Author
Clare Wilkinson
Other affiliations: Health Sciences North, RMIT University, Cardiff University ...read more
Bio: Clare Wilkinson is an academic researcher from Bangor University. The author has contributed to research in topics: Randomized controlled trial & Health care. The author has an hindex of 39, co-authored 133 publications receiving 5928 citations. Previous affiliations of Clare Wilkinson include Health Sciences North & RMIT University.
Papers published on a yearly basis
Papers
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TL;DR: This is the first review encompassing many cancer types, and it is demonstrated that efforts to expedite the diagnosis of symptomatic cancer are likely to have benefits for patients in terms of improved survival, earlier-stage diagnosis and improved quality of life, although these benefits vary between cancers.
Abstract: It is unclear whether more timely cancer diagnosis brings favourable outcomes, with much of the previous evidence, in some cancers, being equivocal. We set out to determine whether there is an association between time to diagnosis, treatment and clinical outcomes, across all cancers for symptomatic presentations. Systematic review of the literature and narrative synthesis. We included 177 articles reporting 209 studies. These studies varied in study design, the time intervals assessed and the outcomes reported. Study quality was variable, with a small number of higher-quality studies. Heterogeneity precluded definitive findings. The cancers with more reports of an association between shorter times to diagnosis and more favourable outcomes were breast, colorectal, head and neck, testicular and melanoma. This is the first review encompassing many cancer types, and we have demonstrated those cancers in which more evidence of an association between shorter times to diagnosis and more favourable outcomes exists, and where it is lacking. We believe that it is reasonable to assume that efforts to expedite the diagnosis of symptomatic cancer are likely to have benefits for patients in terms of improved survival, earlier-stage diagnosis and improved quality of life, although these benefits vary between cancers.
657 citations
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TL;DR: The major finding is the wide difference in the prevalence of depressive disorders found across the study sites, which is a highly prevalent condition in Europe.
Abstract: Background This is the first report on the epidemiology of depressive disorders from the European Outcome of Depression International Network (ODIN) study.
Aims To assess the prevalence of depressive disorders in randomly selected samples of the general population in five European countries.
Method The study was designed as a cross-sectional two-phase community study using the Beck Depression inventory during Phase 1, and the Schedule for Clinical Assessment in Neuropsychiatry during Phase 2.
Results An analysis of the combined sample ( n =8.764) gave an overall prevalence of depressive disorders of 8.56% (95% CI 7.05-10.37). The figures were 10.05% (95% CI 7.80-12.85) for women and 6.61% (95% CI 4.92-8.83) for men. The centres fall into three categories: high prevalence (urban Ireland and urban UK), low prevalence (urban Spain) and medium prevalence (the remaining sites).
Conclusions Depressive disorder is a highly prevalent condition in Europe. The major finding is the wide difference in the prevalence of depressive disorders found across the study sites.
567 citations
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Durham University1, University of Groningen2, National Health Service3, University of Bristol4, Ontario Institute for Cancer Research5, University of Melbourne6, Royal College of Surgeons in Ireland7, University of Ferrara8, University of Toronto9, University of Exeter10, University College London11, Hull York Medical School12, King's College London13, University of Queensland14, Bangor University15, Glenfield Hospital16, University of Cambridge17, Charles University in Prague18, University of Manitoba19, Juravinski Cancer Centre20, Aarhus University21, Oxford Brookes University22, University of Edinburgh23, American Cancer Society24, Utrecht University25
TL;DR: This Commission considers how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal.
Abstract: The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise—from epidemiologists, psychologists, policy makers, and cancer specialists—has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care—its continuous, coordinated, and comprehensive care for individuals and families—are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.
408 citations
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TL;DR: Investigation of the relevant literature found no instruments that had been specifically designed to measure the concept of 'involving patients' in decisions, and reveals that little attention has been given to the processes of patient involvement in decision-making.
234 citations
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TL;DR: When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression, and both interventions reduced caseness and improved subjective function.
Abstract: Objectives: To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function. Design: A pragmatic multicentre randomised controlled trial, stratified by centre. Setting: Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom. Participants: 452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Interventions: Six individual sessions of problem solving treatment (n=128), eight group sessions of the course on prevention of depression (n=108), and controls (n=189). Main outcome measures: Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function. Results: 63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention. The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was −2.63 (95% confidence interval −4.95 to −0.32), and there were significant improvements in SF-36 scores. For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was −1.50 (−4.16 to 1.17), and there were significant improvements in SF-36 scores. Such differences were not observed at 12 months. Neither specific diagnosis nor treatment with antidepressants affected outcome. Conclusions: When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression. Both interventions reduced caseness and improved subjective function.
234 citations
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5,064 citations
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Dresden University of Technology1, Centre for Addiction and Mental Health2, Karlstad University3, Stockholm School of Economics4, University of Copenhagen5, Karolinska Institutet6, University of Florence7, University of Basel8, University of Zurich9, Maastricht University10, University of Lausanne11, European Monitoring Centre for Drugs and Drug Addiction12, Aarhus University Hospital13
TL;DR: The true size and burden of disorders of the brain in the EU was significantly underestimated in the past, and Concerted priority action is needed at all levels, including substantially increased funding for basic, clinical and public health research and policy decisions.
3,079 citations
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01 Jan 1997
TL;DR: This new edition of Ann Bowling's well-known and highly respected text is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services.
Abstract: This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.
2,602 citations