BMJ : British medical journal
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To investigate the ratio of inhaled corticosteroid to bronchodilator as a measure of the quality of asthma prescribing by general practitioners. ⋯ Although the corticosteroid:bronchodilator ratio may be a valid indicator of the quality of prescribing for individual patients with asthma, caution should be applied in interpreting aggregated ratios. Differences in the severity of asthma or the prevalence of chronic obstructive pulmonary disease may explain inconsistent associations between admission rates for asthma and corticosteroid:bronchodilator ratios in family health services authorities and general practices with different deprivation scores.
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To estimate the financial risks of 15 categories of rare costly referrals for total purchasing sites of different population sizes. ⋯ Rare costly referrals seem unlikely to bankrupt total purchasing sites. The management of risk is not in itself justification for total purchasing to be based in several general practices in order to generate large populations. There are other ways of managing risk. Sites can easily explore options by simulations using local referral rates and prices.
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To examine the competence of a cohort trained in cardiopulmonary resuscitation by the BBC's 999 training roadshows. ⋯ Television is an effective means of generating large training cohorts. Volunteers will cooperate with unsolicited testing in their home, such testing being a realistic simulation of the stress and lack of forewarning that would surround a real event. Under such conditions the performance of cardiopulmonary resuscitation was disappointing. However, retraining greatly improves performance.