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https://www.readbyqxmd.com/read/29150473/patient-level-and-practice-level-factors-associated-with-consultation-duration-a-cross-sectional-analysis-of-over-one-million-consultations-in-english-primary-care
#1
Sarah Stevens, Clare Bankhead, Toqir Mukhtar, Rafael Perera-Salazar, Tim A Holt, Chris Salisbury, F D Richard Hobbs
OBJECTIVES: Consultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care. DESIGN AND SETTING: Cross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138197/incidence-of-shoulder-dislocations-in-the-uk-1995-2015-a-population-based-cohort-study
#2
Anjali Shah, Andrew Judge, Antonella Delmestri, Katherine Edwards, Nigel K Arden, Daniel Prieto-Alhambra, Tim A Holt, Rafael A Pinedo-Villanueva, Sally Hopewell, Sarah E Lamb, Amar Rangan, Andrew J Carr, Gary S Collins, Jonathan L Rees
OBJECTIVE: This cohort study evaluates the unknown age-specific and gender-specific incidence of primary shoulder dislocations in the UK. SETTING: UK primary care data from the Clinical Practice Research Datalink (CPRD) were used to identify patients aged 16-70 years with a shoulder dislocation during 1995-2015. Coding of primary shoulder dislocations was validated using the CPRD general practitioner questionnaire service. PARTICIPANTS: A cohort of 16 763 patients with shoulder dislocation aged 16-70 years during 1995-2015 were identified...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29126386/venous-thromboembolism-and-mortality-in-breast-cancer-cohort-study-with-systematic-review-and-meta-analysis
#3
Umair T Khan, Alex J Walker, Sadaf Baig, Tim R Card, Cliona C Kirwan, Matthew J Grainge
BACKGROUND: Breast cancer patients are at an increased risk of venous thromboembolism (VTE). However, current evidence as to whether VTE increases the risk of mortality in breast cancer patients is conflicting. We present data from a large cohort of patients from the UK and pool these with previous data from a systematic review. METHODS: Using the Clinical Practice Research Datalink (CPRD) dataset, we identified a cohort of 13,202 breast cancer patients, of whom 611 were diagnosed with VTE between 1997 and 2006 and 12,591 did not develop VTE...
November 10, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29121851/outputs-and-growth-of-primary-care-databases-in-the-united-kingdom-bibliometric-analysis
#4
Zain Chaudhry, Fahmida Mannan, Angela Gibson-White, Usama Syed, Shirin Ahmed, Antonis Kousoulis, Azeem Majeed
BACKGROUND: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the 'Clinical Practice Research Datalink' (CPRD), 'The Health Improvement Network' (THIN) and 'QResearch'. Over time, outputs from these databases have increased, but have not been evaluated. OBJECTIVE: This study compares research outputs from CPRD, THIN and QResearch assessing growth and publication outputs over a 10-year period (2004-2013)...
October 17, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29114849/risk-of-skin-cancer-among-patients-with-myotonic-dystrophy-type-1-based-on-primary-care-physician-data-from-the-united-kingdom-clinical-practice-research-datalink
#5
Youjin Wang, Ruth M Pfeiffer, Rotana Alsaggaf, Wilhelmine Meeraus, Julia C Gage, Lesley A Anderson, Renée C Bremer, Nikoletta Nikolenko, Hanns Lochmuller, Mark H Greene, Shahinaz M Gadalla
Myotonic dystrophy type 1 (DM1) is an inherited multisystem neuromuscular disorder caused by a CTG trinucleotide repeat expansion in the DMPK gene. Recent evidence documents that DM1 patients have an increased risk of certain cancers, but whether skin cancer risks are elevated is unclear. Using the U.K. Clinical Practice Research Datalink (CPRD), we identified 1,061 DM1 patients and 15,119 DM1-free individuals matched on gender, birth year (±2 years), attending practice, and registration year (±1 year). We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of DM1 diagnosis with skin cancer risk using Cox proportional hazards models, for all skin cancers combined and by histological subtype...
November 7, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29094346/population-based-clinical-practice-research-datalink-study-using-algorithm-modelling-to-identify-the-true-burden-of-hidradenitis-suppurativa
#6
J R Ingram, S Jenkins-Jones, D W Knipe, C L I Morgan, R Cannings-John, V Piguet
BACKGROUND: Epidemiology data regarding hidradenitis suppurativa (HS) are conflicting and prevalence estimates vary 80-fold, from 0.05% in a population-based study, to 4%. OBJECTIVES: To assess the hypothesis that previous population-based studies under-estimated true HS prevalence by missing undiagnosed cases. METHODS: We performed a population-based observational and case-control study using the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics data...
