The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study
REDIRECT: cluster randomised controlled trial of GP training in first-episode psychosis.
Delays in accessing care for young people with a first episode of psychosis are significantly associated with poorer treatment response and higher relapse rates. ⋯ GP training on first-episode psychosis is insufficient to alter referral rates to early-intervention services or reduce the duration of untreated psychosis; however, there is a suggestion that training facilitates access to the new specialist teams for early psychosis.
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Randomized Controlled Trial Multicenter Study
Randomised controlled trial of intensive multifactorial treatment for cardiovascular risk in patients with screen-detected type 2 diabetes: 1-year data from the ADDITION Netherlands study.
A growing body of evidence suggests that earlier diagnosis and treatment of diabetes may be beneficial; however, definitive evidence is lacking. ⋯ Intensified multifactorial treatment of patients with screen-detected diabetes in general practice reduces cardiovascular risk factor levels significantly without worsening HRQoL.
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Randomized Controlled Trial Multicenter Study
Effectiveness of GP access to magnetic resonance imaging of the knee: a randomised trial.
GPs commonly see patients with knee problems. Magnetic resonance imaging (MRI) of the knee is an accurate diagnostic test for meniscus and ligament injuries of the knee, but there is uncertainty about the appropriate use of MRI and when it should enter the diagnostic pathway for patients with these problems. ⋯ GP access to MRI yielded small, but statistically significant, benefits in patients' knee-related quality of life but non-significant improvements in physical functioning.
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Randomized Controlled Trial Multicenter Study
Cost-effectiveness of magnetic resonance imaging of the knee for patients presenting in primary care.
Musculoskeletal problems generate high costs. Of these disorders, patients with knee problems are commonly seen by GPs. Magnetic resonance imaging (MRI) of the knee is an accurate diagnostic test, but there is uncertainty as to whether GP access to MRI for these patients is a cost-effective policy. ⋯ GP access to MRI for patients presenting in primary care with a continuing knee problem represents a cost-effective use of health service resources.
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Randomized Controlled Trial
Motivational interviewing for modifying diabetes risk: a randomised controlled trial.
Around 10-15% of adults aged over 40 years have pre-diabetes, which carries a high risk of progression to type 2 diabetes. Intensive lifestyle intervention reduces progression by as much as 58%. However, the cost and personnel requirements of these interventions are major obstacles to delivery in NHS primary care. ⋯ Short-term weight loss, at a level which, if sustained, is clinically meaningful for reducing diabetes risk, is achievable in primary care, without excessive use of NHS monetary or personnel resources.