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.
Reproducible case-finding rule identifies frequent-attender frail patients for proactive assessment
Baseline analysis of a Swedish randomised trial shows a simple, reproducible case-finding rule can identify multimorbid, frequent emergency attenders as a target group for proactive community assessment.
Unread 2 minNearly a third of older adults with severe breathlessness are lonely, national English cohort finds
A nationally representative English cohort finds loneliness affects almost a third of adults aged 50 and over with severe breathlessness, with deprivation, living alone and depressive symptoms the strongest predictors.
Unread 1 minLargely unsupervised balance training nearly halves fall rate in community-dwelling older adults, trial finds
A multicentre randomised trial finds 12 weeks of self-administered dual-task balance training, with only a sixth of sessions supervised, nearly halved the fall rate compared with self-administered single-task training.
Unread 1 minInternational researchers propose standardised outcome to fix inconsistent cognitive-outcome reporting after stroke and cardiac care
A new position paper proposes a standardised composite outcome, MACE-Cog, to address widespread inconsistency and incompleteness in how cognitive decline is measured and reported after stroke and cardiac interventions.
Unread 2 minEthnic minority patients more likely to enter palliative care via specialist referral, national cohort study finds
A national retrospective cohort of over 200,000 deceased patients in England finds no significant ethnic disparity in overall primary-care palliative identification, but ethnic minority patients were more likely to enter via specialist referral, with differing survival by ethnic group.
Unread 2 minEarlier specialist palliative contact roughly halves end-of-life hospitalisation in pancreatic cancer, national Finnish cohort finds
A nationwide Finnish register study finds patients with pancreatic cancer who had specialist palliative care contact more than 30 days before death were hospitalised far less often, and far more likely to receive care at home, in their final month of life.
Unread 2 minBrief GP-delivered psychological intervention improves quality of life a year after ICU discharge, trial finds
A secondary analysis of a randomised trial finds a brief GP-delivered intervention for ICU survivors with PTSD symptoms produced a delayed but clinically meaningful quality-of-life improvement at 12 months.
Unread 1 minVocational rehabilitation trial finds no benefit on work limitations, and mixed results on retention and cost
A UK multicentre RCT finds occupational-therapy-delivered job-retention vocational rehabilitation shows no benefit over self-help advice on work limitations at 12 months, and was not cost-effective from an NHS perspective.
Unread 1 minSystematic review sets out what makes advance care planning work in nursing homes
A PROSPERO-registered systematic review identifies the structural and process determinants that distinguish nursing homes that implement advance care planning well from those that do not.
Unread 1 minSystematic review finds telerehabilitation a comparable alternative to centre-based cardiac rehabilitation after acute coronary syndrome
A systematic review of 12 randomised trials finds app- and web-based telerehabilitation performs comparably to centre-based cardiac rehabilitation after acute coronary syndrome or revascularisation, with gains in adherence and quality of life.
Unread 1 minPICCs carry far fewer complications than midline catheters in outpatient antimicrobial therapy, US cohort finds
A US retrospective cohort of over 1,100 outpatient parenteral antimicrobial therapy patients finds midline catheters carry more than three times the complication risk of peripherally inserted central catheters.
Unread 1 minParamedic-delivered end-of-life protocol linked to far fewer emergency visits and more home deaths, Finnish cohort finds
A Finnish retrospective cohort finds cancer patients enrolled in a structured, paramedic-delivered end-of-life protocol spent more time at home and died at home six times more often than those not enrolled.
Unread 1 minNearly half of NHS hospital physiotherapists report losing rehabilitation space, survey finds
A Chartered Society of Physiotherapy member survey finds 49% of NHS hospital physiotherapists report losing rehabilitation space, with members linking the loss to rising waiting lists and worsening patient disability.
Unread 1 minMulticentre cohort identifies a distinct vulnerability subgroup after home return from severe brain injury
A large multicentre cohort finds 17% of adults are in a distinct 'multidomain vulnerability' group a year after returning home following severe traumatic brain injury, predicted by identifiable risk factors.
Unread 1 minMeta-analysis finds remote cardiac rehabilitation matches or exceeds centre-based care for heart failure patients
A meta-analysis of eight randomised trials finds mobile-health-supported remote or hybrid cardiac rehabilitation performs as well as, or better than, centre-based rehabilitation on exercise capacity in heart failure, though certainty is low to moderate.
Unread 1 minFeasibility trial tests giving physiotherapists individual feedback to standardise MSK referral decisions
A UK feasibility cluster trial tests whether a dashboard giving First Contact Physiotherapists individualised feedback on their own referral patterns can reduce unwarranted variation in musculoskeletal care decisions.
Unread 1 minCrisis-response models for older people need common commissioning design principles, review finds
A critical review maps five national crisis-response models for older people onto shared commissioning design principles, offering a common benchmark for services usually assessed in isolation.
Unread 1 minBrief six-domain cognitive screen validated for use in acute stroke, UK study finds
A UK validation study finds a brief, 9-to-15-minute cognitive screen performs consistently across left- and right-hemisphere stroke, offering an option where full neuropsychological assessment is not feasible.
Unread 1 minWorld Stroke Organisation issues new scientific statement on vascular cognitive impairment
An international expert statement sets out new diagnostic criteria and management guidance for vascular cognitive impairment, including its overlap with post-stroke cognitive decline.
Unread 1 minTelehome palliative care improves access and continuity, but success hinges on digital readiness, review finds
An integrative review of 33 studies finds telehealth-supported home palliative care improves access and symptom-management continuity, but success depends on digital literacy, caregiver burden and organisational readiness.
Unread 1 minSpecialist screening before OPAT referral avoided almost 14,000 inpatient days over three years, audit finds
A three-year audit of an outpatient parenteral antimicrobial therapy referral pathway finds nearly a third of referrals were not taken onto the service after specialist screening, avoiding an estimated 13,909 inpatient or IV-therapy days.
Unread 1 minReablement-based home rehabilitation shows weak evidence of benefit, meta-analysis finds
A GRADE-assessed systematic review and meta-analysis of 27 trials finds reablement-based home rehabilitation has low-to-very-low-certainty evidence of improving daily function, while structured exercise-based rehabilitation does show benefit.
Unread 1 minQualifying care-home nursing staff in palliative care improves specialist contact and pain management, trial finds
A German cluster randomised study finds a 40-hour palliative qualification course for care-home nursing staff increases specialist outpatient contact and improves pain-management follow-through.
Unread 1 minPharmacist involvement in OPAT teams cuts prescribing errors, meta-analysis finds
A systematic review and meta-analysis finds pharmacist involvement in OPAT multidisciplinary teams improves monitoring adherence and reduces prescribing errors, though impact on readmissions remains inconsistent.
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