November 1, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/29081921/creating-an-index-to-measure-health-state-of-depressed-patients-in-automated-healthcare-databases-the-methodology
#7
Clément François, Adrian Tanasescu, François-Xavier Lamy, Nicolas Despiegel, Bruno Falissard, Ylana Chalem, Christophe Lançon, Pierre-Michel Llorca, Delphine Saragoussi, Patrice Verpillat, Alan G Wade, Djamel A Zighed
Background and objective: Automated healthcare databases (AHDB) are an important data source for real life drug and healthcare use. In the filed of depression, lack of detailed clinical data requires the use of binary proxies with important limitations. The study objective was to create a Depressive Health State Index (DHSI) as a continuous health state measure for depressed patients using available data in an AHDB. Methods: The study was based on historical cohort design using the UK Clinical Practice Research Datalink (CPRD)...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/29065729/factors-associated-with-stroke-myocardial-infarction-ischemic-heart-disease-unstable-angina-or-mortality-in-patients-from-real-world-clinical-practice-with-newly-diagnosed-type-2-diabetes-and-early-glycemic-control
#8
Carlos I Alatorre, Byron J Hoogwerf, Mark A Deeg, David R Nelson, Theresa M Hunter, Wee Teck Ng, Mark D Rekhter
OBJECTIVES: The objective of this study was to identify factors associated with stroke, myocardial infarction (MI), all-cause mortality, or a diagnosis of ischemic heart disease (IHD) or unstable angina (UA), among patients newly-diagnosed with type 2 diabetes (T2DM) with no recent history of cardiovascular (CV) events who rapidly achieve and maintain HbA1c ≤8.0%. METHODS: Data were obtained from the Clinical Practice Research Datalink (CPRD) from January 1990 to December 2012...
October 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29056424/implementing-near-real-time-vaccine-safety-surveillance-using-the-clinical-practice-research-datalink-cprd
#9
Andreia Leite, Sara L Thomas, Nick J Andrews
INTRODUCTION: Near real-time vaccine safety surveillance (NRTVSS) using electronic health records is increasingly used to rapidly detect vaccine safety signals. NRTVSS has not been fully implemented in the UK. We assessed the feasibility of implementing this surveillance using the UK Clinical Practice Research Datalink (CPRD). METHODS: We selected seasonal influenza vaccine/Guillain-Barré Syndrome (GBS) as an example of a rare outcome and measles-mumps-rubella (MMR) vaccine/febrile seizures as a positive control...
October 19, 2017: Vaccine
https://www.readbyqxmd.com/read/29055489/association-between-nice-guidance-on-biologic-therapies-with-rates-of-hip-and-knee-replacement-among-rheumatoid-arthritis-patients-in-england-and-wales-an-interrupted-time-series-analysis
#10
Samuel Hawley, René Cordtz, Lene Dreyer, Christopher J Edwards, Nigel K Arden, Antonella Delmestri, Alan Silman, Cyrus Cooper, Andrew Judge, Daniel Prieto-Alhambra
OBJECTIVE: To estimate the impact of NICE approval of tumor necrosis factor inhibitor (TNFi) therapies on the incidence of total hip replacement (THR) and total knee replacement (TKR) among rheumatoid arthritis (RA) patients in England and Wales. METHODS: Primary care data [Clinical Practice Research Datalink (CPRD)] for the study period (1995-2014) were used to identify incident adult RA patients. The age and sex-standardised 5-year incidence of THR and TKR was calculated separately for RA patients diagnosed in each six-months between 1995-2009...
September 23, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29040269/elevated-blood-pressure-and-risk-of-mitral-regurgitation-a-longitudinal-cohort-study-of-5-5-million-united-kingdom-adults
#11
Kazem Rahimi, Hamid Mohseni, Catherine M Otto, Nathalie Conrad, Jenny Tran, Milad Nazarzadeh, Mark Woodward, Terence Dwyer, Stephen MacMahon
BACKGROUND: Mitral regurgitation in people without prior cardiac disease is considered a degenerative disease with no established risk factors for its prevention. We aimed to test the hypothesis that elevated systolic blood pressure (SBP) across its usual spectrum is associated with higher risk of mitral regurgitation. METHODS AND FINDINGS: We used linked electronic health records from the United Kingdom Clinical Practice Research Datalink (CPRD) from 1 January 1990 to 31 December 2015...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29028914/trajectory-of-total-cholesterol-in-the-last-years-of-life-over-age-80-years-cohort-study-of-99-758-participants
#12
Judith Charlton, Rathi Ravindrarajah, Shota Hamada, Stephen H Jackson, Martin C Gulliford
Background: Epidemiological studies suggest that lower total cholesterol (TC) may be associated with higher mortality. This study aimed to evaluate whether a decline in total cholesterol before death might account for the association of TC with mortality over age 80 years. Methods: Cohort study using primary care electronic health records of 99,758 participants aged 80 to 105 years from the UK Clinical Practice Research Datalink (CPRD). Hazard ratios (HR) for all-cause mortality were adjusted for age, gender, frailty, comorbidity, blood pressure and smoking...
September 27, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29025846/cohort-profile-for-the-mastermind-study-using-the-clinical-practice-research-datalink-cprd-to-investigate-stratification-of-response-to-treatment-in-patients-with-type-2-diabetes
#13
Lauren R Rodgers, Michael N Weedon, William E Henley, Andrew T Hattersley, Beverley M Shields
PURPOSE: This is a retrospective cohort study using observational data from anonymised primary care records. We identify and extract all patients with type 2 diabetes and associated clinical data from the Clinical Practice Research Datalink (CPRD) to inform models of disease progression and stratification of treatment. PARTICIPANTS: Data were extracted from CPRD on 8 August 2016. The initial data set contained all patients (n=313 485) in the database who had received a type 2 diabetes medication...
