Development and validation of a postpartum cardiovascular disease risk prediction model in women incorporating reproductive and pregnancy-related predictors.

Background: Each year, over 700,000 pregnancies occur in the UK, with up to 10% affected by complications such as hypertensive disorders of pregnancy and gestational diabetes mellitus. Pregnancy-related complications and reproductive factors are associated with an increased risk of cardiovascular disease (CVD) later in life. Our aim was to determine whether adding pregnancy factors to a prediction model with established CVD risk factors improves 10-year risk prediction of CVD in postpartum women, using QRISK®-3 as a benchmark model.

Estimating inequality in alcohol-related liver disease burden in the UK, 2009 to 2020: a population-based study using routinely collected data.

Background: There is a need to understand the preventable burden of alcohol-related liver disease (ARLD) and to improve the identification of individuals at high risk. We aimed to establish reliable and stratified epidemiological data to understand the burden of ARLD and the inequalities in this burden related to ethnicity, socioeconomic factors, and region in the UK.

Methods: Data were extracted from Clinical Practice Research Datalink Aurum, a primary care database that includes 20% of UK general practices.

Prevalence trends and risk factors for allergic rhinoconjunctivitis, asthma and eczema in the UK.

Background: Allergic rhinoconjunctivitis (ARC), asthma and eczema carry a substantial morbidity. These conditions often co-exist within the same individual and their prevalence can differ based on age, ethnicity and gender.

Objectives: Using a UK primary care database, we estimated the trends in prevalence over the last decade for ARC, asthma and eczema and associated risk factors.

Perspectives of Health Care Professionals on the Use of AI to Support Clinical Decision-Making in the Management of Multiple Long-Term Conditions: Interview Study.

Background: Managing multiple long-term conditions (MLTC) is complex. Clinical management guidelines are typically focused on individual conditions and lack a robust evidence base for patients with MLTC. MLTC management is largely delivered in primary care, where health care professionals (HCPs) have identified the need for more holistic yet efficient models of care that can address patients' medical, pharmacological, social, and mental health needs.

A systematic review and network meta-analysis of interventions to preserve insulin-secreting beta cell function in people newly diagnosed with type 1 diabetes: results from randomised controlled trials of immunomodulatory therapies.

Background: Type 1 diabetes is characterised by the immune-mediated destruction of pancreatic beta cells. We aimed to determine the effectiveness of immunotherapies for preserving residual beta cell function in newly diagnosed (stage 3) type 1 diabetes.

Methods: Searches were carried out in MEDLINE, Embase, Cochrane CENTRAL and trial registries until 31st Jul 2024.

The epidemiology of hereditary spastic paraplegia and associated common mental health outcomes in England and Northern Ireland.

Background: Hereditary Spastic Paraplegia (HSP) is a rare genetic neurological disorder that causes progressive spasticity and weakness in the lower limbs. This study aims to describe the prevalence and incidence of HSP and examine common mental health outcomes (depression and anxiety) in HSP patients in England and Northern Ireland.

Methods: This retrospective cohort study used CPRD Aurum primary care data from 1 January 2000 to 31 December 2021.

Prevalence and patterns of pre-existing multimorbidity in pregnancy in Northern Ireland: a population-based, retrospective study using linked routinely collected healthcare data.

Background: Multimorbidity in pregnancy increases health risks to women and babies, and creates challenges for services. The aim of this study was to explore the prevalence and patterns of maternal multimorbidity in a UK population.

Methods: This population-based, retrospective study used individual-level, linked, routinely collected health data accessed via The Health and Social Care Northern Ireland Business Service Organisation Honest Broker Service within a Trusted Research Environment following the Five Safes Framework.

Trends in the prevalence of autoimmune diseases during pregnancy in the UK, 2000-21: a retrospective cohort study.

Background: Autoimmune diseases are increasingly prevalent worldwide and disproportionately affect women of reproductive age, including during pregnancy. Given the association between autoimmune diseases, comorbidities, and risk factors for adverse pregnancy outcomes, we aimed to estimate the burden of autoimmune disease in pregnancy.

