Severity of illness (Therapeutic Index Severity Score, Classes 1-4) and direct clinical costs (labour costs, diagnostic costs, drugs, disposables, etc.) were determined for 100 consecutive patients admitted to Royal Newcastle Hospital Intensive Care Unit over six weeks. Outcome was assessed using mortality, quality of life, functional status, productivity and mental status one month after separation from the Unit.

A nurse-led 24-h hotline for patients with COPD is safe, is used by patients and carers and, when used, reduces hospital presentations with AECOPD.

Within his lengthy editorial 'Chronic diseases and calls to action' 1 devoted to chronic diseases prevention and health promotion in low-and middle-income countries. Shah Ebrahim questions the scientific evidence for the population strategy in the prevention of coronary heart disease within a rather provocative

Clinical investigation by means of special technical tests has increased in clinical practice during recent years. Pressures causing this increase are said to include: rapid technological change making many more tests available, clinical uncertainty, peer pressure, greater patient awareness, and concern for diagnostic completeness. Cost factors do not appear to have influenced test-ordering behaviour to any large extent, and those ordering investigations are frequently ignorant of the cost of the test which they are ordering, both to the patient and the community. The relation of clinical investigational activity to quality of outcome of patient care remains largely unestablished. Studies of the possible modification of test-ordering behaviour through educational and institutional policy pressures are reviewed. A rational approach to investigating the effectiveness of techniques designed to encourage the more economic and effective use of investigations is presented in brief on the basis of this review of previously published work.