October 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29020193/generalizing-randomized-clinical-trial-results-implementation-and-challenges-related-to-missing-data-in-the-target-population
#14
Jin-Liern Hong, Michele Jonsson Funk, Robert LoCasale, Sara E Dempster, Stephen R Cole, Michael Webster-Clark, Jessie K Edwards, Til Stürmer
Statins are indicated in patients with elevated high-sensitivity C-reactive protein and normal low-density lipoprotein cholesterol based on the multi-country JUPITER trial (2003-2008) results, but the benefit in real-world populations remains unknown. We sought to generalize JUPITER results to trial-eligible population using the UK Clinical Practice Research Datalink (CPRD) 2001-2014. We multiply imputed missing baseline characteristics for the CPRD population and selected the trial-eligible CPRD population as target population based on observed and imputed values...
August 10, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28982809/understanding-the-health-economic-burden-of-patients-with-tuberous-sclerosis-complex-tsc-with-epilepsy-a-retrospective-cohort-study-in-the-uk-clinical-practice-research-datalink-cprd
#15
Charles Shepherd, Matthias Koepp, Melissa Myland, Keyur Patel, Cristiana Miglio, Vathani Siva, Elizabeth Gray, Maureen Neary
INTRODUCTION: Epilepsy is highly prevalent in tuberous sclerosis complex (TSC), a multi-system genetic disorder. The clinical and economic burden of this condition is expected to be substantial due to treatment challenges, debilitating co-morbidities and the relationship between TSC-related manifestations. This study estimated healthcare resource utilisation (HCRU) and costs for patients with TSC with epilepsy (TSC+E) in the UK. METHODS: Patients with TSC+E in the Clinical Practice Research Datalink (CPRD) linked to Hospital Episodes Statistics were identified from April 1997 to March 2012...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28979165/validation-of-autism-spectrum-disorder-diagnoses-recorded-in-the-clinical-practice-research-datalink-1990-2014
#16
Katrina Wilcox Hagberg, Susan S Jick
BACKGROUND: Prior studies have reported that the validity of autism spectrum disorder (ASD) diagnoses recorded in the Clinical Practice Research Datalink (CPRD) was high; however, diagnostic criteria and screening practices have changed since the last study was published in 2004. OBJECTIVES: 1) To calculate the positive predictive value (PPV) of ASD diagnoses recorded in the CPRD compared to original medical records and 2) to describe characteristics of cases and use of clinical codes that support the ASD diagnosis as recorded in the electronic data by general practitioners over time...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28972301/peripartum-hysterectomy-an-economic-analysis-of-direct-health-care-costs-using-routinely-collected-data
#17
Felix Achana, Kate M Fleming, Laila J Tata, Alyshah Abdul Sultan, Stavros Petrou
OBJECTIVE: To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. DESIGN/SETTING: Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. POPULATION: Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. METHODS: Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators...
October 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28968790/interval-between-onset-of-psoriasis-and-psoriatic-arthritis-comparing-the-uk-clinical-practice-research-datalink-with-a-hospital-based-cohort
#18
William Tillett, Rachel Charlton, Alison Nightingale, Julia Snowball, Amelia Green, Catherine Smith, Gavin Shaddick, Neil McHugh
Objectives: To describe the time interval between the onset of psoriasis and PsA in the UK primary care setting and compare with a large, well-classified secondary care cohort. Methods: Patients with PsA and/or psoriasis were identified in the UK Clinical Practice Research Datalink (CPRD). The secondary care cohort comprised patients from the Bath PsA longitudinal observational cohort study. For incident PsA patients in the CPRD who also had a record of psoriasis, the time interval between PsA diagnosis and first psoriasis record was calculated...
August 25, 2017: Rheumatology
https://www.readbyqxmd.com/read/28951401/evolving-landscape-of-stroke-prevention-in-atrial-fibrillation-within-the-uk-between-2012-and-2016-a-cross-sectional-analysis-study-using-cprd
#19
Laure Lacoin, Matthew Lumley, Essra Ridha, Marta Pereira, Laura McDonald, Sreeram Ramagopalan, Cinira Lefèvre, David Evans, Julian P Halcox
OBJECTIVE: To describe the changes in prescribing of oral anticoagulant (AC) and antiplatelet (AP) agents in patients with non-valvular atrial fibrillation (NVAF) in the UK and to identify the characteristics associated with deviation from guideline-based recommendations. DESIGN: Five cross-sectional analyses in a large retrospective population-based cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Datalink...
September 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28946908/factors-influencing-the-development-of-primary-care-data-collection-projects-from-electronic-health-records-a-systematic-review-of-the-literature
#20
Marie-Line Gentil, Marc Cuggia, Laure Fiquet, Camille Hagenbourger, Thomas Le Berre, Agnès Banâtre, Eric Renault, Guillaume Bouzille, Anthony Chapron
BACKGROUND: Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects...
September 25, 2017: BMC Medical Informatics and Decision Making
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