Maximising recruitment into randomised controlled trials: the role of multidisciplinary cancer teams.

Multidisciplinary cancer teams offer many theoretical benefits, although few have been formally examined. This study evaluated the role of multidisciplinary team (MDT) meetings in recruitment into randomised controlled trials (RCTs). Consecutive MDT patient records were categorised into those with or without a recommendation for a national multicentre RCT. Clinical trial office records identified whether patients were subsequently screened and randomised. In 125 MDT meetings, 350 new patients were discussed, of whom 103 were potentially suitable for a RCT. The MDT recommended 68 patients for the trial, of whom 58 (85%) were screened for trial eligibility. Of the 35 without an MDT trial recommendation, only 23 (66%) were screened (p=0.022). This difference persisted and resulted in a greater proportion of MDT recommended patients being recruited (65% versus 49%; p=0.12). This study demonstrates that trial recommendation by an MDT significantly increases trial screening rates and may improve recruitment.

Speech therapy for psychogenic voice disorder: a survey of current practice and training.

A survey of speech therapists in the United Kingdom showed that they usually undertook the treatment of psychogenic voice disorders. Their pre-qualification education had provided advice that was usually reflected accurately in the experience they gained in practice, though during their education about a third had lacked any opportunity to treat or observe psychogenic voice disorders. The appropriate duration of treatment appears to be in doubt. At present, speech therapists acquire many of the psychological skills required for treatment after qualification. There is a substantial need for post-qualification courses, although more practical instruction on psychological treatment might advantageously be incorporated in initial education.

Teaching and learning about terminal care.

Because the same three teachers at the London Hospital Medical College both taught and examined students over an 11-year period it was possible to compare what was taught with what was recalled at examinations. The results suggest that aspects of terminal care vary greatly in their perceived importance, at least as measured by their recall and selection for presentation in the final examination. Most aspects of the taught material increased their penetration into the students' recall over the 11 years. There is evidence that the caring aspects are stressed more by women; this difference was less for descriptions of pain, and absent from accounts of the pharmacology of analgesic drugs.

Bopindolol: a new long acting beta-receptor antagonist; its effects on haemodynamics, and on the renin response to tilting.

Oral administration of single doses of bopindolol (1-4mg) caused significant reductions in the rises of systolic blood pressure and heart rate produced by exercise; only the reduction in the rise of heart rate was significantly dose-related. Resting heart rate was reduced by bopindolol. There were small effects on resting blood pressure. Bopindolol caused a significant attenuation of the rise in plasma renin activity produced by passive head-up tilting to 75-85 degrees. Bopindolol produced a dose-related attenuation of the increase in pulse rate evoked by passive tilting. All effects 1-4 were maintained for at least 24 h. There was no measurable effect on plasma potassium concentration, peak flow rate or forced expiratory volume (FEV1).