A5101706356- Medical Malpractice and Liability Issues
- Global Cancer Incidence and Screening
- COVID-19 and healthcare impacts
- Healthcare Policy and Management
- Hip and Femur Fractures
- Health Systems, Economic Evaluations, Quality of Life
- Patient Safety and Medication Errors
- Cardiac, Anesthesia and Surgical Outcomes
- COVID-19 Clinical Research Studies
- Primary Care and Health Outcomes
- Long-Term Effects of COVID-19
- Atrial Fibrillation Management and Outcomes
- Global Health Care Issues
- Medical Coding and Health Information
- Colorectal Cancer Screening and Detection
- Economic and Financial Impacts of Cancer
- Trauma and Emergency Care Studies
- Breast Cancer Treatment Studies
- Frailty in Older Adults
- Nutrition and Health in Aging
- Healthcare Quality and Management
- Hospital Admissions and Outcomes
- Meta-analysis and systematic reviews
- COVID-19 epidemiological studies
- Pain Management and Placebo Effect
Pfizer (United Kingdom)
2023-2025
NIHR Bristol Biomedical Research Centre
2019-2024
University of Bristol
2019-2024
National Institute for Health Research
2020-2024
Pfizer (United States)
2023-2024
Health Economics and Outcomes Research (United Kingdom)
2020-2022
London School of Hygiene & Tropical Medicine
2015-2020
University Hospitals Bristol NHS Foundation Trust
2019-2020
Medical Research Council
2020
Royal College of Surgeons of England
2015-2016
Hip fracture is the most common serious injury of older people. The UK National Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve quality hip care, but has not yet been externally evaluated.We used routinely collected data on 471,590 people (aged 60 years and older) admitted with Health Service (NHS) hospitals England between 2003 2011. main variables interest were use early surgery (on day admission, or after) mortality at...
To identify patient and general practice (GP) characteristics associated with emergency (unplanned) first admissions for cancer in secondary care. Patients who had a first-time admission primary diagnosis of during 2007/08 to 2009/10 were identified from administrative hospital data. We modelled the associations between odds these being unplanned various GP using national data sets, including Quality Outcomes Framework (QOF). There 639 064 patients cancer, 139 351 unplanned, 7957 practices....
to describe the increase in orthogeriatrician involvement hip fracture care England and its association with improvements time surgery mortality.analysis of Hospital Episode Statistics for 196,401 patients presenting 150 hospitals between 1 April 2010 28 February 2014, combined data on hours from a national organisational survey.we examined changes average number worked by orthogeriatricians orthopaedic departments per patient fracture, their potential effect mortality within 30 days...
Abstract Aims To evaluate the ability of a machine learning algorithm to identify patients at high risk atrial fibrillation in primary care. Methods A retrospective cohort study was undertaken using DISCOVER registry validate an developed Clinical Practice Research Datalink (CPRD) dataset. The validation dataset included care London, England aged ≥30 years from 1 January 2006 31 December 2013, without diagnosis prior 5 years. Algorithm performance metrics were sensitivity, specificity,...
Long COVID, a diverse set of symptoms that persist after minimum 4 weeks from the initial SARS-CoV-2 infection, has posed substantial burden to healthcare systems. There is some evidence COVID-19 vaccination may be associated with lower risk long COVID. However, little known about association between status and COVID-associated resource utilisation (HCRU) costs. We conducted cohort study using primary care electronic health record data in England Clinical Practice Research Datalink (CPRD)...
Objective To create case definitions for confirmed COVID-19 diagnoses, vaccination status and three separate of high risk severe COVID-19, as well to assess whether the implementation these in a cohort reflected sociodemographic clinical characteristics epidemiology England. Design Retrospective study. Setting Electronic healthcare records from primary care (Clinical Practice Research Datalink, CPRD) linked secondary data (Hospital Episode Statistics) covering 24% population Participants 2...
More accurate and recent estimates of adverse events in primary care are necessary to assign resources for improvement patient safety, while predictors must be identified ameliorate risk.To determine the incidence recorded iatrogenic harm general practice identify risk factors these events.Cross-sectional sample 74,763 patients at 457 English practices between 1 January 1999 31 December 2008, obtained from General Practice Research Database.Patient age study entry, sex, ethnicity,...