Methods: This was a UK population-based retrospective cohort study using routinely collected data from two large databases (Clinical Practice Research Datalink Gold and Aurum) and associated pregnancy registers.

The emergence of common health conditions across the life course: evidence from the Born in Bradford family cohort.

Background: Born in Bradford (BiB) is a family cohort study with linked routine health records. We calculated the rates of common health conditions and explored differences between White European and South Asian participants.

Methods: 21 health conditions were identified using diagnostic codes and prescription records extracted from electronic health records.

Importance of sample size on the quality and utility of AI-based prediction models for healthcare.

Rigorous study design and analytical standards are required to generate reliable findings in healthcare from artificial intelligence (AI) research. One crucial but often overlooked aspect is the determination of appropriate sample sizes for studies developing AI-based prediction models for individual diagnosis or prognosis. Specifically, the number of participants and outcome events required in datasets for model training and evaluation remains inadequately addressed.

Protocol: what are the ethnic inequities in care outcomes related to haematological malignancies, treated with transplant/cellular therapies, in the UK? A systematic review.

Introduction: Haematological cancers are common in the UK, with a variety of morphologies. Stem cell transplants and chimeric antigen receptor (CAR) T-cell therapies provide significant options for hard to treat haematological cancers, although with difficult to predict outcomes. Research into the determinates of treatment efficacy, and access to treatments, is key to ensuring equal benefit across patients and patient safety.

Trends in prevalence of anaemia among people living with HIV in the UK: 20 cross-sectional analyses using population-based electronic primary healthcare records.

Background: People living with HIV have a greater prevalence of anaemia compared with people without HIV, which increases the risk of associated morbidity and premature mortality. Risk factors for anaemia among people living with HIV have changed in recent decades due to new antiretroviral therapy (ART), increased uptake of ART and increasing chronic conditions among people living with HIV; thus, anaemia prevalence may have changed over time. We aimed to identify the prevalence and trends of anaemia among people living with HIV over a 20-year period.

Quantifying, Understanding and Enhancing Relational Continuity of Care (QUERCC): a mixed-methods protocol.

Introduction: Relational continuity of care is where patients see the same clinicians over time. Evidence suggests relational continuity of care is valued by patients and clinicians and results in better health. While current National Health Service policy aims to maintain relational continuity of care, it has been declining in recent years, which may be linked to the growth in practice size, increased staff turnover, part-time working and the focus on patient access.

Defining phenotypes of disease severity for long-term cardiovascular, renal, metabolic, and mental health conditions in primary care electronic health records: A mixed-methods study using the nominal group technique.

Objective: Inclusion of severity measures for long-term conditions (LTC) could improve prediction models for multiple long-term conditions (MLTC) but some severity measures have limited availability in electronic health records (EHR). We aimed to develop consensus on feasible severity phenotypes for nine cardio-renal-metabolic and mental health conditions.

Methods: This was a mixed-methods study using novel methodology.

Comprehensive Update on Multiple Sclerosis-Associated Uveitis and New Epidemiological Insights from the United Kingdom.

Multiple sclerosis (MS)-associated uveitis is characterised most frequently by bilateral intermediate uveitis with peripheral vascular leakage or panuveitis. The interesting association between these autoimmune diseases, which develop in two immune-privileged sites, places some undifferentiated uveitis patients at heightened risk of demyelination and clinical MS precipitation from the use of licensed anti-tumour necrosis factor α (TNFα) biologic therapy. However, their association may also open novel treatment avenues, considering the rapidly expanding arsenal of highly effective MS disease-modifying therapies.

Implementation of hospital-initiated complex interventions for adult people with multiple long-term conditions: a scoping review.

Background: The increasing prevalence of multiple long-term conditions (MLTC) presents significant challenges to healthcare delivery globally. Although interventions for long-term conditions have predominantly been designed and evaluated in primary care settings, there is a growing recognition of the need to address the management of MLTC within secondary care. This scoping review aims to comprehensively evaluate hospital-initiated complex interventions for people with MLTC.

Uncertainty of risk estimates from clinical prediction models: rationale, challenges, and approaches.

