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155. Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial

Author

Healey, Emma L., primary, Jinks, Clare, additional, Tan, Valerie A., additional, Chew-Graham, Carolyn A., additional, Lawton, Sarah A., additional, Nicholls, Elaine, additional, Finney, Andrew G., additional, Porcheret, Mark, additional, Cooper, Vince, additional, Lewis, Martyn, additional, Dziedzic, Krysia S., additional, Wathall, Simon, additional, and Mallen, Christian D., additional

Published
2015
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156. Lateral epicondylitis in general practice: Course and prognostic indicators of outcome

Author

Smidt, Nynke, Lewis, Martyn, Van Der Windt, Daniëlle A.W.M., Hay, Elaine M., Bouter, Lex M., Croft, Peter, and Executive board Vrije Universiteit

Subjects
SDG 3 - Good Health and Well-being, Randomized controlled trial, Tennis elbow, Prognosis, Primary health care
Abstract

Objective. To investigate the course of lateral epicondylitis and identify prognostic indicators associated with short- and longterm outcome of pain intensity. Methods. We prospectively followed patients (n = 349) from 2 randomized controlled trials investigating conservative interventions for lateral epicondylitis in primary care. Uni- and multivariate linear regression analyses were used to investigate the association between potential prognostic indicators and pain intensity (0-100 point scale) measured at 1,6, and 12 months after randomization. Potential prognostic factors were duration of elbow complaints, concomitant neck pain, concomitant shoulder pain, previous elbow complaints, baseline pain scores, age, gender, involvement of dominant side, social class, and work status. The variables "study" and "treatment" were included as covariates in all models. Results. Pain scores at 1 month followup were higher in patients with severe pain, a long duration of elbow complaints, and concomitant shoulder pain. At 12 month followup, the only different prognostic indicator for poor outcome was concomitant neck pain, in place of shoulder pain. Patients from higher social classes reported lower pain scores at 12 month followup than patients from lower social classes. Conclusions. Lateral epicondylitis seems to be a self-limiting condition in most patients. Long duration of elbow complaints, concomitant neck pain, and severe pain at presentation are associated with poor outcome at 12 months. Our results will help care providers give patients accurate information regarding their prognosis and assist in medical decision-making.

Published
2006

157. Lateral epicondylitis in general practice:Course and prognostic indicators of outcome

Author

Smidt, Nynke, Lewis, Martyn, Van Der Windt, Daniëlle A.W.M., Hay, Elaine M., Bouter, Lex M., and Croft, Peter

Subjects
SDG 3 - Good Health and Well-being, Randomized controlled trial, Tennis elbow, Prognosis, Primary health care
Abstract

Objective. To investigate the course of lateral epicondylitis and identify prognostic indicators associated with short- and longterm outcome of pain intensity. Methods. We prospectively followed patients (n = 349) from 2 randomized controlled trials investigating conservative interventions for lateral epicondylitis in primary care. Uni- and multivariate linear regression analyses were used to investigate the association between potential prognostic indicators and pain intensity (0-100 point scale) measured at 1,6, and 12 months after randomization. Potential prognostic factors were duration of elbow complaints, concomitant neck pain, concomitant shoulder pain, previous elbow complaints, baseline pain scores, age, gender, involvement of dominant side, social class, and work status. The variables "study" and "treatment" were included as covariates in all models. Results. Pain scores at 1 month followup were higher in patients with severe pain, a long duration of elbow complaints, and concomitant shoulder pain. At 12 month followup, the only different prognostic indicator for poor outcome was concomitant neck pain, in place of shoulder pain. Patients from higher social classes reported lower pain scores at 12 month followup than patients from lower social classes. Conclusions. Lateral epicondylitis seems to be a self-limiting condition in most patients. Long duration of elbow complaints, concomitant neck pain, and severe pain at presentation are associated with poor outcome at 12 months. Our results will help care providers give patients accurate information regarding their prognosis and assist in medical decision-making.

