BMJ 2013;347:f6614 doi: 10.1136/bmj.f6614 (Published 6 November 2013)
Page 1 of 1
Letters
LETTERS QUANTIFICATION OF HARMS
Consider factors that are important to patients when quantifying harms David Curtis consultant psychiatrist East London NHS Foundation Trust, Glasshouse Fields Centre, London E1W 3AB, UK
The definition of “harm” in Heleno and colleagues’ literature review of the quantification of harms in cancer screening trials is too narrow.1 I have argued elsewhere that when considering cost-benefit, factors that are important to patients but usually overlooked by professionals should be considered.2 These include time taken off work or away from childcare, pain, nausea, distress, and indignity. It is easy for professionals to underestimate how upsetting it may be for a patient to undergo a simple blood test, let alone mammography or a cervical smear. Such minor harms, which may be experienced by large numbers
of patients, should be considered alongside the more substantial harms reported on here. Competing interests: None declared. 1 2
Heleno B, Thomsen MF, Rodrigues DS, Jørgensen KJ, Brodersen J. Quantification of harms in cancer screening trials: literature review. BMJ 2013;347:f5334. (16 September.) Curtis D. Patient experience—the ingredient missing from cost-effectiveness calculations. Patient Prefer Adher 2011;5:251-4.
Cite this as: BMJ 2013;347:f6614 © BMJ Publishing Group Ltd 2013
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS QUANTIFICATION OF HARMS
Consider factors that are important to patients when quantifying harms David Curtis consultant psychiatrist East London NHS Foundation Trust, Glasshouse Fields Centre, London E1W 3AB, UK
The definition of “harm” in Heleno and colleagues’ literature review of the quantification of harms in cancer screening trials is too narrow.1 I have argued elsewhere that when considering cost-benefit, factors that are important to patients but usually overlooked by professionals should be considered.2 These include time taken off work or away from childcare, pain, nausea, distress, and indignity. It is easy for professionals to underestimate how upsetting it may be for a patient to undergo a simple blood test, let alone mammography or a cervical smear. Such minor harms, which may be experienced by large numbers
of patients, should be considered alongside the more substantial harms reported on here. Competing interests: None declared. 1 2
Heleno B, Thomsen MF, Rodrigues DS, Jørgensen KJ, Brodersen J. Quantification of harms in cancer screening trials: literature review. BMJ 2013;347:f5334. (16 September.) Curtis D. Patient experience—the ingredient missing from cost-effectiveness calculations. Patient Prefer Adher 2011;5:251-4.
Cite this as: BMJ 2013;347:f6614 © BMJ Publishing Group Ltd 2013
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
