A survey of statistics in three UK general practice journal

Background Many medical specialities have reviewed the statistical content of their journals. To our knowledge this has not been done in general practice. Given the main role of a general practitioner as a diagnostician we thought it would be of interest to see whether the statistical methods reported reflect the diagnostic process. Methods Hand search of three UK journals of general practice namely the British Medical Journal (general practice section), British Journal of General Practice and Family Practice over a one-year period (1 January to 31 December 2000). Results A wide variety of statistical techniques were used. The most common methods included t-tests and Chi-squared tests. There were few articles reporting likelihood ratios and other useful diagnostic methods. There was evidence that the journals with the more thorough statistical review process reported a more complex and wider variety of statistical techniques. Conclusions The BMJ had a wider range and greater diversity of statistical methods than the other two journals. However, in all three journals there was a dearth of papers reflecting the diagnostic process. Across all three journals there were relatively few papers describing randomised controlled trials thus recognising the difficulty of implementing this design in general practice

Bayesian networks for raster data (BayNeRD): plausible reasoning from observations

This paper describes the basis functioning and implementation of a computer-aided Bayesian Network (BN) method that is able to incorporate experts’ knowledge for the benefit of remote sensing applications and other raster data analyses: Bayesian Network for Raster Data (BayNeRD). Using a case study of soybean mapping in Mato Grosso State, Brazil, BayNeRD was tested to evaluate its capability to support the understanding of a complex phenomenon through plausible reasoning based on data observation. Observations made upon Crop Enhanced Index (CEI) values for the current and previous crop years, soil type, terrain slope, and distance to the nearest road and water body were used to calculate the probability of soybean presence for the entire Mato Grosso State, showing strong adherence to the official data. CEI values were the most influencial variables in the calculated probability of soybean presence, stating the potential of remote sensing as a source of data. Moreover, the overall accuracy of over 91% confirmed the high accuracy of the thematic map derived from the calculated probability values. BayNeRD allows the expert to model the relationship among several observed variables, outputs variable importance information, handles incomplete and disparate forms of data, and offers a basis for plausible reasoning from observations. The BayNeRD algorithm has been implemented in R software and can be found on the internet. \ an

Increasing access to integrated ESKD care as part of Universal Health Coverage

The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals from around the globe with diverse expertise and professional backgrounds. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle–income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across 8 themes: (i) estimates of ESKD burden and treatment coverage, (ii) advocacy, (iii) education and training/workforce, (iv) financing/funding models, (v) ethics, (vi) dialysis, (vii) transplantation, and (viii) conservative care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include improved data availability, integration of core registry measures and analysis to inform development of health care policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient, and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide