Editorials Quality improvement in primary care Kath Checkland BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p582 (Published 22 March 2023)Cite this as: BMJ 2023;380:p582 Lessons from the end of QOF in Scotland The Quality and Outcomes Framework (QOF) pay-for-performance scheme began in the UK National Health Service in the early 2000s.1 Under a new contract, as much as 20% of general practices’ remuneration was initially tied to the achievement of per...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Point of Care Ultrasound: The Critical Imaging Tool for the Critically Unwell This article aims to discuss the specific role of point of care ultrasound (POCUS) in the diagnosis and management of pathology in the critical care setting, as well as a specific tool to aid in invasive procedures. We discuss the ABCDE assessment of patients within critical care using POCUS. Introduction Since its introdu...

ICU Management & Practice, Volume 22 - Issue 5, 2022 The Role of Lung Imaging to Personalise Lung Ventilation in ARDS Patients Computed tomography (CT) remains an invaluable technique to evaluate lung morphology and response to ventilatory strategy and to understand the pathophysiology of Acute Respiratory Distress Syndrome (ARDS) patients. The first report of Acute Respiratory Distress Syndrome (ARDS) in 1967 described patients with severe hypoxaemia an...

ICU Management & Practice, Volume 22 - Issue 5, 2022 The Use of Critical Care Ultrasound Critical care ultrasound examination should be considered in specific situations in the intensive care unit. It has become increasingly important to understand and master all the possible applications and future innovations of ultrasonography in the critical care setting. Point of care application of ultrasound has been widely validated as an essential imaging techni...

ICU Management & Practice, Volume 22 - Issue 5, 2022 The Clinical Utility of Estimated Plasma Volume in Critical Care An overview of clinical evidence that demonstrates the prognostic value of estimated plasma volume (ePVS) in critically ill patients. Relevance Plasma volume (PV) is the total volume of blood plasma – the extracellular fluid volume of the vascular space. It is associated with regulating interstitial and intravascular spaces; hence it c...

Viewpoint  March 20, 2023 The Rapid Growth of Mega-Journals: Threats and Opportunities John P. A. Ioannidis, Angelo Maria Pezzullo, Stefania Boccia JAMA. Published online March 20, 2023. doi:10.1001/jama.2023.3212 Mega-journals, those that publish large numbers of articles per year,1 are growing rapidly across science and especially in biomedicine. Although 11 Scopus-indexed journals published more than 2000 biomedical full papers (articles o...

COMMENT|ONLINE FIRST Higher-dose dexamethasone for patients with COVID-19 and hypoxaemia? Anders Perner, Balasubramanian Venkatesh Lancet Published:April 12, 2023 DOI:https://doi.org/10.1016/S0140-6736(23)00587-1 Early in the COVID-19 pandemic, the RECOVERY trial showed that anti-inflammatory therapy with 6 mg daily dexamethasone improved survival in patients requiring oxygen supplementation.1Additional anti-inflammatory therapy with either interleukin-6 (I...

Editorial  March 21, 2023 Toward Personalizing Care: Assessing Heterogeneity of Treatment Effects in Randomized Trials Issa J. Dahabreh, Dhruv S. Kazi JAMA. Published online March 21, 2023. doi:10.1001/jama.2023.3576 Clinicians know that individual patients may respond differently to a given treatment and that the overall treatment effect reported in a randomized trial of the treatment may not be directly applicable to all patients in clinica...

Time to Move From SOFA 1.0 to 2.0? The Sequential Organ Failure Assessment (SOFA) score was developed in 1994, more than 25 years ago. The primary purpose of the score was to provide clinicians with a method that could help them assess and monitor organ dysfunction in critically ill patients. SOFA score became one of the most widely used scoring systems in intensive care. However, many changes have occurred in clinical practice over the last decades. New interventi...

Measuring Global Response to Antimicrobial Resistance In order to evaluate current progress and future planning to overcome antimicrobial resistance, it is important to understand strategic commitments and policy responses. The most important mechanism guiding national strategy and action for antimicrobial resistance governance is the national action plans (NAPs). Several NAPs have been developed, but to date, there has been no comprehensive analysis of these plans...