Last week, during a visit to a Pennsylvania coal mine that was recently fined for violating environmental laws, Pruitt dismissed concerns from environmentalists who he said think that in a push to increase coal, oil and gas production, he and others are "compromising outcomes with respect to our environment".
Self-management interventions which reduce costs without compromising outcomes might be attractive to commissioners, but so might interventions which increase costs, while providing significant additional health benefits.
We sought to determine which models of self-management support are associated with significant reductions in health services utilisation without compromising outcomes among patients with long-term conditions.
Such plots identify studies in the appropriate quadrant (i.e. those that reduce costs without compromising outcomes) and those in problematic quadrants (i.e. those that reduce costs but also compromise outcomes, or those that compromise both outcomes and costs).
Recent publications suggest that with adequate surgical debridement and vacuum dressings, the proportion of cases which need to be managed with free soft tissue transfer can be reduced without compromising outcomes.
Inconclusive results from these two studies and a range of opinions among medical oncologists who treat CRC led us to evaluate whether asymptomatic patients should receive chemotherapy immediately or could defer therapy without compromising outcomes.
In a developing country like Pakistan, huge tumor burden, limited treatment facilities, and affordability make it necessary to develop cheaper regimens with shorter duration of administration without compromising outcomes.
The research question underlying this review was: What models of self-management support are associated with significant reductions in health services utilisation without compromising outcomes, among patients with long-term conditions?
Our aim (to identify studies that reduce costs while not compromising outcomes) reflects the current economic context faced by many commissioners of health care services, but does not map neatly onto current economic analyses, which focus on the incremental cost effectiveness ratio and net mean benefit.
