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https://www.readbyqxmd.com/read/29777229/fate-of-the-metabolically-healthy-obese-is-this-term-a-misnomer-a-study-from-the-clinical-practice-research-datalink
#1
Osama Moussa, Chanpreet Arhi, Paul Ziprin, Ara Darzi, Omar Khan, Sanjay Purkayastha
INTRODUCTION: The metabolically healthy obese (MHO) phenotype may express typical characteristics on long-term follow-up. Little is known about the initiation of this phenotypes and its future stability. AIM: The Clinical Practice Research Datalink (CPRD) is a large-scale primary care database. The aim of this study was to assess the stability of, and evaluate the factors associated with a transition into an unhealthy outcome in, a MHO population in the UK. METHODS: The CPRD was interrogated for a diagnosis of 'obesity' and cross-referenced with a body mass index (BMI) ≥35 kg/m2 ; participants were further classified as MH using a clinical diagnostic code or a relative therapeutic code...
May 17, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29752705/risk-associated-with-cumulative-oral-glucocorticoid-use-in-patients-with-giant-cell-arteritis-in-real-world-databases-from-the-usa-and-uk
#2
Sara Gale, Jessica C Wilson, Jenny Chia, Huong Trinh, Katie Tuckwell, Neil Collinson, Sophie Dimonaco, Susan Jick, Christoph Meier, Shalini V Mohan, Khaled Sarsour
INTRODUCTION: Treatment of giant cell arteritis (GCA) involves immediate initiation of high-dose glucocorticoid therapy with slow tapering of the dose over many months. Chronic exposure to glucocorticoids is associated with serious comorbidities. The objective of this analysis was to determine the glucocorticoid exposure and risk of glucocorticoid-related adverse events (AEs) in real-world patients with GCA. METHODS: Data from the Truven Healthcare MarketScan® database (from January 1, 2000, to June 30, 2015) and the Clinical Practice Research Datalink (CPRD; from January 1, 1995, to August 31, 2013) were used to retrospectively analyze patients aged ≥ 50 years with GCA in the USA and UK, respectively...
May 11, 2018: Rheumatology and Therapy
https://www.readbyqxmd.com/read/29740896/gold-assessment-of-copd-severity-in-the-clinical-practice-research-datalink-cprd
#3
Cristina Rebordosa, Estel Plana, Jaume Aguado, Steven Thomas, Esther García-Gil, Susana Perez-Gutthann, Jordi Castellsague
PURPOSE: To evaluate availability of spirometry and symptom data in the Clinical Practice Research Datalink (United Kingdom) to assess COPD severity using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016 definition and comparing it with an algorithm used in other studies. METHODS: This was a descriptive, noninterventional, secondary database cohort study of patients with COPD aged 40 years or older, who initiated treatment with specific COPD medications...
May 8, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29740872/prodromal-symptoms-of-multiple-sclerosis-in-primary-care
#4
Giulio Disanto, Chiara Zecca, Sharon MacLachlan, Rosaria Sacco, Lahiru Handunnetthi, Ute C Meier, Alex Simpson, Laura McDonald, Andrea Rossi, Pascal Benkert, Jens Kuhle, Sreeram V Ramagopalan, Claudio Gobbi
OBJECTIVE: Early diagnosis and treatment initiation significantly influence long term disability outcome in multiple sclerosis (MS). We aimed at identifying prodromal symptoms of MS in primary care settings. METHODS: This was a nested case-control study comparing the occurrence of various symptoms in MS patients vs controls at 0-2, 2-5 and 5-10 years before index date (first MS record). A total of 10,204 incident MS cases were identified within the UK Clinical Practice Research Datalink (CPRD) between 01/01/1987 and 28/02/2016 (median (IQR) age=47 (39-57) years, females=7,308 (71...
May 8, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29732725/time-trends-and-geographical-variation-in-prescribing-of-drugs-for-diabetes-in-england-1998-2017
#5
Helen J Curtis, John M Dennis, Beverley M Shields, Alex J Walker, Seb Bacon, Andrew T Hattersley, Angus G Jones, Ben Goldacre
AIMS: UK guidelines for type II diabetes leave the choice of glucose lowering therapies after metformin largely to prescribers. They vary greatly in cost, and comparative effectiveness data is lacking. We set out to measure the variation in prescribing of these second-line non-insulin diabetes drugs. MATERIALS AND METHODS: We evaluated time trends 1998-2016, using England's publicly available prescribing datasets, and stratified by the order prescribed to patients using the Clinical Practice Research Datalink (CPRD)...
