A5061346775- Global Cancer Incidence and Screening
- Colorectal Cancer Screening and Detection
- Primary Care and Health Outcomes
- Economic and Financial Impacts of Cancer
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Lung Cancer Diagnosis and Treatment
- Healthcare Policy and Management
- Lung Cancer Treatments and Mutations
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Clinical Reasoning and Diagnostic Skills
- COVID-19 and healthcare impacts
- Healthcare Systems and Technology
- Cervical Cancer and HPV Research
- Air Quality and Health Impacts
- Health and Medical Research Impacts
- Global Health Workforce Issues
- Health, psychology, and well-being
- Cancer Genomics and Diagnostics
- Pancreatic and Hepatic Oncology Research
- Climate Change and Health Impacts
- Advances in Oncology and Radiotherapy
- Meta-analysis and systematic reviews
- Cancer survivorship and care
- Venous Thromboembolism Diagnosis and Management
NHS England
2023-2025
King's College London
2016-2025
National Cancer Registration Service
2020-2024
Europe for Business
2020-2023
Public Health England
2020-2022
Royal College of General Practitioners
2021-2022
University College London
2020
University of Essex
2016
University of Sri Jayewardenepura
2016
Queen Mary University of London
2014
Background Pragmatic trials compare the effects of different decisions in usual clinical practice. Objectives To develop and evaluate methods to implement simple pragmatic using routinely collected electronic health records (EHRs) recruiting patients at point care; identify barriers facilitators for general practitioners (GPs) experiences trial participants. Design Two exemplar randomised (Retropro eLung) with qualitative evaluations. Setting Four hundred fifty-nine English Scottish...
<b>Objective</b> To assess the overall effect of English urgent referral pathway on cancer survival. <b>Setting</b> 8049 general practices in England. <b>Design</b> Cohort study. Linked information from national Cancer Waiting Times database, NHS Exeter and National Register was used to estimate mortality patients relation propensity their practice use pathway. <b>Participants</b> 215 284 with cancer, diagnosed or first treated England 2009 followed up 2013. <b>Outcome measure</b> Hazard...
Objective: Clinically irrelevant but psychologically important factors such as patients' expectations for antibiotics encourage over-prescribing.We aimed to i) provide missing causal evidence of this effect, ii) identify whether the distort perceived probability a bacterial infection either in pre-or post-decisional distortions pathway and iii) detect possible moderators effect.Methods: Family physicians expressed their willingness prescribe (Experiment 1, n 1 =305) or decision 2, 2 =131)...
<h3>Background</h3> Designers of computerised diagnostic support systems (CDSSs) expect physicians to notice when they need advice and enter into the CDSS all information that have gathered about patient. The poor use CDSSs tendency not follow once a leading diagnosis emerges would question this expectation. <h3>Aim</h3> To determine whether providing GPs with diagnoses consider before start testing hypotheses improves accuracy. <h3>Design setting</h3> Mixed factorial design, where 297...
Background There is considerable variation between GP practices in England their use of urgent referral pathways for suspected cancer. Aim To determine the association practice and cancer stage at diagnosis patient mortality, all cancers most common types (colorectal, lung, breast, prostate). Design setting National cohort study 1.4 million patients diagnosed with 2011 2015. Method The was stratified according to quintiles metrics. Cox proportional hazards regression used quantify risk...
There is substantial variation in the use of urgent suspected cancer referral (2-week wait [2WW]) between practices.To examine change 2WW referrals England over 10 years (2009/2010 to 2018/2019) and practice population factors associated with detection.Retrospective cross-sectional study English general practices their Cancer Waiting Times database detection data (all cancers other than non-melanoma skin cancers) from 2009/2010 2018/2019.A retrospective conducted using descriptive statistics...
First impressions are thought to exert a disproportionate influence on subsequent judgments; however, their role in medical diagnosis has not been systematically studied. We aimed elicit and measure the association between first diagnoses common presentations with subtle indications of cancer.Ninety UK family physicians conducted interactive simulated consultations online, while phone researcher. They saw 6 patient cases, 3 which could be cancers. Each cancer case included 2 consultations,...
