A5015536695- Prostate Cancer Diagnosis and Treatment
- Prostate Cancer Treatment and Research
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Emergency and Acute Care Studies
- Organ Transplantation Techniques and Outcomes
- Liver Disease and Transplantation
- Colorectal Cancer Screening and Detection
- Advanced Radiotherapy Techniques
- Renal Transplantation Outcomes and Treatments
- Colorectal Cancer Surgical Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Global Cancer Incidence and Screening
- Pancreatic and Hepatic Oncology Research
- Health Services Management and Policy
- Colorectal Cancer Treatments and Studies
- Economic and Financial Impacts of Cancer
- Chronic Disease Management Strategies
- COVID-19 Clinical Research Studies
- Cardiomyopathy and Myosin Studies
- Liver Disease Diagnosis and Treatment
- Patient Satisfaction in Healthcare
- Bladder and Urothelial Cancer Treatments
- Radiomics and Machine Learning in Medical Imaging
- Healthcare cost, quality, practices
Royal College of Surgeons of England
2018-2025
London School of Hygiene & Tropical Medicine
2018-2025
Faculty of Public Health
2020-2025
University of London
2018-2023
University of Manchester
2022
King's College Hospital NHS Foundation Trust
2021-2022
National Health Service
2021-2022
Cardiff University
2015-2022
University Hospital of Bern
2022
University of Bern
2022
SummaryBackgroundMultimorbidity, the presence of two or more mental physical chronic non-communicable diseases, is a major challenge for health system in China, which faces unprecedented ageing its population. Here we examined distribution multimorbidity relation to socioeconomic status; association between multimorbidity, health-care service use, and catastrophic expenditures; whether these associations varied by group social insurance schemes.MethodsIn this population-based, panel data...
<h3>Objective</h3> Myocardial fibrosis identified by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM) is associated adverse events, but its value as an independent risk factor for sudden cardiac death (SCD) unknown. We investigated the role of LGE-CMR stratification HCM. <h3>Methods</h3> conducted a prospective cohort study tertiary referral centre. Consecutive HCM (n=711, median age 56.3 years, IQR 46.7–66.6; 70.0%...
The number of visits to hospital emergency departments (EDs) in England has increased by 20% since 2007-08, placing unsustainable pressure on the National Health Service (NHS). Some patients attend EDs because they are unable access primary care services. This study examined association between and ED England.A cross-sectional, population-based analysis registered with 7,856 general practices was conducted, for time period April 2010 March 2011. outcome measure self-referred discharged...
Objectives To assess the complications of transrectal (TR) compared to transperineal prostate (TP) biopsies. Patients and Methods Men diagnosed with cancer between 1 April 2014 31 March 2017 in England were identified National Prostate Cancer Audit. Administrative hospital data then used categorize type biopsy subsequent requiring admission. identify patients staying overnight immediately after those readmitted separately for admissions because sepsis, urinary retention or haematuria....
Demand for unplanned hospital services is rising, and children are frequent users, especially where access to primary care poor. In England, universal health coverage entitles parents see a general practitioner (GP) first-contact care. However, GP appointments variable, few patients can their own regular out of hours (OOH). The goal this study explored the association between GPs , emergency department (ED) visits short hospitalizations (<2 days) in England.ED visit hospitalization rates...
Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis COVID-19, although evidence is not conclusive. However, effects COVID-19 vaccine on this association, or effect other subtypes, are clear. We aimed to investigate association between and 2, 1, gestational non-specific diabetes, COVID- 19 vaccination, up 52 weeks diagnosis.
Spinal muscular atrophy (SMA) is a rare neurodegenerative disease characterized by progressive weakness, which occurs in one 6,000 to 10,000 live births. The burden of SMA on Canadian patients and caregivers not known.
<h3>Background</h3> The annual number of unplanned attendances at accident and emergency (A&E) departments in England increased by 11% (2.2 million attendances) between 2008–2009 2012–2013. A national review urgent care has emphasised the role access to primary services preventing A&E attendances. <h3>Aim</h3> To estimate 2012–2013 that were preceded attending patient being unable obtain an appointment or a convenient their general practice. <h3>Design setting</h3> Cross-sectional...
