Press Releases Saturday 3 July 1999
No 7201 Volume 319
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://www.bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) NEW COMPUTER
PROGRAMME COULD HELP
ASSESS CANCER
RISKS
(2) STIGMAS
OF MENTAL DISORDERS WILL
DISAPPEAR
IN FUTURE
(3) THE PRIVATE
FINANCE INITIATIVE IS A "FREE
LUNCH" THAT
COULD DESTROY THE NHS
(1) NEW COMPUTER PROGRAMME COULD HELP
ASSESS CANCER RISKS
(Computer support for recording and
interpreting family
histories of breast and ovarian
cancer in primary care
(RAGs): qualitative evaluation with
simulated patients)
http://www.bmj.com/cgi/content/full/319/7201/32
A new computer programme, to help family
doctors work
with patients to assess their genetic
risk of cancer, seems to
have faired well in initial trials, the
results of which are
published in this week's BMJ. A collaboration
between the
Cancer Research Campaign and the Imperial
Cancer
Research Fund, "risk assessment in genetics"
(RAGs) is a
computer programme which draws pedigrees,
assesses risk
based on a family history of breast and
ovarian cancer and
suggests an appropriate course of action.
The study was conducted with 15 general
practitioners,
each consulted by two female patients,
played by actors,
concerned about their risk of cancer.
Most of the doctors
involved in the study found the programme
easy to use and
that it enabled them to tackle the complex
area of assessing
genetic risk with their patients. However,
users also
reported a sense of "being out of control"
during the
consultation. For example, some participants
found it
awkward sitting next to their patient,
with the screen in front
of them, unable to predict the information
that would be
displayed. When the programme calculated
that a patient
should be considered "high risk" doctors
commented that
they felt a sense of panic and wanted
to turn the screen
away from the patient in order to break
the bad news more
gently.
The authors of the study also found that
some users were
uncomfortable with the speed of the programme.
Some
preferred to "stage" the process of assessment
so that they
had time to prepare themselves for presenting
bad news to a
patient. Some users found it difficult
to access the additional
information explaining what the risk assessment
actually
meant for the patient, which was contained
within the
programme. Once they found these explanations
they were
able to reassure the patient and feel
more in control of the
consultation.
The team conclude that RAGs could provide
the necessary
support to assist the assessment of the
genetic risk of cancer
in the primary care setting and report
that the study throws
up a need for some important changes to
the software to
improve the role of the programme within
the doctor/patient
consultation. They also note that their
findings have identified
a number of issues related to the use
of computers in patient
consultations that may have implications
for the testing of
software for primary care in the future.
Contact:
Dr Jon Emery, Cancer Research Campaign
Primary Care
Oncology Research Fellow, ICRF General
Practice
Research Group, Division of Public Health
and Primary
Health Care, Institute of Health Sciences,
University of Oxford, Oxford
Email: jon.emery{at}green.ox.ac.uk
Esther Ferguson, Press Office, Cancer Research Campaign
Dr Iain Foulkes, Press Office,
Imperial Cancer Research Fund
(2) STIGMAS OF MENTAL
DISORDERS WILL
DISAPPEAR IN FUTURE
(Behaviour and genes)
http://www.bmj.com/cgi/content/full/319/7201/37
Researchers in this week's BMJ predict
that increased
understanding of psychiatric conditions
will improve public
perception and acceptance of disorders
such as depression,
autism, schizophrenia and attention deficit
hyperactivity
disorder. Peter McGuffin from the Institute
of Psychiatry,
London and Neilson Martin from the University
of Wales
College of Medicine say that improved
understanding of the
causes and mechanisms of mental disorders
is likely to
reduce stigma.
In a review outlining some of the basic
concepts of the role
genes and the environment in which we
exist, play in
determining human behaviour, the authors
explain that by
identifying and understanding the basic
neurobiology of
diseases the development of new and more
specific drug
treatments should be possible. They also
suggest that by
being able to predict whether someone
will develop a
psychiatric disorder may also lead to
the development of
both effective treatments and preventive
methods, which, as
yet, do not exist.
McGuffin and Martin report that it has
sometimes been
feared that "geneticisation" could contribute
to the stigma of
mental disorder, and yet to date, experience
has been just
the opposite. Drawing on the example of
Alzheimer's
disease, now recognised as a disorder,
they conclude that
this will be the start of a trend of improved
public perception
of psychiatric conditions.
Contact:
Professor Peter McGuffin, Director, Social
Genetic and
Developmental Psychiatry Research Centre,
Kings College
London, London
Email: p.mcguffin{at}iop.kcl.ac.uk
(3) THE PRIVATE FINANCE
INITIATIVE IS A "FREE
LUNCH" THAT COULD DESTROY THE NHS
(PFI: perfidious financial idiocy)
http://www.bmj.com/cgi/content/full/319/7201/2
The British government should abandon the
private finance
initiative (PFI) and come up with an alternative
that will
allow the modernisation of the NHS, says
editor Dr Richard
Smith in a leader published in this week's
BMJ. Introducing
a new series on PFI which starts this
week in the BMJ, he
reports that the private finance initiative
schemes are in fact
costing much more than traditional public
funding of capital
developments and suggests that this extra
cost is likely to be
covered by an increase in private healthcare.
In areas with (PFI) schemes, both the number
of private
beds and the proportion of all beds that
they represent are
increasing. Until now, says the author,
the complexity of the
PFI issue has left electors bemused. But,
he argues, we must
wake up to the profound implications of
PFI before it is too
late.
Dr Smith also raises concerns over the
closed nature of the
planning process of PFI schemes, whereby
private
companies are making decisions on, for
example, the
numbers of beds without adequate accountability.
He also
argues that there is no evidence to suggest
that PFI schemes
are effective - in fact all the evidence
that exists suggests it is
a very bad idea. Finally he speculates
that PFI presents
"..generous scope for corruption". With
the vital
"...ingredients (of)... big sums of public
money; closed
decision making and inadequate accountability....Sooner
or
later we will have a scandal".
He concludes that the government is currently
lacking in
sufficient imagination and commitment
to think of an
alternative and persisting with such schemes
in a bid to save
face. He calls for the abandonment of
the PFI scheme in the
NHS and argues that the electorate wants
modernisation not
destruction.
Contact:
Dr Richard Smith, Editor, BMJ, c/o Jill
Shepherd,
BMJ Press Office
Email: jshepherd{at}bma.org.uk
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact Jill Shepherd;pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
