London SE1 Research Articles

International Journal of Eating DisordersVolume 49, Issue 4 p. 374-377 An Idea Worth Researching Will a comprehensive, person-centered, team-based early intervention approach to first episode illness improve outcomes in eating disorders? Ulrike Schmidt MD, PhD, FRCPsych, Corresponding Author Ulrike Schmidt MD, PhD, FRCPsych Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomCorrespondence to: Ulrike Schmidt, Professor of Eating Disorders, PO 59, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park London SE5 8AF, UK. E-mail: [email protected]Search for more papers by this authorAmy Brown DClinPsy, Amy Brown DClinPsy Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this authorJessica McClelland PhD, Jessica McClelland PhD Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSearch for more papers by this authorDanielle Glennon BSc Hons, MA, Danielle Glennon BSc Hons, MA Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this authorVictoria A. Mountford DClinPsy, Victoria A. Mountford DClinPsy Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this author Ulrike Schmidt MD, PhD, FRCPsych, Corresponding Author Ulrike Schmidt MD, PhD, FRCPsych Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomCorrespondence to: Ulrike Schmidt, Professor of Eating Disorders, PO 59, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park London SE5 8AF, UK. E-mail: [email protected]Search for more papers by this authorAmy Brown DClinPsy, Amy Brown DClinPsy Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this authorJessica McClelland PhD, Jessica McClelland PhD Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSearch for more papers by this authorDanielle Glennon BSc Hons, MA, Danielle Glennon BSc Hons, MA Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this authorVictoria A. Mountford DClinPsy, Victoria A. Mountford DClinPsy Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, United KingdomSearch for more papers by this author First published: 28 March 2016 https://doi.org/10.1002/eat.22519Citations: 37Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume49, Issue4April 2016Pages 374-377 RelatedInformation

Read full abstract

Comments Correspondence: John Withington, Department of Urology, Guy’s Hospital, Great Maze Pond, London SE1 9RT, UK. e-mail: john.withington@gstt.nhs.uk Abbreviations: HES, Hospital Episode Statistics; PCNL, percutaneous nephrolithotomy; SCTS, Society of Cardiothoracic Surgeons. Proton Therapy Websites: Information Anarchy Creates Confusion Marnique Basto, Matthew R. Cooperberg* and Declan G. Murphy Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; and *Department of Urology, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA Introduction Proton beam therapy (PBT) is a form of external beam radiotherapy (RT) that has been in therapeutic use for almost half a century. The advantage over the more commonly used photon-based RT lies in its ability to deliver maximum tumour doses at the end of the beam range with minimal exit dose, thus reducing dose to adjacent healthy tissue [1]. Evidence is emerging for the superiority of PBT for certain paediatric cancers and those of the eye, spine and skull [2], but no evidence currently exists showing any clinical superiority for PBT over brachytherapy or intensity modulated RT (IMRT) for the treatment of localised prostate cancer. In response to recent public concern the American Society for Radiation Oncology (ASTRO) released recommendations against the use of PBT ‘outside of a prospective clinical trial or registry’, stating ‘there is no clear evidence that proton beam therapy oﬀers any clinical advantage’ [3]. The other consideration with respect to PBT clinical development is the extraordinary outlay for the facilities, each of which costs $150–200 million (American dollars) to build. Despite this dearth of evidence and expenditure, many internet-based resources aimed at both patients and professionals claim the superiority of PBT over photon-based RT and other interventions. In the USA, the number of PBT facilities expanded from three to 13 between 2001 and 2013. The number of Medicare beneﬁciaries receiving PBT nearly doubled between 2006 and 2009 due to a 68% increase in use for ‘conditions of possible beneﬁt’ mostly accounted for by prostate cancer [4]. Given the relatively rare incidence of paediatric, eye, skull and spinal cancers, PBT centres have come under scrutiny for possibly seeking a more ‘common cancer’ as a means of recouping the massive capital and running costs. USA Medicare reimbursements for PBT peaked at $28 million in 2007, of which prostate cancer treatment accounted for 83.3% of this ($23.3 million), a mean total cost of $34 954 per patient [4]. It is noteworthy that due to lack of evidence of superiority, a few major insurance companies in California recently announced they will no longer cover the costs of PBT for prostate cancer [5]. Patients considering prostate cancer treatment increasingly rely on web-based resources, in 2010 the number of internet users in the USA who searched online for health information increased from 25% to 80% over the prior decade [6]. Additionally, a recent study of men aged <50 years with Gleason 6 prostate cancer, revealed the internet was the second most frequent information source, after their doctor, in dictating treatment decision-making [7]. However, the anarchic nature of the internet means consumers could be making healthcare decisions based on low quality or inaccurate claims. Shah et al. [6] analysed 37 websites with information pertaining to PBT and found 38% had commercial aﬃliations with shortcomings in quality and accuracy of consumer-oriented health information. This potential for misleading web-based material has been previously highlighted for robotic surgery where sites have purportedly overestimated beneﬁts, neglected risks and were strongly inﬂuenced by the manufacturer [8]. We thus sought to evaluate PBT websites with respect to characteristics of website information and claims made. We identiﬁed websites using snowball-purposive sampling to emulate a consumer searching the internet. This methodology has been used in previous studies [6] and captures additional © 2014 The Authors BJU International © 2014 BJU International

