groups improving overall.
Unread 2 minOPAT coordination consistency depends on a designated lead and checklist process, not on clinical suitability, US study finds
A mixed-methods US study across Veterans Affairs hospitals finds marked heterogeneity in outpatient parenteral antimicrobial therapy governance, with postdischarge coordination gaps concentrated at sites lacking a designated OPAT lead and checklist-based processes.
Unread 1 minNon-immersive exergames and remote exercise show the most consistent cognitive benefit for older adults, network meta-analysis finds
A Bayesian network meta-analysis of 51 randomised trials finds digital exercise interventions produce domain-specific cognitive benefits in older adults, with remote exercise and non-immersive exergames flagged as practical options for rural and resource-limited settings, though certainty of evidence is very low for most comparisons.
Unread 1 minMemory clinic patient volumes more than doubled over 25 years as referral thresholds broadened, national survey finds
A repeated national survey of Dutch memory clinics spanning 1998 to 2023 finds patient volume per clinic has more than doubled as the proportion of attendees diagnosed with dementia has fallen, with a third of clinics reporting infrastructure not yet ready for new disease-modifying treatment pathways.
Unread 1 minLandmark African trial finds early oral step-down non-inferior to prolonged IV antibiotics for severe childhood pneumonia
A large randomised trial across 13 hospitals in five sub-Saharan African countries finds stepping down to oral amoxicillin once children with severe community-acquired pneumonia improve, with total treatment as short as four to five days, is non-inferior to prolonged intravenous-only care.
Unread 1 minInpatient stroke rehabilitation is near-universal across Europe, but community and telerehabilitation provision lags well behind, survey finds
A cross-sectional survey of stroke rehabilitation services in 30 European countries finds inpatient provision is near-universal, but early supported discharge, community-based rehabilitation and telerehabilitation are markedly less consistently available.
Unread 1 minExercise improves short-term function in frail older adults but its effect on actual falls remains unproven, meta-analysis finds
A meta-analysis of 14 randomised trials finds short-term exercise improves gait speed and functional mobility in frail older adults, but falls-incidence data were too sparse to pool, leaving the link between functional gains and actual falls reduction unresolved.
Unread 1 minCommunity nursing time per palliative patient fell by two-thirds over a decade even as referrals rose, national data show
A decade-long national analysis of community nursing services in England finds referrals rose by roughly half while median time on caseload fell by two-thirds, with end-of-life care increasingly compressed into shorter, more out-of-hours contact.
Unread 1 min£343m expansion of community mental health centres will only work if staffed by psychologists, professional body warns
The UK government has committed £343m to up to 159 new NHS mental health facilities in England, but the British Psychological Society says the expansion will only succeed if centres are staffed with practitioner psychologists rather than built on new estate alone.
Unread 1 minValidated triage tool for same-day emergency care outperforms existing scores in a deprived urban population
A retrospective diagnostic study of 152,877 emergency department attendances across three Birmingham hospitals derives and internally validates a new triage tool for identifying patients suitable for same-day emergency care, outperforming existing prediction scores.
Unread 2 minRetest effects in serial cognitive testing can mask a year or more of genuine age-related decline
A secondary analysis of a large US trial in 977 community-dwelling older adults finds that retest effects on repeat neuropsychological testing are large enough to offset roughly a year of expected age-related cognitive decline.
Unread 1 minProbenecid-boosted dosing offers a stability-compliant route to intravenous amoxicillin for community antibiotic therapy
A study backed by the BSAC OPAT Initiative finds citrate-buffered continuous-infusion amoxicillin fails UK stability criteria for community use, but probenecid-boosted intermittent or extended infusion regimens achieve adequate target attainment against clinically relevant organisms.
Unread 1 minNearly half of new psychoactive prescribing after intensive care discharge lacks a documented diagnosis
A US claims-database cohort of 7,898 mechanically ventilated ICU survivors finds 5.3% newly prescribed a psychoactive medication within 30 days of discharge, of which 43% lacked a documented supporting diagnosis, persisting out to two years.
Unread 1 minNational physiotherapy workforce survey signals a capacity warning against NICE-mandated rehabilitation intensity
The Chartered Society of Physiotherapy's quarterly member survey finds 79% of NHS physiotherapy staff report insufficient staffing for patient need, with recruitment freezes, deleted posts and whole-service cuts rising year on year.
Unread 1 minMulticomponent interventions outperform single reminders for raising advance care plan completion in primary care
A narrative review of 40 studies from 2000 to 2025 finds that multicomponent advance care planning interventions combining training, decision aids, systems prompts and dedicated consultations most consistently raise completion rates, while single-component reminders alone perform weaker.
Unread 1 minMajor Cochrane update on stroke dysphagia therapy adds 140 trials, reaffirms behavioural and electrical stimulation as first line
A major update of the Cochrane review on swallowing therapy for dysphagia in acute and subacute stroke, now spanning 181 randomised trials and 11,500 participants, finds moderate-certainty evidence for behavioural interventions and neuromuscular electrical stimulation.
Unread 1 minFive-year study finds post-stroke fatigue follows four distinct trajectories, not a uniform decline
A Norwegian multicentre cohort of 693 stroke patients followed for five years finds fatigue prevalence stable at 24-30% throughout, but latent trajectory modelling identifies four distinct fatigue subgroups requiring different follow-up approaches.
Unread 1 minEducation alone underperforms exercise for patellofemoral pain, but professional-led education matches it by medium term
A systematic review and meta-analysis of 20 randomised trials finds education alone underperforms exercise and multimodal physiotherapy on short-term pain and function for patellofemoral pain, though health-professional-delivered education performs comparably by medium-term follow-up.
Unread 1 minEarlier specialist palliative care contact halves in-hospital deaths in colorectal cancer, though most deaths still occur in hospital
A Finnish nationwide register cohort of 1,445 colorectal cancer patients finds that specialist palliative care contact more than 30 days before death is associated with fewer ED attendances, fewer hospitalisations and fewer in-hospital deaths than late or no specialist contact.
Unread 1 minBlood-based biomarkers materially change diagnostic confidence in memory clinic decision-making
A prospective study across three Netherlands academic memory clinics finds that disclosing a plasma biomarker panel at multidisciplinary team meetings increased diagnostic confidence in 46% of cases and revised the suspected diagnosis in 5%, using far less invasive testing than CSF or PET.
Unread 1 minAdvance care planning uptake in ALS has risen over a decade but remains held back by cognitive impairment
An Italian registry study of 1,219 people with ALS finds advance care planning discussions rose from roughly half to 62% over the past decade and were positively associated with palliative care activation and home death, but cognitive impairment reduced ACP uptake.
Unread 1 min