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https://www.readbyqxmd.com/read/29040555/the-effectiveness-of-varenicline-versus-nicotine-replacement-therapy-on-long-term-smoking-cessation-in-primary-care-a-prospective-cohort-study-of-electronic-medical-records
#1
Gemma M J Taylor, Amy E Taylor, Kyla H Thomas, Timothy Jones, Richard M Martin, Marcus R Munafò, Frank Windmeijer, Neil M Davies
Background: There is limited evidence about the effectiveness of varenicline and nicotine replacement therapy (NRT) for long-term smoking cessation in primary care, or whether the treatment effectiveness differs by socioeconomic position (SEP). Therefore, we estimated the long-term effectiveness of varenicline versus NRT (> 2 years) on smoking cessation, and investigated whether effectiveness differs by SEP. Methods: This is a prospective cohort study of electronic medical records from 654 general practices in England, within the Clinical Practice Research Datalink, using three different analytical methods: multivariable logistic regression, propensity score matching and instrumental variable analyses...
June 26, 2017: International Journal of Epidemiology
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
#2
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/29036565/long-term-risk-of-acute-myocardial-infarction-stroke-and-death-with-outpatient-use-of-clarithromycin-a-retrospective-cohort-study
#3
Andrew D Mosholder, Joo-Yeon Lee, Esther H Zhou, Elizabeth M Kang, Mayurika Ghosh, Rima Izem, Jacqueline M Major, David J Graham
This retrospective cohort study of subjects enrolled in the United Kingdom Clinical Practice Research Datalink from 2000-2013 evaluated long-term risks of death, stroke, and acute myocardial infarction (AMI) in adults prescribed clarithromycin. Subjects were outpatients aged 40-85 years prescribed clarithromycin, doxycycline, or erythromycin (287,748, 267,729, and 442,999 patients, respectively), or H. pylori eradication therapy with a proton pump inhibitor, amoxicillin, and either clarithromycin (27,639 patients) or metronidazole (14,863 patients)...
September 20, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29032229/sulfonylureas-as-initial-treatment-for-type-2-diabetes-and-the-risk-of-severe-hypoglycemia
#4
Oriana Yu, Laurent Azoulay, Hui Yin, Kristian B Filion, Samy Suissa
PURPOSE: The magnitude of the risk of severe hypoglycemia associated with sulfonylureas as the initial treatment for type 2 diabetes in the real-world setting is unknown. We assessed the risk of severe hypoglycemia associated with initiating monotherapy with sulfonylurea compared to metformin for the treatment of type 2 diabetes. METHODS: Using the UK Clinical Practice Research Datalink and Hospital Episode Statistics linked to the Office for National Statistics, we identified a cohort of patients with type 2 diabetes who initiated sulfonylureas or metformin monotherapy between April 1, 1998 and December 31, 2012, with follow-up until December 31, 2013...
October 12, 2017: American Journal of 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
#5
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
#6
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
#7
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/29018566/risks-of-smoking-and-benefits-of-smoking-cessation-on-hospitalisations-for-cardiovascular-events-and-respiratory-infection-in-patients-with-rheumatoid-arthritis-a-retrospective-cohort-study-using-the-clinical-practice-research-datalink
#8
Rebecca M Joseph, Mohammad Movahedi, William G Dixon, Deborah Pm Symmons
OBJECTIVES: To investigate the associations between smoking status, smoking cessation and hospitalisations for cardiovascular events (CVE) and respiratory tract infections (RTI) in an inception cohort of patients with rheumatoid arthritis (RA). METHODS: The study was set within UK primary care electronic health records (the Clinical Practice Research Datalink) linked to hospital inpatient data (Hospital Episode Statistics). Patients with RA were followed from diagnosis to hospitalisation with a record of CVE or RTI, leaving their general practice, death, or 10 January 2012, whichever was earliest...
2017: RMD Open
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
#9
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/28982720/routes-to-diagnosis-of-heart-failure-observational-study-using-linked-data-in-england
#10
Alex Bottle, Dani Kim, Paul Aylin, Martin R Cowie, Azeem Majeed, Benedict Hayhoe
OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28979165/validation-of-autism-spectrum-disorder-diagnoses-recorded-in-the-clinical-practice-research-datalink-1990-2014
#11
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/28977564/population-trends-in-the-incidence-and-initial-management-of-osteoarthritis-age-period-cohort-analysis-of-the-clinical-practice-research-datalink-1992-2013
#12
Dahai Yu, Kelvin P Jordan, John Bedson, Martin Englund, Fiona Blyth, Aleksandra Turkiewicz, Daniel Prieto-Alhambra, George Peat
Objective: To determine recent trends in the rate and management of new cases of OA presenting to primary healthcare using UK nationally representative data. Methods: Using the Clinical Practice Research Datalink we identified new cases of diagnosed OA and clinical OA (including OA-relevant peripheral joint pain in those aged over 45 years) using established code lists. For both definitions we estimated annual incidence density using exact person-time, and undertook descriptive analysis and age-period-cohort modelling...