May 7, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29732718/impact-of-treatment-with-pioglitazone-on-stroke-outcomes-a-real-world-database-analysis
#6
Christopher Ll Morgan, Silvio E Inzucchi, Jorge Puelles, Sara Jenkins-Jones, Craig J Currie
AIMS: Randomised controlled trials have reported an association between pioglitazone and reduced incidence of stroke in type 2 diabetic (T2DM) and insulin-resistant populations. We investigated this association within a real-world database. MATERIALS AND METHODS: T2DM patients initiating pioglitazone between 2000-2012 were extracted from the Clinical Practice Research Datalink (CPRD); a UK routine. Two non-exposed control cohorts were matched on age, gender, HbA1c, diabetes duration, stroke history, co-morbidities and prior T2DM regimen...
May 7, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29725942/exploring-the-potential-routine-use-of-electronic-healthcare-record-data-to-strengthen-early-signal-assessment-in-uk-medicines-regulation-proof-of-concept-study
#7
Katherine Donegan, Rebecca Owen, Helena Bird, Brian Burch, Alex Smith, Phil Tregunno
INTRODUCTION: Electronic healthcare record (EHR) databases are used within pharmacoepidemiology studies to confirm or refute safety signals arising from spontaneous adverse event reports. However, there has been limited routine use of such data earlier in the signal management process, to help rapidly contextualise signals and strengthen preliminary assessment or to inform decisions regarding action including the need for further studies. This study explores the value of EHR used in this way within a regulatory environment via an automated analysis platform...
May 3, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29723926/variation-in-cardiovascular-risk-related-to-individual-antimuscarinic-drugs-used-to-treat-overactive-bladder-a-cohort-study-in-the-uk
#8
Alejandro Arana, Andrea V Margulis, Lisa J McQuay, Ryan Ziemiecki, Jennifer L Bartsch, Kenneth J Rothman, Billy Franks, Milbhor D Silva, Kwame Appenteng, Cristina Varas-Lorenzo, Susana Perez-Gutthann
BACKGROUND: Blocking muscarinic receptors could have an effect upon cardiac function, especially among elderly patients with overactive bladder (OAB). STUDY OBJECTIVE: To investigate the risk of cardiovascular events in users of antimuscarinic drugs to treat OAB. DESIGN, SETTING AND PARTICIPANTS: Cohort study of new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, or trospium, aged ≥18 years old in the United Kingdom's Clinical Practice Research Datalink (CPRD), 2004-2012...
May 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29717405/risk-of-gerd-related-disorders-in-obese-patients-on-ppi-therapy-a-population-analysis
#9
Simon Erridge, Osama M Moussa, Paul Ziprin, Ara Darzi, Sanjay Purkayastha
BACKGROUND: Increasing prevalence of obesity has shown an associated increase in gastroesophageal reflux disease (GERD)-related diseases. Proton pump inhibitor (PPI) therapy has been demonstrated to reduce the incidence of such diseases. The study's aim was to analyze the Clinical Practice Research Datalink (CPRD) to determine factors that increase the propensity of obese patients on PPIs to develop Barrett's esophagus (BE) and esophageal carcinoma. METHOD: A case-control population study was carried out, including patients from the CPRD...
May 1, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29676453/risk-factors-for-burkitt-lymphoma-a-nested-case-control-study-in-the-uk-clinical-practice-research-datalink
#10
Parisa Karimi, Brenda M Birmann, Lesley A Anderson, Charlene M McShane, Shahinaz M Gadalla, Joshua N Sampson, Sam M Mbulaiteye
Burkitt lymphoma (BL) occurs as three subtypes: endemic BL, immunosuppression-related BL and sporadic BL. Descriptive studies of BL age-specific incidence patterns have suggested multimodal peaks near 10, 40 and 70 years of age, but the risk factors for BL at different ages are unknown. We investigated risk factors for BL in the United Kingdom among 156 BL cases and 608 matched BL-free controls identified in the Clinical Practice Research Datalink (CPRD) between 1992 and 2016. Associations with pre-diagnostic body mass index, cigarette smoking, alcohol consumption, hepatitis, Epstein-Barr virus (EBV), human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), malaria, allergic and autoimmune conditions, and prednisone use were evaluated...