Patients diagnosed with cancer by the emergency route often have more advanced diseases and poorer outcomes. Rates of through unplanned admissions vary within between countries, suggesting potential inconsistencies in quality care. To reduce diagnoses this improve patient outcomes, high risk groups must be identified. This cross-sectional observational study determined incidence first-ever (unplanned) admission identified patient-level factors for these England. Data 74,763 randomly selected...
Objectives Studies that use national datasets to evaluate the management of older women with breast cancer are often constrained by a lack information on patient fitness. This study constructed frailty index for secondary care administrative records and evaluated its ability improve models treatment patterns overall survival in cancer. Design Retrospective cohort study. Participants Women aged ≥50 years oestrogen receptor (ER) positive early invasive diagnosed between 2014 2017 England....
The aim of the PULsE-AI trial was to assess effectiveness a machine learning risk-prediction algorithm in conjunction with diagnostic testing for identifying undiagnosed atrial fibrillation (AF) primary care England.Eligible participants (aged ≥30 years without AF diagnosis; n = 23 745) from six general practices England were randomized into intervention and control arms. Intervention arm participants, identified by as high risk (n 944), invited 256 consented); those who did not accept...
To quantify direct costs and healthcare resource utilisation (HCRU) associated with acute COVID-19 in adults England.
Abstract Background Placebo-controlled trials play an important role in the evaluation of healthcare interventions. However, they can be challenging to design and deliver for invasive interventions, including surgery. In-depth understanding component parts treatment intervention is needed ascertain what should, should not, delivered as part placebo. Assessment risk patients strategies ensure that placebo effectively mimics are also required. To date, no guidance exists This study aimed...
Objective To develop a core outcome set for international burn research. Design Development and consensus, from April 2017 to November 2019. Methods Candidate outcomes were identified systematic reviews stakeholder interviews. Through Delphi survey, clinicians, researchers, UK patients prioritised outcomes. Anonymised feedback aimed achieve consensus. Pre-defined criteria retaining agreed. A consensus meeting with voting was held finalise the set. Results Data source examination 1021 unique...
Background Although the majority of patient contact within UK's National Health Service (NHS) occurs in primary care, relatively little is known about safety care this setting compared to hospital care. Measurement methods detect iatrogenic diseases require extensive development. Routinely collected data have been successfully applied develop indicators secondary Given availability electronic health we explored potential build adverse event screening tools using computerised medical record...
To investigate the predictive performance of machine learning (ML) algorithms for estimating anticoagulation control in patients with atrial fibrillation (AF) who are treated warfarin. This was a retrospective cohort study adult (≥18 years) between 2007 and 2016 using linked primary secondary care data (Clinical Practice Research Datalink GOLD Hospital Episode Statistics). Various ML techniques were explored to predict suboptimal control, defined as time therapeutic range (TTR) < 70% based...
to describe differences in care and 30-day mortality of patients admitted with hip fracture on weekends (Saturday-Sunday) compared weekdays (Monday-Friday), their relationship the organisation care.data came from National Hip Fracture Database (NHFD) linked ONS data 52,599 presenting 162 units England between 1 January 31 December 2014. This was combined information geriatrician staffing major trauma centre (MTC) status. were for at weekdays; separately treated grouped by mean level input...
Objective The aim of this study was to evaluate the potential real-world application a machine learning (ML) algorithm, developed and trained on heart failure (HF) cohorts in USA, detect patients with undiagnosed wild type cardiac amyloidosis (ATTRwt) UK. Design In retrospective observational study, anonymised, linked primary secondary care data (Clinical Practice Research Datalink GOLD Hospital Episode Statistics, respectively, were used identify diagnosed HF between 2009 2018 International...
ABSTRACT Objective To create case definitions for confirmed COVID diagnoses, vaccination status, and three separate of high risk severe COVID, as well to assess whether the implementation these in a cohort reflected sociodemographic clinical characteristics epidemiology England. Design Retrospective study Setting Electronic healthcare records from primary care (Clinical Practice Research Datalink, or CPRD) linked secondary data (Hospital Episode Statistics, HES) covering 24% population...
ABSTRACT Background Hyperkalaemia is an electrolyte abnormality associated with adverse clinical outcomes; however, few studies have investigated the relationship patterns of hyperkalaemia over time. This study explored impact time spent in a hyperkalaemic state and variability serum potassium (sK+) on major cardiovascular events (MACE) all-cause mortality patients chronic kidney disease (CKD), resistant hypertension, heart failure diabetes. Methods Cohorts comprised adult diagnosed CKD...