Published
2006

159. Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the Management of OsteoArthritis In Consultations (MOSAICS) study protocol

Author

Dziedzic, Krysia S, primary, Healey, Emma L, additional, Porcheret, Mark, additional, Ong, Bie Nio, additional, Main, Chris J, additional, Jordan, Kelvin P, additional, Lewis, Martyn, additional, Edwards, John J, additional, Jinks, Clare, additional, Morden, Andrew, additional, McHugh, Gretl A, additional, Ryan, Sarah, additional, Finney, Andrew, additional, Jowett, Sue, additional, Oppong, Raymond, additional, Afolabi, Ebenezer, additional, Pushpa-Rajah, Angela, additional, Handy, June, additional, Clarkson, Kris, additional, Mason, Elizabeth, additional, Whitehurst, Tracy, additional, Hughes, Rhian W, additional, Croft, Peter R, additional, and Hay, Elaine M, additional

Published
2014
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160. Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)

Author

Bishop, Annette, primary, Wynne-Jones, Gwenllian, additional, Lawton, Sarah A, additional, van der Windt, Danielle, additional, Main, Chris, additional, Sowden, Gail, additional, Burton, A Kim, additional, Lewis, Martyn, additional, Jowett, Sue, additional, Sanders, Tom, additional, Hay, Elaine M, additional, and Foster, Nadine E, additional

Published
2014
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166. Moving into the live virtual classroom: live virtual training enables us to match the learning experience to the way people work today--in a more networked world where they tackle many more responsibilities and tasks in the course of a day

Author

Lewis, Martyn

Subjects
Decision-making -- Analysis, Online education -- Evaluation, Virtual classrooms -- Management, Company business management, Business, Education, Human resources and labor relations
Abstract

With increasing pressure on learning organizations to deliver greater results and with ever-decreasing resources and time, there is an understandable race away from the physical to the virtual classroom. The [...]

Published
2011

167. How I made the Grade

Author

Lewis, Martyn

Subjects
Channel Four Television Corp. Channel 4 -- Officials and employees, Television broadcasting industry -- Officials and employees, General interest, News, opinion and commentary
Abstract

British television executive Michael Grade's formula for success is picking the right people and giving them as much responsibility as possible. Grade, who is leaving his post as chief executive of Channel 4 (C4) on May 30, 1997, to join First Leisure, explains that he has always wanted to be the best at what he was doing but has never planned his career. He admits that he would not have obtained a traineeship on the Daily Mirror at the age of 17 had it not been for his family connections. Grade, a self-confessed workaholic, argues that complacency is the greatest enemy of success.

Published
1997

168. Point-of-care testing: a look ahead

Author

Lewis, Martyn

Subjects
Medical tests -- Forecasts and trends -- Technology application, Diagnosis -- Technology application -- Forecasts and trends, Market trend/market analysis, Technology application, Business, Health care industry
Abstract

Point-of-care technology (POCT) isn't a new concept, yet the degree of acceptance and, therefore, the rate of adoption vary considerably around the world. In some regions the flexibility that a [...]

Published
2015

173. Bipolar sport disorder

Author

Lewis, Martyn

Subjects
Bipolar disorder, Banking, finance and accounting industries, Business, Business, international
Abstract

From Mr Martyn Lewis. Sir, I can well understand Gordon Brown's supporting Scotland but also, on occasion, England at football ('The club versus country dilemma facing Gordon Brown', January 6/7). [...]

Published
2007

182. A randomised clinical trial of subgrouping and targeted treatment for low back pain compared with best current care. The STarT Back Trial Study Protocol

Author

Hay, Elaine M, primary, Dunn, Kate M, additional, Hill, Jonathan C, additional, Lewis, Martyn, additional, Mason, Elizabeth E, additional, Konstantinou, Kika, additional, Sowden, Gail, additional, Somerville, Simon, additional, Vohora, Kanchan, additional, Whitehurst, David, additional, and Main, Chris J, additional

Published
2008
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183. STarT Back Screening Tool

Author

Hill, Jonathan C., primary, Dunn, Kate M., additional, Lewis, Martyn, additional, Mullis, Ricky, additional, Main, Chris J., additional, Foster, Nadine E., additional, and Hay, Elaine M., additional

Published
2008
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189. Letters

Author

Foster, Nadine E., primary, Konstantinou, Kika, additional, Lewis, Martyn, additional, and Cairns, Melinda, additional

Published
2006
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198. Relaxin induces vascular endothelial growth factor expression and angiogenesis selectively at wound sites

Author

UNEMORI, ELAINE N, primary, LEWIS, MARTYN, additional, CONSTANT, JAMES, additional, ARNOLD, GRETCHEN, additional, GROVE, BEVERLY H, additional, NORMAND, JOSEE, additional, DESHPANDE, USHA, additional, SALLES, ADAM, additional, PICKFORD, LESLEY B, additional, ERIKSON, MARK E, additional, HUNT, THOMAS K, additional, and HUANG, XINFAN, additional

Published
2000
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199. The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial.