Introduction Lung cancer outcomes in England are inferior to comparable countries. Patient or disease characteristics, healthcare-seeking behaviour, diagnostic pathways, and oncology service provision may contribute. We aimed quantify associations between geographic variations treatment survival of patients England. Methods retrieved detailed registration data analyse the variation 176,225 lung patients, diagnosed 2010-2014. used Kaplan-Meier analysis Cox proportional hazards regression...
Background Cervical cancer disproportionately affects women ≥65 years, especially those not screened regularly. Speculum use is a key barrier. Aim To assess if offering non-speculum clinician-taken sampling and self-sampling increases uptake for lapsed attenders aged 50–64 years. Design setting Pragmatic randomised control trial conducted at 10 general practices in East London, UK. Method Participants were 784 last 6–15 years before randomisation. Intervention participants received letter...
Objectives To establish a methodology to categorise urgent suspected cancer (USC) referrals in England and use these categories understand individual patient referral patterns by demographic characteristics, financial year pathway. Design Cross-sectional population-based cohort study. Setting From Cancer Waiting Times data, linked information held the National Disease Registration Service, referral-level data on all USC between 1 April 2013 31 March 2018. Participants After restricting...
<h3>Background</h3> Airway macrophage (AM) phagocytosis is impaired in severe asthma. Prostaglandin (PG) E<sub>2</sub> and D<sub>2</sub> are increased asthma suppress AM phagocytic function vitro. In this study, we sought evidence for PG-mediated impairment of inhalable carbonaceous particulate matter (PM) by children with compared mild asthmatics healthy controls. <h3>Methods</h3> were obtained from controls using induced sputum. carbon area (μm<sup>2</sup>) was assessed image analysis. a...
Structured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering in a deprived ethnically diverse area prove challenging. Evaluation of system change to enhance COPD delivery primary setting between 2010 and 2013 using observational data. All 36 practices one inner London trust were grouped geographically into eight networks 4–5 practices, each supported by network manager, clerical staff an educational budget. A multidisciplinary group, including...
Abstract Background Recruitment to birth cohort studies is a challenge. Few have addressed the attitudes of women about taking part in particularly those from ethnic minority groups. Objective To seek views people diverse backgrounds participation proposed examining impact infections. Design and setting Eight focus groups pregnant mothers young children took place GP surgeries community centres an ethnically area east London. Purposeful sampling language support ensured representation Audio...
A well-funded, four-year integrated care programme was implemented in south London. The attempted to integrate across primary, acute, community, mental health and social care. purpose of this paper is reduce hospital admissions nursing home placements. Programme evaluation aimed identify what worked well did not; lessons learnt; the value investment.Qualitative data were obtained from documentary analysis, stakeholder interviews, focus groups observational meetings. Framework analysis...
Purpose The linked prescriptions cancer registry data resource was set up to extend our understanding of the pathway for patients with past secondary care into community, ultimately improve patient outcomes. Participants is currently available April July 2015, all diagnosed in England a dispensed prescription that time frame. are collected by National Health Service (NHS) Prescription Services, and processed Public England. All routine healthcare data, used purposes, using pseudonymised...
BackgroundFollowing referral for investigation of urgent suspected cancer within the English National Health Service system, 7% referred individuals are diagnosed with cancer. This study aimed to investigate risk occurrence 1–5 years finding no following an referral.MethodsThis national cohort used data England from Cancer Waiting Times dataset and linked it diagnosis Registration dataset. Data were extracted eight most commonly pathways (breast, gynaecological, head neck, lower upper...
Background In international studies, greater investment in primary health care is associated with improved population outcomes. Aim To determine whether general practice secondary utilisation, patient satisfaction, and clinical Design setting Retrospective cross-sectional study of practices England, 2014–2015. Method Practice-level data were stratified into three groups according to GP contract type: national General Medical Services (GMS) contracts, or without the capitation supplement...