August 4, 2017: Rheumatology
https://www.readbyqxmd.com/read/28972301/peripartum-hysterectomy-an-economic-analysis-of-direct-health-care-costs-using-routinely-collected-data
#13
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
#14
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/28961927/estimating-the-burden-of-medically-attended-norovirus-gastroenteritis-modelling-linked-primary-care-and-hospitalization-datasets
#15
Thomas Verstraeten, Tom Cattaert, John Harris, Ben Lopman, Clarence C Tam, Germano Ferreira
Background: Norovirus is the leading cause of community-acquired and nosocomial acute gastroenteritis. Routine testing for norovirus is seldom undertaken and diagnosis is mainly based on presenting symptoms. This makes understanding the burden of medically-attended norovirus-attributable gastroenteritis (MA-NGE) and targeting care and prevention strategies challenging. Methods: We used linked population-based health care datasets (Clinical Practice Research Datalink General Practice OnLine Database linked with Hospital Episode Statistics Admitted Patient Care) to model the incidence of MA-NGE associated with primary care consultations or hospitalisations according to age groups in England in the period July 2007 - June 2013...
August 18, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28953430/long-term-use-of-long-acting-insulin-analogs-and-breast-cancer-incidence-in-women-with-type-2-diabetes
#16
Jennifer W Wu, Laurent Azoulay, Agnieszka Majdan, Jean-François Boivin, Michael Pollak, Samy Suissa
Purpose The association between long-acting insulin analogs and increased breast cancer risk is uncertain, particularly with the short follow-up in previous studies. We assessed this risk long term in women with type 2 diabetes. Methods A population-based cohort of women 40 years or older, all of whom were treated with long-acting (glargine, detemir) or neutral protamine Hagedorn (NPH) insulin between 2002 and 2012, was formed using the United Kingdom's Clinical Practice Research Datalink. Women were followed until February 2015 or breast cancer diagnosis...
September 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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
#17
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/28944519/a-15-year-overview-of-increasing-tramadol-utilisation-and-associated-mortality-and-the-impact-of-tramadol-classification-in-the-united-kingdom
#18
Teng-Chou Chen, Li-Chia Chen, Roger David Knaggs
PURPOSE: This study aimed to develop hypotheses to explain the increasing tramadol utilisation, evaluate the impact of tramadol classification, and explore the trend between tramadol utilisation and related deaths in the United Kingdom. METHODS: This cross-sectional study used individual patient data, the Clinical Practice Research Datalink from 1993 to 2015, to calculate monthly defined daily dose (DDD)/1000 registrants, monthly prevalence and incidence of tramadol users, annual supply days, and mean daily dose of tramadol...
September 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28941187/evaluation-of-a-prediction-model-for-colorectal-cancer-retrospective-analysis-of-2-5-million-patient-records
#19
Jacqueline Birks, Clare Bankhead, Tim A Holt, Alice Fuller, Julietta Patnick
Earlier detection of colorectal cancer greatly improves prognosis, largely through surgical excision of neoplastic polyps. These include benign adenomas which can transform over time to malignant adenocarcinomas. This progression may be associated with changes in full blood count indices. An existing risk algorithm derived in Israel stratifies individuals according to colorectal cancer risk using full blood count data, but has not been validated in the UK. We undertook a retrospective analysis using the Clinical Practice Research Datalink...
September 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28939590/trends-for-prevalence-and-incidence-of-resistant-hypertension-population-based-cohort-study-in-the-uk-1995-2015
#20
Sarah-Jo Sinnott, Liam Smeeth, Elizabeth Williamson, Ian J Douglas
Objective To estimate the incidence and prevalence of resistant hypertension among a UK population treated for hypertension from 1995 to 2015.Design Cohort study.Setting Electronic health records from the UK Clinical Practice Research Datalink in primary care.Participants 1 317 290 users of antihypertensive drugs with a diagnosis of hypertension.Main outcome measures Resistant hypertension was defined as concurrent use of three antihypertensive drugs inclusive of a diuretic, uncontrolled hypertension (≥140/90 mm Hg), and adherence to the prescribed drug regimen, or concurrent use of four antihypertensive drugs inclusive of a diuretic and adherence to the prescribed drug regimen...
September 22, 2017: BMJ: British Medical Journal
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