Author

Ndosi, Mwidimi, Lewis, Martyn, Hale, Claire, Quinn, Helen, Ryan, Sarah, Emery, Paul, Bird, Howard, and Hill, Jackie

Abstract

Objective To determine the clinical effectiveness and cost-effectiveness of nurse-led care (NLC) for people with rheumatoid arthritis (RA). Methods In a multicentre pragmatic randomised controlled trial, the assessment of clinical effects followed a non-inferiority design, while patient satisfaction and cost assessments followed a superiority design. Participants were 181 adults with RA randomly assigned to either NLC or rheumatologist-led care (RLC), both arms carrying out their normal practice. The primary outcome was the disease activity score (DAS28) assessed at baseline, weeks 13, 26, 39 and 52; the non-inferiority margin being DAS28 change of 0.6. Mean differences between the groups were estimated controlling for covariates following per-protocol (PP) and intention-to-treat (ITT) strategies. The economic evaluation (NHS and healthcare perspectives) estimated cost relative to change in DAS28 and quality-adjusted life-years (QALY) derived from EQ5D. Results Demographics and baseline characteristics of patients under NLC (n=91) were comparable to those under RLC (n=90). Overall baseline-adjusted difference in DAS28 mean change (95% CI) for RLC minus NLC was -0.31 (-0.63 to 0.02) for PP and -0.15 (-0.45 to 0.14) for ITT analyses. Mean difference in healthcare cost (RLC minus NLC) was £710 (-£352, £1773) and -£128 (-£1263, £1006) for PP and ITT analyses, respectively. NLC was more cost-effective with respect to cost and DAS28, but not in relation to QALY utility scores. In all secondary outcomes, significance was met for non-inferiority of NLC. NLC had higher 'general satisfaction' scores than RLC in week 26. Conclusions The results provide robust evidence to support non-inferiority of NLC in the management of RA. Trial registration ISRCTN29803766 [ABSTRACT FROM AUTHOR]

Published
2014
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200. Subacromial impingement syndrome and pain: protocol for a randomised controlled trial of exercise and corticosteroid injection (the SUPPORT trial).

Author

Roddy, Edward, Zwierska, Irena, Hay, Elaine M., Jowett, Sue, Lewis, Martyn, Stevenson, Kay, van der Windt, Danielle, and Foster, Nadine E.

Subjects
SYNDROMES, CLINICAL trials, CORTICOSTEROIDS, MUSCULOSKELETAL diseases in old age, PHYSICAL therapists
Abstract

Background: Subacromial impingement syndrome is the most frequent cause of shoulder problems which themselves affect 1 in 3 adults. Management commonly includes exercise and corticosteroid injection. However, the few existing trials of exercise or corticosteroid injection for subacromial impingement syndrome are mostly small, of poor quality, and focus only on short-term results. Exercise packages tend to be standardised rather than individualised and progressed. There has been much recent interest in improving outcome from corticosteroid injections by using musculoskeletal ultrasound to guide injections. However, there are no high-quality trials comparing ultrasound-guided and blind corticosteroid injection in subacromial impingement syndrome. This trial will investigate how to optimise the outcome of subacromial impingement syndrome from exercise (standardised advice and information leaflet versus physiotherapist-led exercise) and from subacromial corticosteroid injection (blind versus ultrasound-guided), and provide long-term follow-up data on clinical and cost-effectiveness. Methods/Design: The study design is a 2x2 factorial randomised controlled trial. 252 adults with subacromial impingement syndrome will be recruited from two musculoskeletal Clinical Assessment and Treatment Services at the primary-secondary care interface in Staffordshire, UK. Participants will be randomised on a 1:1:1:1 basis to one of four treatment groups: (1) ultrasound-guided subacromial corticosteroid injection and a physiotherapist-led exercise programme, (2) ultrasound-guided subacromial corticosteroid injection and an advice and exercise leaflet, (3) blind subacromial corticosteroid injection and a physiotherapist-led exercise programme, or (4) blind subacromial corticosteroid injection and an advice and exercise leaflet. The primary intention-to-treat analysis will be the mean differences in Shoulder Pain and Disability Index (SPADI) scores at 6 weeks for the comparison between injection interventions and at 6 months for the comparison between exercise interventions. Although independence of treatment effects is assumed, the magnitude of any interaction effect will be examined (but is not intended for the main analyses). Secondary outcomes will include comparison of long-term outcomes (12 months) and cost-effectiveness. A secondary per protocol analysis will also be performed. Discussion: This protocol paper presents detail of the rationale, design, methods and operational aspects of the SUPPORT trial. [ABSTRACT FROM AUTHOR]

Published
2014
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