BMJ : British medical journal
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Clinical Trial Controlled Clinical Trial
Effectiveness of a regional trauma system in reducing mortality from major trauma: before and after study.
To assess the effect of the development of an experimental trauma centre and regional trauma system on the survival of patients with major trauma. ⋯ Any reductions in mortality from regionalising major trauma care in shire areas of England would probably be modest compared with reports from the United States.
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To examine the variation in surgical and adjuvant treatment of breast cancer of known histology and detected on screening in a large cohort of patients treated by the surgeons of a health region. ⋯ Mastectomy rates for similar tumours vary widely by surgeon independently of casemix or caseload, but surgeons with a higher caseload tend to have a lower mastectomy rate. Omission of postoperative radiotherapy or tamoxifen after conservative treatment is not related to risk factors for local recurrence or caseload. Confidential feedback of treatment profiles to individual surgeons has been used, but when benefit has been established treatment should be guided by evidence based protocol.
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To determine whether histopathologists with deficient colour vision make more errors in slide interpretation than those with normal colour vision. ⋯ Histopathologists and medical laboratory scientific officers should have their colour vision tested; if they are found to have a severe protan or deutan deficiency, they should be advised to adopt a safe system of working.