Clinical prediction models estimate an individual’s risk (probability) of a health related outcome to help guide patient counselling and clinical decision making. Most models provide a single point estimate of risk but without the associated uncertainty. Riley and colleagues argue that this needs to change, as understanding uncertainty of risk estimates helps to inform critical evaluation of a model and may impact shared decision making.

The effect of non-pharmacological sleep interventions on glycaemic measures in adults with sleep disturbances and behaviours: A systematic review and meta-analysis.

Background: Sleep insufficiency is known to negatively impact on glucose metabolism. Consequently, there is interest in determining the impact of improving sleep on glucose metabolism. We conducted a meta-analysis of studies that aimed at improving sleep using cognitive behavioural therapy for insomnia (CBT-I) and/or sleep hygiene or sleep extension on glucose metabolism.

Variation in the commissioning of specialist weight management services and bariatric surgery across England: Results of a freedom of information-based mapping exercise across the 42 integrated Care Systems of England.

Specialist weight management services including bariatric surgery are commissioned within regions of England called Integrated Care Systems (ICSs) with eligibility and treatment guidelines determined as part of the National Institute for Health and Care Excellence (NICE) guidance. Reported variation in commissioning and bariatric surgery eligibility criteria has not been previously mapped. Freedom of Information (FOI) requests provide a tool, supported by legislation, to ask questions of public authorities including ICSs such that they must respond accurately.

Obstructive sleep apnoea syndrome and future risk of dementia among individuals managed in UK general practice.

Background: Obstructive sleep apnoea syndrome (OSAS) has been recognised as a potential risk factor for cognitive decline, yet its precise relationship with dementia remains uncertain. This study aimed to determine the risk of dementia among individuals with and without OSAS.

Methods: Data derived from 2.

The risk of immune-mediated inflammatory diseases following exposure to childhood maltreatment: A retrospective cohort study using UK primary care data.

Background: As a global public health issue, childhood maltreatment is associated with significant morbidity and mortality. We aimed to investigate the association between childhood maltreatment and immune-mediated inflammatory disorders (IMIDs).

Methods: We conducted a retrospective matched open cohort study using a UK primary care database between January 1, 1995 and January 31, 2021.

Using Repeated Measurements to Predict Cardiovascular Risk in Patients With Type 2 Diabetes.

The QRISK cardiovascular disease (CVD) risk assessment model is not currently optimized for patients with type 2 diabetes (T2DM). We aim to identify if the abundantly available repeatedly measured data for patients with T2D improves the predictive capability of QRISK to support the decision-making process regarding CVD prevention in patients with T2DM. We identified patients with T2DM aged 25 to 85, not on statin treatment and without pre-existing CVD from the IQVIA Medical Research Data United Kingdom primary care database and then followed them up until the first diagnosis of CVD, ischemic heart disease, or stroke/transient ischemic attack.

Pharmacologic Treatments for Dementia and the Risk of Developing Age-Related Macular Degeneration.

Importance: Age-related macular degeneration (AMD) is the leading cause of blindness among people aged 50 years or older worldwide. There is a need for new strategies for the prevention and treatment of AMD. There is some limited evidence to suggest the possibility of a protective association of dementia medications with the development of some types of AMD, but the evidence is weak.

Key considerations for digital decentralised clinical trials from a feasibility study assessing pacing interventions for long COVID.

Post COVID-19 condition or long COVID is highly prevalent and often debilitating, with key symptoms including fatigue, breathlessness, and brain fog. There is currently a lack of evidence-based treatments for this highly complex syndrome. There is a need for clinical trial platforms to rapidly evaluate nonpharmacological treatments to support affected individuals with symptom management.

Clinical decision support systems for maternity care: a systematic review and meta-analysis.

Background: The use of Clinical Decision Support Systems (CDSS) is increasing throughout healthcare and may be able to improve safety and outcomes in maternity care, but maternity care has key differences to other disciplines that complicate the use of CDSS. We aimed to identify evaluated CDSS and synthesise evidence of their impact on maternity care.

Methods: We conducted a systematic review for articles published before 24th May 2024 that described i) CDSS that ii) investigated the impact of their use iii) in maternity settings.