Bradford Royal Infirmary is a large teaching hospital in Bradford, West Yorkshire, England, and is operated by the Bradford Teaching Hospitals NHS Foundation Trust. The infirmary is affiliated with the Leeds School of Medicine.
BACKGROUND:Early diagnosis is crucial in improving oral cancer outcomes. Patient education materials support timely recognition and management. However, these resources are often written above recommended reading levels, beyond patients' health literacy and limiting accessibility. OBJECTIVES:To assess the readability of available patient information on oral cancer by the NHS, to evaluate three large language models (LLMs; ChatGPT, Claude and Gemini) in simplifying texts while preserving their content, and to propose an improved leaflet based on UK materials, expert review and LLM adjustment to match average UK reading levels. METHODS:Materials were collected from NHS-affiliated websites. Original and LLM-simplified texts were assessed using validated readability tools (FRES, FKGL, GFI, CLI and SMOG). Content fidelity was assessed using character 3-5-g cosine, sentence-content retention and latent semantic analysis (LSA). An expert review was applied to the proposed leaflet. RESULTS:LLM-revisions significantly improved readability across all five indices (p < 0.0001). Mean FRES of original texts was 66.4 ± 7.7, while Claude (81.6 ± 6.2) was the only model to surpass the 80 benchmark. Semantic similarity to source text remained high (LSA means 0.97 ± 0.04, 0.94 ± 0.09 and 0.96 ± 0.08; character 3-5-g cosine 0.85 ± 0.05, 0.80 ± 0.08 and 0.82 ± 0.08 for respective models). Baseline readability of the proposed leaflet was comparable to NHS materials (FRES 65.7); Claude increased this to 81.2. CONCLUSIONS:LLM-based simplification enhanced readability while preserving content fidelity. This approach can help enhance accessibility, particularly for populations disproportionately affected by oral cancer. With human oversight, it could be adopted at the policy level to standardise patient education and reduce health literacy disparities.
OBJECTIVE:To assess the economic consequences of initiating full milk feeds from birth compared with intravenous fluids with gradual feeding in infants born preterm. DESIGN:Within-trial economic evaluation alongside a prospective, multicentre, randomised controlled trial (Fluids Exclusively Enteral from Day 1). A cost-consequence approach was used (revised from the planned cost-effectiveness analysis to avoid double counting length of stay within costs). SETTING:46 UK National Health Service (NHS) neonatal units. PATIENTS:Preterm infants born at 30+0to 32+6 weeks' gestation. INTERVENTIONS:Infants were allocated to either full milk feeds or gradual feeding with intravenous support within 3 hours of birth. MAIN OUTCOME MEASURE:Resource use and costs were captured from birth to 6 weeks' corrected age. Costs were assessed from an NHS and personal social services perspective. The primary clinical outcome was length of hospital stay. RESULTS:2088 infants were enrolled. There was no statistically significant difference in mean (95% CI) length of hospital stay between groups (-0.050 days (-0.638 to 0.538)). Mean total costs were £670 lower in the full milk group (95% CI: -£1562 to £223; p=0.141). Subgroup analyses suggested lower costs among infants born at 30 weeks' gestation and those below the 10th birth weight centile; no evidence of interaction was found. CONCLUSIONS:Initiating full milk feeds from birth was associated with a modest reduction in costs compared with gradual feeding. While overall hospital stays and costs were not significantly reduced, early full feeding may offer economic advantages in selected subgroups. Further research is needed to assess long-term outcomes. TRIAL REGISTRATION NUMBER:ISRCTN89654042.
BACKGROUND:Research on the hearing implant journey in older adults is scarce. AIMS/OBJECTIVES:To conduct a multicenter scoping survey on the clinical routine in the treatment of hearing loss, specifically cochlear implantation, in older adults. MATERIALS AND METHODS:A survey comprising 39 questions on the treatment of hearing loss in older adults was sent to 20 cochlear implant clinics worldwide. RESULTS:Most respondents referred to older adults in the context of cochlear implantation as adults aged 60 years or older with postlingual, mostly progressive hearing loss with different aetiologies. Preoperative assessment in older adults should go beyond standard audiometric tests, including cognitive screening and involving a multidisciplinary team. Significant others and social support play a key role in the rehabilitation process in older adult CI recipients and users. CONCLUSIONS AND SIGNIFICANCE:A guideline for the management of cochlear implantation in older adults is needed.
Background Orthopaedics currently has the largest waiting list of any surgical speciality in the UK, and the number of patients awaiting elective surgery is continuing to climb. This retrospective study aims to quantify the impact of coding errors on elective surgery waiting times at a large UK district general hospital. Method Data from 381 patients who underwent operations on elective orthopaedic operating lists between January 1, 2025, and March 31, 2025, were included in the study. Most orthopaedic patients with acute issues are operated on a dedicated acute list. However, surges in acute referrals may result in re-purposing of elective operating lists to treat acute patients. These cases are at risk of being incorrectly coded as elective operations. The electronic booking code of the operation was compared with the case notes of each patient to determine if the coding as elective or acute was accurate. Results Of the 381 patients coded as elective, 44 were acute cases falsely coded as elective. The mean waiting time for these false elective cases was 10.86 days, in comparison to 247.24 days for the true elective cases. Overall, incorrect coding of trauma cases as elective cases artificially reduced the mean waiting time by 27.14 days, or 11.01%. A Mann-Whitney U test showed this to be statistically significant (p = 0.012). Conclusion Inaccurate electronic coding substantially and artificially reduces orthopaedic surgery waiting time. This is likely driven by human error and software errors that can prevent correct coding. These issues might be addressed through a review of the approved Electronic Patient Record (EPR) software systems, staff training, and a further push towards cold-site operating to better separate acute and elective orthopaedic care. Finally, a multi-centre study would demonstrate how far-reaching these coding errors are.
