Between-hospital variability in the management and outcomes of postoperative periprosthetic femoral fractures.

Aims: Postoperative periprosthetic femoral fractures (POPFFs) following hip arthroplasty pose complex challenges, with differences in management and outcomes across healthcare facilities. However, there is limited published literature on such variability to inform improvement initiatives. This study aims to quantify the between-hospital variations in surgical management and short-term outcomes.

Between-practice variation in chronic obstructive pulmonary disease diagnosis guideline compliance: database study.

Background: Early chronic obstructive pulmonary disease (COPD) diagnosis is vital, but little is known about compliance with relevant diagnostic guidelines or variation in primary care.

Aim: To quantify between-practice variations in guideline compliance and over time.

Design & Setting: observational study in English primary care.

Breathlessness intensity recorded in general practice is associated with shorter times to unplanned hospital admissions and longer lengths of stay: a UK cohort study.

Background And Objective: Breathlessness is associated with higher rates of unplanned health service utilisation. We aimed to evaluate any associations between the severity of (hereafter ), time between recording and subsequent unplanned hospital admissions, and length of stay.

Methods: A retrospective cohort study of adults seen in general practice (UK Clinical Practice Research Datalink) with (Medical Research Council (MRC) breathlessness scale; 1-5; 5 is most intense), no pre-existing cardio-respiratory disease and a subsequent unplanned hospital admission.

Description of probiotic use in preterm infants in England and Wales 2016-2022.

Objective: To describe the use of probiotics among preterm infants in neonatal units and explore factors that influence exposure.

Design: Observational study using prospectively recorded health data.

Setting: England and Wales.

Deep learning classification models demonstrate high accuracy and clinical potential in radiograph interpretation in the arthroplasty clinical pathway: A systematic review and meta-analysis.

Purpose: Imaging is a cornerstone of the osteoarthritis (OA)-arthroplasty clinical pathway: the continuum of care that patients with OA undergo, from initial diagnosis through to arthroplasty and postoperative follow-up. With growing interest from the orthopaedic community, this meta-analysis broadly evaluates the performance of deep learning algorithms in interpreting radiographs and cross-sectional imaging in this pathway. The authors hypothesise that deep learning algorithms will have comparable performance to clinicians when interpreting radiographs, but not cross-sectional imaging, with negligible difference in diagnostic and prognostic tasks.

Pain and Sedative Medication Use Among Individuals With Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study.

Background: Individuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain-relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co-prescribing increase the risk of respiratory depression, dependence, and overdose.

GenAI exceeds clinical experts in predicting acute kidney injury following paediatric cardiopulmonary bypass.

The emergence of large language models (LLMs) opens new horizons to leverage, often unused, information in clinical text. Our study aims to capitalise on this new potential. Specifically, we examine the utility of text embeddings generated by LLMs in predicting postoperative acute kidney injury (AKI) in paediatric cardiopulmonary bypass (CPB) patients using electronic health record (EHR) text, and propose methods for explaining their output.

Critical components of 'Early Intervention in Psychosis': national retrospective cohort study.

Background: Psychotic disorders are severe mental health conditions frequently associated with long-term disability, reduced quality of life and premature mortality. Early Intervention in Psychosis (EIP) services aim to provide timely, comprehensive packages of care for people with psychotic disorders. However, it is not clear which components of EIP services contribute most to the improved outcomes they achieve.

Outcomes of patellofemoral joint arthroplasty compared with total knee arthroplasty for osteoarthritis : a population-based cohort study using data from the National Joint Registry and Hospital Episode Statistics for England.

Aims: The surgical options for patients with osteoarthritis (OA) of the patellofemoral joint (PFJ) involve a patellofemoral joint arthroplasty (PFA) or a total knee arthroplasy (TKA). The aim of this study was to describe and compare the safety profile and risk of revision of these two procedures.

Methods: The records of patients from the UK National Joint Registry who underwent PFA or TKA between April 2003 and December 2021 were linked to the Hospital Episode Statistics database.

Is geographical variation in emergency epilepsy admissions related to variation in new epilepsy diagnoses among children and young people across England? An observational study using linked datasets.

Introduction: Previous studies have reported widespread unexplained geographical variations in emergency paediatric admissions for epilepsy.

Objectives: Our aim was to investigate the extent to which geographical variation in epilepsy admissions among children and young people (CYP) aged 0-18 years, in England, reflects variation in new epilepsy diagnoses.

Design And Setting: A retrospective secondary analysis of Hospital Episode Statistics data for emergency admissions between April 2018 and March 2019, and Epilepsy12 audit data for new epilepsy diagnoses in England, between July and November 2018.

Association Between Surgeon Volume and Patient Outcomes After Elective Patellofemoral Arthroplasty: A Population-Based Cohort Study Using Data from the National Joint Registry and Hospital Episode Statistics for England.

