We asked our SCPN team and friends what they thought was the most interesting paper that had come across their desks this year. Next in our series is Dr Katie Robb, Reader at University of Glasgow, who highlights the following paper which details creating a learning health system through randomised quality improvement work.

Creating a Learning Health System through Rapid-Cycle, Randomized Testing

Leora I. Horwitz, Masha Kuznetsova and Simon A. Jones

The New England Journal of Medicine

https://www.nejm.org/doi/full/10.1056/NEJMsb1900856

Why this paper?

As a researcher interested in cancer screening I think we can make our excellent cancer screening programmes even better with a learning health system approach. Invitation letters, leaflets, reminders, follow-up letters etc. could potentially be changed using evidence from behavioural science to improve effectiveness. For example, if we could prompt more people to respond to their first invitation letter rather than a reminder, the NHS would save the cost of mailing the reminder. Similarly, a learning health system approach NHS services related to cancer risk factors such as smoking, obesity and alcohol could also be effective.

Main take home messages: A learning health system informed by evidence has the potential to improve health and health care at lower cost.