April 20, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29667263/assumptions-made-when-preparing-drug-exposure-data-for-analysis-have-an-impact-on-results-an-unreported-step-in-pharmacoepidemiology-studies
#11
Stephen R Pye, Thérèse Sheppard, Rebecca M Joseph, Mark Lunt, Nadyne Girard, Jennifer S Haas, David W Bates, David L Buckeridge, Tjeerd P van Staa, Robyn Tamblyn, William G Dixon
PURPOSE: Real-world data for observational research commonly require formatting and cleaning prior to analysis. Data preparation steps are rarely reported adequately and are likely to vary between research groups. Variation in methodology could potentially affect study outcomes. This study aimed to develop a framework to define and document drug data preparation and to examine the impact of different assumptions on results. METHODS: An algorithm for processing prescription data was developed and tested using data from the Clinical Practice Research Datalink (CPRD)...
April 17, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29659802/cancer-incidence-in-patients-with-a-high-normal-platelet-count-a-cohort-study-using-primary-care-data
#12
Emily Ankus, Sarah J Price, Obioha C Ukoumunne, William Hamilton, Sarah E R Bailey
Background: A platelet count >400 × 109/l (i.e. thrombocytosis) is a recently discovered risk marker of cancer. The risk of undiagnosed cancer in patients with thrombocytosis is 11.6% for men and 6.2% for women, well above the 3% risk threshold set by National Institute for Health and Care Excellence (NICE) for cancer investigation. Patients with a platelet count at the upper end of the normal range (325-400 × 109/l) could be at increased risk of undiagnosed malignancy. Objective: To quantify the risk of an undiagnosed cancer in patients with a platelet count at the upper end of the normal range...
April 12, 2018: Family Practice
https://www.readbyqxmd.com/read/29642882/assessing-the-healthcare-resource-use-associated-with-inappropriate-prescribing-of-inhaled-corticosteroids-for-people-with-chronic-obstructive-pulmonary-disease-copd-in-gold-groups-a-or-b-an-observational-study-using-the-clinical-practice-research-datalink
#13
James D Chalmers, Chris Poole, Samantha Webster, Abigail Tebboth, Scott Dickinson, Alicia Gayle
BACKGROUND: Recent recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) position inhaled corticosteroids (ICS) for use in chronic obstructive pulmonary disease (COPD) patients experiencing exacerbations (≥ 2 or ≥ 1 requiring hospitalisation); i.e. GOLD groups C and D. However, it is known that ICS is frequently prescribed for patients with less severe COPD. Potential drivers of inappropriate ICS use may be historical clinical guidance or a belief among physicians that intervening early with ICS would improve outcomes and reduce resource use...
April 11, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29627994/the-prevalence-low-density-lipoprotein-cholesterol-levels-and-treatment-of-patients-at-very-high-risk-of-cardiovascular-events-in-the-united-kingdom-a-cross-sectional-study
#14
Mark D Danese, Eduard Sidelnikov, Lucie Kutikova
OBJECTIVE: To assess the prevalence of patients at very high risk of cardiovascular (CV) events in the United Kingdom (UK) and evaluate low-density lipoprotein cholesterol (LDL-C) values and treatment patterns in these patients. METHODS: This cross-sectional study used primary care data from UK electronic medical records in the Clinical Practice Research Datalink (CPRD) in 2013. Very high-risk patients were defined per European Society of Cardiology guidelines as those with hyperlipidemia (assessed by co-medication) and documented cardiovascular disease (CVD) or hyperlipidemia and type 2 diabetes (DM2) without CVD (DM2w/oCVD)...
April 9, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29619668/performing-studies-using-the-uk-clinical-practice-research-datalink-to-link-or-not-to-link
#15
Laura McDonald, Anna Schultze, Robert Carroll, Sreeram V Ramagopalan
The Clinical Practice Research Datalink (CPRD) is a repository of electronic medical records collected during routine primary care clinical practice in the UK, and is one of the most widely used sources of real-world data for healthcare research. Although CPRD provides access to comprehensive longitudinal patient records, the data does not fully capture diagnoses or outcomes occurring in secondary care and/or mortality. We provide here an overview of CPRD and the potential bias when using unlinked data in certain situations...