Background: The objective of this study was to determine the relationship between surgical volume and patient outcome after arthroplasty of the patellofemoral joint, to improve patient outcomes and inform future resource planning.

Methods: All patellofemoral arthroplasty (PFA) records in the National Joint Registry from January 2003 to December 2021 were linked to the Hospital Episode Statistics database for England. The main outcome measure was revision surgery.

GP consultations for respiratory tract infections in children aged <5 years: a retrospective cohort study 2016-2023.

Background: Little is known about how GP consultation rates for children's respiratory tract infections (RTIs) have changed since the COVID-19 pandemic restrictions lifted.

Aim: To describe changes in GP consultation rates for RTIs in children aged <5 years from 2016 to 2023.

Design & Setting: A population-based retrospective cohort study using electronic health records from primary care practices across England.

Post-operative periprosthetic femoral fractures in England: Patient profiles and short-term outcomes.

Background And Objective: Post-operative periprosthetic femoral fractures (POPFF) present a growing challenge for healthcare services, but there are limited national data on patient profiles, short-term outcomes, and post-discharge follow-up. We aimed to fill these gaps.

Methods: Using Hospital Episode Statistics (HES), we identified POPFF discharges from hospitals in England for patients aged 18 and above between April 2016 and December 2022.

The Impact of COVID-19 on Acute Surgeries in England Among the Under-25s: A Retrospective Study of 61,360 Appendicitis and 15,850 Testicular Torsion Admissions.

Background: Little is known about how COVID-19 impacted acute surgical activity for children and young people (CYP) across England. Appendicitis and testicular torsion are common surgical conditions where treatment delays can lead to avoidable complications. We undertook a retrospective national cohort study.

Has multimorbidity and frailty in adult hospital admissions changed over the last 15 years? A retrospective study of 107 million admissions in England.

Background: Few studies have quantified multimorbidity and frailty trends within hospital settings, with even fewer reporting how much is attributable to the ageing population and individual patient factors. Studies to date have tended to focus on people over 65, rarely capturing older people or stratifying findings by planned and unplanned activity. As the UK's national health service (NHS) backlog worsens, and debates about productivity dominate, it is essential to understand these hospital trends so health services can meet them.

Can ChatGPT make surgical decisions with confidence similar to experienced knee surgeons?

Background: Unicompartmental knee replacements (UKRs) have become an increasingly attractive option for end-stage single-compartment knee osteoarthritis (OA). However, there remains controversy in patient selection. Natural language processing (NLP) is a form of artificial intelligence (AI).

Associations between prior healthcare use, time to diagnosis, and clinical outcomes in inflammatory bowel disease: a nationally representative population-based cohort study.

Background: Timely diagnosis and treatment of inflammatory bowel disease (IBD) may improve clinical outcomes.

Objective: Examine associations between time to diagnosis, patterns of prior healthcare use, and clinical outcomes in IBD.

Design: Using the Clinical Practice Research Datalink we identified incident cases of Crohn's disease (CD) and ulcerative colitis (UC), diagnosed between January 2003 and May 2016, with a first primary care gastrointestinal consultation during the 3-year period prior to IBD diagnosis.

Exploration of understanding of impactibility analysis and application through workshops to inform model design for population health management policy: a qualitative assessment.

Objectives: Assess understanding of impactibility modelling definitions, benefits, challenges and approaches.

Design: Qualitative assessment.

Setting: Two workshops were developed.

The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study.

Background: COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level.

Evaluation of emergency hospital admissions for inflammatory bowel disease as a possible marker of quality of care of British IBD inflammatory bowel disease units.

Background: Key performance indicators (KPIs) are required to facilitate quality improvement for inflammatory bowel disease (IBD). Emergency admissions for IBD may represent a possible KPI.

Methods: IBD emergency admissions for 2018-2019 from Hospital Episodes Statistics for England were compared per population and per IBD cases with patient-reported quality of care from the IBD Patient Survey 2019.

Modifiable risk factors that may be addressed in routine care to prevent progression to and extension of multimorbidity in people with COPD: a systematic literature review.

Chronic obstructive pulmonary disease (COPD) is a multisystem disease, and many patients have multiple conditions. We explored multimorbidity patterns that might inform intervention planning to reduce health-care costs while preserving quality of life for patients. Literature searches up to February 2022 revealed 4419 clinical observational and comparative studies of risk factors for multimorbidity in people with COPD, pulmonary emphysema, or chronic bronchitis at baseline.

Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study.

Objective: To describe the COVID-19 pandemic's impact on acute appendicitis management on children and young people (CYP).

Design: Retrospective cohort study.

Setting: All English National Health Service hospitals.