Richard J. Lilford

Peter J Chilton7
Karla Hemming6
Alan J Girling4
7Peter J Chilton
6Karla Hemming
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BACKGROUND Stepped wedge randomised trial designs involve sequential roll-out of an intervention to participants (individuals or clusters) over a number of time periods. By the end of the study, all participants will have received the intervention, although the order in which participants receive the intervention is determined at random. The design is(More)
By most measures, the adoption of modeling and simulation techniques in healthcare service development falls well short of the uptake of such techniques evident in other sectors, such as business and commerce or aerospace and the military. The question is, why? To answer this, we consider three questions and then turn to the nature of answer which might(More)
OBJECTIVE To assess the validity of case mix adjustment methods used to derive standardised mortality ratios for hospitals, by examining the consistency of relations between risk factors and mortality across hospitals. DESIGN Retrospective analysis of routinely collected hospital data comparing observed deaths with deaths predicted by the Dr Foster Unit(More)
BACKGROUND Empathy is frequently cited as an important attribute in physicians and some groups have expressed a desire to measure empathy either at selection for medical school or during medical (or postgraduate) training. In order to do this, a reliable and valid test of empathy is required. The purpose of this systematic review is to determine the(More)
BACKGROUND Cluster randomised controlled trials (CRCTs) are frequently used in health service evaluation. Assuming an average cluster size, required sample sizes are readily computed for both binary and continuous outcomes, by estimating a design effect or inflation factor. However, where the number of clusters are fixed in advance, but where it is possible(More)
Because of the recent and controversial example of sham surgery for the evaluation of fetal tissue transplants for Parkinson's disease, there is renewed interest in the ethics of using "active" placebos in surgical trials, where otherwise there are no inert procedures available, and in pharmacological trials, where there are inert substances, but where(More)
BACKGROUND We developed a method to estimate the expected cost-effectiveness of a service intervention at the design stage and 'road-tested' the method on an intervention to improve patient handover of care between hospital and community. METHOD The development of a nine-step evaluation framework: 1. Identification of multiple endpoints and arranging them(More)
BACKGROUND This protocol concerns the assessment of cost-effectiveness of hospital health information technology (HIT) in four hospitals. Two of these hospitals are acquiring ePrescribing systems incorporating extensive decision support, while the other two will implement systems incorporating more basic clinical algorithms. Implementation of an(More)
OBJECTIVE To understand how the results of laboratory tests are communicated to patients in primary care and perceptions on how the process may be improved. DESIGN Qualitative study employing staff focus groups. SETTING Four UK primary care practices. PARTICIPANTS Staff involved in the communication of test results. FINDINGS Five main themes emerged(More)
BACKGROUND Medication errors are an important source of potentially preventable morbidity and mortality. The PINCER study, a cluster randomised controlled trial, is one of the world's first experimental studies aiming to reduce the risk of such medication related potential for harm in general practice. Bayesian analyses can improve the clinical(More)