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Background Lung cancer is a major health problem. CT lung screening can reduce lung cancer mortality through early diagnosis by at least 20%. Screening high-risk individuals is most effective. Retrospective analyses suggest that identifying individuals for screening by accurate prediction models is more efficient than using categorical agesmoking criteria, such as the US Preventive Services Task Force (USPSTF) criteria. This study prospectively compared the effectiveness of the USPSTF2013 and PLCOm2012 model eligibility criteria. MethodsIn this prospective cohort study, participants from the International Lung Screening Trial (ILST), aged 55-80 years, who were current or former smokers (ie, had ≥30 pack-years smoking history or ≤15 quit-years since last permanently quitting), and who met USPSTF2013 criteria or a PLCOm2012 risk threshold of at least 1•51% within 6 years of screening, were recruited from nine screening sites in Canada, Australia, Hong Kong, and the UK. After enrolment, patients were assessed with the USPSTF2013 criteria and the PLCOm2012 risk model with a threshold of at least 1•70% at 6 years. Data were collected locally and centralised. Main outcomes were the comparison of lung cancer detection rates and cumulative life expectancies in patients with lung cancer between USPSTF2013 criteria and the PLCOm2012 model. In this Article, we present data from an interim analysis. To estimate the incidence of lung cancers in individuals who were USPSTF2013-negative and had PLCOm2012 of less than 1•51% at 6 years, ever-smokers in the Prostate Lung Colorectal and Ovarian Cancer Screening Trial (PLCO) who met these criteria and their lung cancer incidence were applied to the ILST sample size for the mean follow-up occurring in the ILST. This trial is registered at ClinicalTrials.gov, NCT02871856. Study enrolment is almost complete.

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It is well known that 40 - 80% of information provided by clinicians is forgotten immediately by patients. Furthermore, 50% of the information remembered is incorrect. Research has shown that receiving written communication meets with high satisfaction from patients. According to the NHS plan to improve healthcare delivery, it has been recommended that patients should receive copies of letters written by doctors and that the policy would be implemented in full by April 2004. A total of 100 consecutive patients undergoing day-case gynaecological surgery under a single consultant were sent a postal questionnaire. Questions included were whether the letter was helpful, informative, reassuring, confusing or alarming. Patients were further asked whether they would prefer a similar communication in the future. A total of 78 patients replied. Of these, 67 patients found the letter helpful and preferred to have similar communication in future. Only two patients found the letter confusing and one of these was alarmed as well. Overall, 62 patients found the letter reassuring. The majority of the patients found the copy of GP discharge letter helpful, informative, non-alarming and reassuring and wanted a similar communication in the future. The extra workload involved was minimal and the extra expense involved only an extra page, envelope and postage.

The current evidence does not support the routine use of hCG in the treatment of threatened miscarriage.