Read full abstract

London SE1 Research Articles

Articles published on London SE1

Abstracts from The Aerosol Society Drug Delivery to the Lungs 33.

IoT Advancements in Agronomy: A Mini Review

Reply by Authors.

Bronchopulmonary MDR protein expression may protect against COVID-19 infection.

COVID‐19 and dermatologic surgery: Hazards of surgical plume

Bringing anatomy to life for general practitioners.

William Dameshek: haematologist whose research initiated organ transplantation.

Raising the steaks ‐ a taste of what's to come

Author Index

Oral presentations

Will a comprehensive, person-centered, team-based early intervention approach to first episode illness improve outcomes in eating disorders?

News and Notes

Guidelines on the measurement of ultraviolet radiation levels in ultraviolet phototherapy: report issued by the British Association of Dermatologists and British Photodermatology Group 2015

Could a dye offer a cheap and simple approach to detect bladder cancer using white-light cystoscopy?

Underutilisation of the British Rhinological Society minimum electronic dataset in an age of mandatory reporting; an investigation

Model of understanding fatigue after stroke.

Proton therapy websites: information anarchy creates confusion.

Targeting the vasculature for cerebroprotection in the immature brain

Science made simple: tissue microarrays (TMAs)

Lead the way for us

Editage

Paperpal

R Discovery

Mind the Graph

London SE1 Research Articles

Articles published on London SE1

Abstracts from The Aerosol Society Drug Delivery to the Lungs 33.

IoT Advancements in Agronomy: A Mini Review

Reply by Authors.

Bronchopulmonary MDR protein expression may protect against COVID-19 infection.

COVID‐19 and dermatologic surgery: Hazards of surgical plume

Bringing anatomy to life for general practitioners.

William Dameshek: haematologist whose research initiated organ transplantation.

Raising the steaks ‐ a taste of what's to come

Author Index

Oral presentations

Will a comprehensive, person-centered, team-based early intervention approach to first episode illness improve outcomes in eating disorders?

News and Notes

Guidelines on the measurement of ultraviolet radiation levels in ultraviolet phototherapy: report issued by the British Association of Dermatologists and British Photodermatology Group 2015

Could a dye offer a cheap and simple approach to detect bladder cancer using white-light cystoscopy?

Underutilisation of the British Rhinological Society minimum electronic dataset in an age of mandatory reporting; an investigation

Model of understanding fatigue after stroke.

Proton therapy websites: information anarchy creates confusion.

Targeting the vasculature for cerebroprotection in the immature brain

Science made simple: tissue microarrays (TMAs)