General medicine

Breathlessness imposes major burdens on individuals, the health care system, and the economy

Anthony P Sunjaya · Leanne M Poulos · Gian Luca Di Tanna · Thomas Lung · Guy B Marks · Helen K Reddel · Christine R Jenkins

Artificial intelligence chatbots have the potential to assist clinicians in diagnosing complex cases

Ian A Scott · Tim Miller · Carmel Crock

Simple training programs for senior physicians can change self-reported behaviour that may support the mental health of their staff

Aimée Gayed · Jessica Strudwick · Nathasha Kugenthiran · Anthony D LaMontagne · Andrew Mackinnon · Helen Christensen · Nicholas Glozier · Samuel Harvey

Vishnu Khanal · Deborah J Russell · John Wakerman

The updated Clinical Care Standard is an important tool that can support best practice care for people with knee osteoarthritis

Ilana N Ackerman · Fiona Doukas · Rachelle Buchbinder · Sally Dooley · Wendy Favorito · Phoebe Holdenson Kimura · David J Hunter · James Linklater · John B North · Louise Elvin‐Walsh · Christopher Vertullo · Alice L Bhasale · Samantha Bunzli

The health and economic burdens of long COVID are substantial, especially for working adults

Valentina Costantino · Quentin Grafton · Tom Kompas · Long Chu · Damian Honeyman · Adriana Notaras · C Raina MacIntyre

In reply: We thank Millar1 for taking the time to respond to our article,2 which details an evaluation of the Alfred Health post‐COVID‐19 clinical service established in June 2020. At that time we, like many health services around the world, faced the challenge of providing ongoing clinical management for patients with persistent and debilitating symptoms following SARS‐CoV‐2 infection, with little evidence to guide service provision or model of care. As there were no data to guide patient selection, we invited all patients with a diagnosis of COVID‐19 who had been managed by our health service (in hospital or in the community) to opt in if they perceived a need for ongoing care. This allowed us to quantify demand, as identified by patients who were affected. Our data confirm that a small proportion (6%) of individuals had persistent symptoms of long COVID that required medical and allied health specialist management. We consider this opt in approach a strength of our report; estimates of ongoing care needs following COVID‐19 vary enormously,3 and our data suggest that demand may be at the lower end of those estimates. As the pandemic progressed and more people with COVID‐19 were managed in the community, we adapted to the clinical needs of our patients by accepting referrals from general practice. We agree that there are limitations to our report, which are inherent in its nature as a service evaluation. We did not aim to provide epidemiological data on the prevalence or characteristics of long COVID; rather, we aimed to document the proportion of our patients following COVID‐19 who identified ongoing care needs, and to describe their characteristics. The recent federal parliamentary inquiry into long COVID4 states that “The role of specific long COVID clinics as a resource for primary health providers is very important to allow adequate services for major complications” and calls for the establishment of multidisciplinary long COVID clinics in selected public hospitals. We hope that our experience might be informative for other health services who are seeking to provide care for this small but important group of patients.

Anne Holland · Simone Dal Corso

Ross S Bailie · Megan Passey · Edward Jegasothy

Daniel Lindsay · David C Whiteman · Louisa G Collins

A larger, population-based study of the incidence of stroke in Aboriginal people is both feasible and needed

Angela Dos Santos (Gumbaynggirr, Kwiamble) · Edmund Cheong · Anna H Balabanski · Kendall Goldsmith · Luke Burchill (Yorta Yorta, Dja Dja Wurrung) · James Burrow · Stephen Brady · Ferdous Alam · Mark Parsons · Judith M Katzenellenbogen · Amanda G Thrift · Timothy J Kleinig · Alex Brown (Wadi Wadi)

Cardiologists require competency and confidence in managing not only deteriorating but also end of life, heart failure

Dominica Zentner · Vithoosharan Sivanathan · Jennifer Philip · Natasha Smallwood

Barbara Depczynski · Brenda Ta · Sue Mei Lau

Factors contributing to lower keratinocyte cancer treatment rates among younger Australians require further investigation

Catherine M Olsen · Nirmala Pandeya · Rachel E Neale · David C Whiteman

David A Prentice