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Biomedical subjects

R D Weir

Publications and source records attributed to R D Weir.

At least 19 recordsLinked to original sources
PubMed1990

Clinical outcome and costs of care in radioiodine treatment of hyperthyroidism.

The long-term clinical outcome and costs of treatment of hyperthyroidism with radioiodine have been examined in two cohorts of patients from Sheffield and Scotland. The majority of patients in both series were considered to have Graves' disease. The Sheffield patients (660) were included in a trial of three radioiodine dose regimens of 3,500 (312), 7,000 (323) and 14,000 (25) rad determined using a formula for accurate dosimetry. The Scottish patients (3,920) drawn from five centres in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness were treated using an arbitrary scale, for the activity of radioiodine administered, related to goitre size. Their results are grouped into five MBq 'dose' bands: 37-185, 186-370, 371-555, 556-740 and 741+. The proportion of patients with persistent hyperthyroidism was higher in both cohorts for low-dose radioiodine regimens, but 15-25% of patients who received high doses showed persistent hyperthyroidism. Early and late onset hypothyroidism was lower after low doses but differences between the treatment groups were small in terms of clinical benefit. Total morbidity at 10 years follow-up, in terms of hyperthyroidism, and hypothyroidism, was highest after low-dose therapy. There was little variation in total costs, but patient costs were lowest for the Scottish regimen and highest for low-dose therapy. A dose of at least 370-555 MBq which will ensure early elimination of hyperthyroidism will also limit the medical workload and total costs.

Adult↗
PubMed1982

Do we need thyroid follow-up registers? A cost-effective study.

Patients who had received radioiodine treatment for hyperthyroidism were followed up by two different methods. 576 patients (group 1) were followed up conventionally by their general practitioners and as hospital outpatients. 609 similarly treated patients (group 2) were followed up by a computer-assisted system, the Scottish Automated Follow-up Register (S.A.F.U.R.). Follow-up in the two groups were compared on the basis of cost-effectiveness. On average, patients were seen for follow-up about once every 8 months if in group 1 and every 14 1/2 months in group 2. The overall cost of follow-up and treatment for group 2 patients was less than 60% of that for group 1 patients. A central follow-up register is reliable and cost-effective, particularly so when patients are dispersed over a wide area.

Cost-Benefit Analysis↗
PubMed1981

Breast cancer in thyroid disease: fact or fallacy?

The incidence of breast cancer was examined prospectively in 2523 patients registered in a thyroid follow-up system. No significant differences were found between the observed and expected numbers of cases in any of the sub-groups defined by age, underlying pathology, or type of treatment. These results provide no indication that the risk of breast cancer is increased in patients treated for thyroid disease.

Breast Neoplasms↗
PubMed1976

Commitment and concern in the health service.

As part of a general review of the use of local health services resources, a specific enquiry was mounted to examine the recurring complaint of a lack of identity or sense of belonging made by staff working in the largest district of the Grampian Health Board. The investigation pointed to clearly identifiable sources of confusion and concern: (a) a need to identify with and feel committed to the health service; (b) a sense of purpose and direction; (c) satisfaction with the conditions of service; (d) an understanding of an individual's role and its relationship to others'. It is relatively easy to list the problems, such as friction between occupational groups, lack of commitment, uncertainty over duties and authority, reluctance to delegate and resistance to, or even outright rejection of, decisions apparently at variance with professional advice. In addition to these internal stresses the health service is perpetually beset by two other external problems, namely what it is expected to achieve and the finance allowed to attain its goals. The various groups within the service are in no way agreed on roles and responsibilities, Without agreement goals cannot be defined. Without goals, use of resources cannot be rationalized. Without a demonstrably fair distribution of resources, neither the public nor health service staff will feel confident or committed. Somewhere this cycle must be broken.

Attitude of Health Personnel↗
PubMed1970

Computer-assisted follow-up register for the north-east of Scotland.

An automated follow-up register for the detection of iatrogenic thyroid disease has been established as a joint venture between the general practitioners in the north-east of Scotland and the thyroid clinic of Aberdeen General Hospitals.The data-processing operations in the system are handled by an International Computers Limited 4/50 computer. Patients are followed up at predetermined intervals and the system has been designed to process, screen, and store clinical and biochemical follow-up data and report results to the patients, general practitioners, and the hospital records department.

Computers↗