April 4, 2018: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29570897/methodological-challenges-when-evaluating-potential-off-label-prescribing-of-drugs-using-electronic-health-care-databases-a-case-study-of-dabigatran-etexilate-in-europe
#16
Miguel Cainzos-Achirica, Cristina Varas-Lorenzo, Anton Pottegård, Joelle Asmar, Estel Plana, Lotte Rasmussen, Geoffray Bizouard, Joan Forns, Maja Hellfritzsch, Kristina Zint, Susana Perez-Gutthann, Manel Pladevall-Vila
PURPOSE: To report and discuss estimated prevalence of potential off-label use and associated methodological challenges using a case study of dabigatran. METHODS: Observational, cross-sectional study using 3 databases with different types of clinical information available: Cegedim Strategic Data Longitudinal Patient Database (CSD-LPD), France (cardiologist panel, n = 1706; general practitioner panel, n = 2813; primary care data); National Health Databases, Denmark (n = 28 619; hospital episodes and dispensed ambulatory medications); and Clinical Practice Research Datalink (CPRD), UK (linkable to Hospital Episode Statistics [HES], n = 2150; not linkable, n = 1285; primary care data plus hospital data for HES-linkable patients)...
March 23, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29567847/reliability-of-coded-data-to-identify-earliest-indications-of-cognitive-decline-cognitive-evaluation-and-alzheimer-s-disease-diagnosis-a-pilot-study-in-england
#17
Grazia Dell'Agnello, Urvi Desai, Noam Y Kirson, Jody Wen, Mark K Meiselbach, Catherine C Reed, Mark Belger, Alan Lenox-Smith, Carlos Martinez, Jill Rasmussen
OBJECTIVES: Evaluate the reliability of using diagnosis codes and prescription data to identify the timing of symptomatic onset, cognitive assessment and diagnosis of Alzheimer's disease (AD) among patients diagnosed with AD. METHODS: This was a retrospective cohort study using the UK Clinical Practice Research Datalink (CPRD). The study cohort consisted of a random sample of 50 patients with first AD diagnosis in 2010-2013. Additionally, patients were required to have a valid text-field code and a hospital episode or a referral in the 3 years before the first AD diagnosis...
March 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29477504/use-of-parenteral-glucocorticoids-and-the-risk-of-new-onset-type-2-diabetes-mellitus-a-case-control-study
#18
Ala Keyany, Johannes T H Nielen, Patrick C Souverein, Frank de Vries, Bart van den Bemt
BACKGROUND: Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type 2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data on the effect of parenteral GC use on T2DM. OBJECTIVE: To assess the association between use of parenteral GCs and the risk of receiving a first prescription of a non-insulin antidiabetic drug (NIAD) as a proxy for new onset of T2DM. METHODS: A population based case-control study was performed using the Clinical Practice Research Datalink (CPRD)...
March 10, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29397000/estimating-the-health-care-costs-of-children-born-to-pregnant-smokers-in-england-cohort-study-using-primary-and-secondary-health-care-data
#19
Luis R Vaz, Matthew J Jones, Lisa Szatkowski, Laila J Tata, Stavros Petrou, Tim Coleman
BACKGROUND AND AIMS: Little is known about the long-term economic consequences of smoking during pregnancy. We estimated the association between smoking in pregnancy and the costs of delivering health-care to infants and children in England, and investigated which aspects of care are the key drivers of these costs. METHODS: We used Hospital Episode Statistics (HES) linked with Clinical Practice Research Datalink (CPRD) data in England from January 2003 to January 2015 in children with longitudinal data for at least 1, 5 and 10 years after birth...
February 3, 2018: Addiction
https://www.readbyqxmd.com/read/29391368/predicting-prostate-cancer-progression-protocol-for-a-retrospective-cohort-study-to-identify-prognostic-factors-for-prostate-cancer-outcomes-using-routine-primary-care-data
#20
Samuel W D Merriel, Margaret T May, Richard M Martin
INTRODUCTION: Prostate cancer is the most common cancer in men in the UK, with nearly 40 000 diagnosed in 2014; and it is the second most common cause of male cancer-related mortality. The clinical conundrum is that most men live with prostate cancer rather than die from it, while existing treatments have significant associated morbidity. Recent studies have shown very low mortality rates (1% after a median of 10-year follow-up) and no treatment-related reductions in mortality, in men with localised prostate cancer...
January 31, 2018: BMJ Open
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