This month in Eyes on Evidence

Social integration and risk of suicide in men
A cohort study in the US found that professional middle-aged men who were socially well integrated had a lower risk of suicide than men with fewer family, friendship and religious connections.

Surgical versus non-surgical treatment for fracture of the heel
A small, 2-year randomised controlled trial in the UK reported that surgical treatment appeared to be no better than non-surgical treatment at improving function and pain in patients with intra-articular fracture of the heel, and was associated with a higher rate of complications.

Improving cardiovascular disease through networks of general practices
An observational study in London found that grouping general practices into managed networks and emphasising clinical engagement and education was associated with small improvements in outcomes related to cardiovascular disease, although it was not clear which elements of the networks were most important.

Antibiotics in fetal and early life and subsequent childhood asthma
A Swedish observational study found an association between antibiotic use in fetal and early life and asthma. However, this link was reduced or disappeared in analyses that compared children with siblings who did not have asthma, suggesting that factors shared in families may explain any observed association between antibiotic exposure and asthma.

Detecting atrial fibrillation in people who have had a stroke
Two randomised controlled trials reported that long-term electrocardiogram monitoring was more effective at detecting atrial fibrillation than 24-hour or intermittent electrocardiogram monitoring in people who had experienced apparent cryptogenic stroke or transient ischaemic attack.

Case studies from the Quality and Productivity collection
We highlight 2 new examples from the Quality and Productivity collection demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality:

• Mobile clinics for chronic stable glaucoma management
• Ensuring appropriate use of monitored dosage systems

Evidence Updates
NICE has recently published Evidence Updates on:

• Fertility
• Psychosis and schizophrenia in children and young people
• Occupational therapy and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care
• Promoting physical activity for children and young people

Changes to NICE evidence awareness products
NICE has announced some changes to 2 of its evidence awareness products: Evidence Updates and Eyes on Evidence. Evidence Updates are being replaced by guideline surveillance reports, and Eyes on Evidence has moved to a new home on the NICE website.