Abstract Background The five-tiered Cambridge Prognostic Group (CPG) classification is a better predictor of prostate cancer-specific mortality than the traditional three-tiered (low, intermediate, and high risk). We investigated radical treatment rates according to CPG in men diagnosed with non-metastatic cancer England between 2014 2017. Methods Patients were identified from National Prostate Cancer Audit database. Men risk stratified classification. Risk ratios (RR) estimated for...
As the general election in UK approaches and NHS policies are set to take centre stage, <b>Thomas E Cowling</b>, <b>Matthew J Harris</b>, <b>Azeem Majeed</b> discuss evidence, uncertainty, debate behind access primary care
The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A E) departments after being unable get suitable general practice appointments. Direct admission hospital via a practitioner (GP) averts A E use, may reduce total costs. It could also enhance the continuity of information between GPs doctors, possibly improving healthcare outcomes.To determine whether access associated with route admission-via GP versus an...
Abstract Background Despite improvement in health outcomes over the past few decades, China still experiences striking rural-urban inequalities. There is limited research on differences system performance China. Method We conducted a cross-sectional analysis to compare between rural and urban areas five key domains of system: effectiveness, cost, access, patient-centredness equity, using data from WHO Study Global AGEing adult (SAGE), Multiple logistic linear regression models were used...
International guidelines recommend treatment intensification combining docetaxel or androgen receptor pathway inhibitors with deprivation therapy for metastatic hormone-sensitive prostate cancer (mHSPC). However, evidence suggests underuse in many high-income countries. This study evaluates the use of English National Health Service (NHS) and explores patient hospital-level factors associated variation. All men diagnosed mHSPC England between January 2018 December 2022 were identified...
Routinely collected data are increasingly being used for cancer research and health service evaluation. For both purposes, accurately identifying metastatic disease at diagnosis is essential. We developed an approach to identify time of primary according national hospital administrative (HAD) in patients identified with colorectal (CRC) the English registry (CR). A cohort CRC diagnosed between 2013 2018 England CR were linked HAD. Metastatic was assumed be present HAD if least one a set...
If randomised controlled trials can be successfully emulated using real-world data (RWD), confidence in the validity of RWD for estimating treatment effects questions that have not been assessed increases. We used routinely collected administrative and clinical national linked datasets from England to emulate PR07 trial high-risk prostate cancer patients, which compared radiotherapy added hormone therapy (RT+HT) within 8 weeks randomisation (the 'grace period') only (HT) on all-cause...
Objective To evaluate the area-based incidence of metastatic prostate cancer at diagnosis, reflecting risk late-stage and overall incidence, over-diagnosis, in a country without formal screening programme. Methods analysis National study annual between 2015 2019. Mixed-effects regression estimated adjusted for age, ethnicity socioeconomic deprivation. Linear assessed association incidence. Results was 5.7 per 10 000 men 43.9. Higher both were observed areas with older populations more black...
There is a debate about the effectiveness and toxicity of pelvic lymph node (PLN) irradiation for treatment men with high-risk prostate cancer. This study compared intensity-modulated radiation therapy (IMRT) to nodes (PPLN-IMRT) prostate-only IMRT (PO-IMRT).
Objectives To investigate whether patient‐reported urinary incontinence (UI) and bother scores after radical prostatectomy (RP) result in subsequent intervention with UI surgery. Patients Methods Men diagnosed prostate cancer the English National Health Service between April 2014 January 2016 were identified. Administrative data used to identify men who had undergone a RP those subsequently underwent procedure. The Prostate Cancer Audit database was also completed post‐treatment survey....
In the last decade, there have been major advances in inflammatory bowel disease (IBD) management but their impact on hospital admissions requires evaluation. We aim to investigate nationwide trends IBD surgical/medical elective and emergency admissions, including endoscopy cytokine inhibitor infusions, between 2003 2013.