Publications
229 results found
Prevost AT, Mason D, Griffin S, et al., 2007, Allowing for correlations between correlations in random-effects meta-analysis of correlation matrices, PSYCHOLOGICAL METHODS, Vol: 12, Pages: 434-450, ISSN: 1082-989X
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- Citations: 11
Eborall HC, Griffin SJ, Prevost AT, et al., 2007, Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial, BMJ-BRITISH MEDICAL JOURNAL, Vol: 335, Pages: 486-489, ISSN: 1756-1833
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- Citations: 103
Emery J, Morris H, Goodchild R, et al., 2007, The GRAIDS trial: A cluster randomised controlled trial of computer decision support for the management of familial cancer risk in primary care, British Journal of Cancer, Vol: 97, Pages: 486-493, ISSN: 0007-0920
The objective was to evaluate the effect of an assessment strategy using the computer decision support system (the GRAIDS software), on the management of familial cancer risk in British general practice in comparison with best current practice. The design included cluster randomised controlled trial, and involved forty-five general practice teams in East Anglia, UK. Randomised to GRAIDS (Genetic Risk Assessment on the Internet with Decision Support) support (intervention n=23) or comparison (n=22). Training in the new assessment strategy and access to the GRAIDS software (GRAIDS arm) was conducted, compared with an educational session and guidelines about managing familial breast and colorectal cancer risk (comparison) were mailed. Outcomes were measured at practice, practitioner and patient levels. The primary outcome measure, at practice level, was the proportion of referrals made to the Regional Genetics Clinic for familial breast or colorectal cancer that were consistent with referral guidelines. Other measures included practitioner confidence in managing familial cancer (GRAIDS arm only) and, in patients: cancer worry, risk perception and knowledge about familial cancer. There were more referrals to the Regional Genetics Clinic from GRAIDS than comparison practices (mean 6.2 and 3.2 referrals per 10 000 registered patients per year; mean difference 3.0 referrals; 95% confidence interval (CI) 1.2–4.8; P=0.001); referrals from GRAIDS practices were more likely to be consistent with referral guidelines (odds ratio (OR)=5.2; 95% CI 1.7–15.8, P=0.006). Patients referred from GRAIDS practices had lower cancer worry scores at the point of referral (mean difference −1.44 95% CI −2.64 to −0.23, P=0.02). There were no differences in patient knowledge about familial cancer. The intervention increased GPs' confidence in managing familial cancer. Compared with education and mailed guidelines, assessment including computer decision suppor
D'Vaz AP, Ostor AJK, Speed CA, et al., 2006, Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial, RHEUMATOLOGY, Vol: 45, Pages: 566-570, ISSN: 1462-0324
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- Citations: 51
Cross JJ, Baguley DM, Antoun NM, et al., 2006, Reproducibility of volume measurements of vestibular schwannomas - a preliminary study, CLINICAL OTOLARYNGOLOGY, Vol: 31, Pages: 123-129, ISSN: 1749-4478
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- Citations: 29
Braithwaite D, Emery J, Walter F, et al., 2006, Psychological impact of genetic counseling for familial cancer: A systematic review and meta-analysis, FAMILIAL CANCER, Vol: 5, Pages: 61-75, ISSN: 1389-9600
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- Citations: 72
Baguley DM, Bird J, Humphriss RL, et al., 2006, The evidence base for the application of contralateral bone anchored hearing aids in acquired unilateral sensorineural hearing loss in adults, CLINICAL OTOLARYNGOLOGY, Vol: 31, Pages: 6-14, ISSN: 1749-4478
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- Citations: 83
Koo BC, Ng CS, U-King-Im J, et al., 2006, Minimal preparation CT for the diagnosis of suspected colorectal cancer in the frail and elderly patient, CLINICAL RADIOLOGY, Vol: 61, Pages: 127-139, ISSN: 0009-9260
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- Citations: 15
Shetty A, Loddo M, Fanshawe T, et al., 2005, DNA replication licensing and cell cycle kinetics of normal and neoplastic breast, British Journal of Cancer, Vol: 93, Pages: 1295-1300, ISSN: 0007-0920
Mcm2–7 (MCM) proteins are part of the origin licensing machinery that regulates initiation of DNA replication. Geminin is a licensing repressor and prevents reinitiation of DNA replication during S–G2–M phase by blocking reloading of Mcm2–7 at replication origins. Here, we have analysed these replication licensing factors (RLFs) to determine whether the pathway becomes deregulated during mammary carcinogenesis, and have assessed their potential value as prognostic markers. Protein expression profiles were generated for Ki67, Mcm2, geminin, HER-2, ER and PR in a series of reduction mammoplasty (n=18) and breast cancer specimens (n=120), and compared to clinicopathological parameters. A large proportion of epithelial cells of the terminal duct lobular unit reside in a primed ‘replication licensed’ but not proliferating state. This state is characterised by Mcm2 expression and absence of Ki67 and the S/G2/M marker geminin. In breast cancers, increasing tumour grade is associated with increased Ki67, Mcm2 and geminin expression. The Mcm2/Ki67 ratio decreases through the grades, indicating a shift from a predominantly licensed state to an actively proliferating state. This shift is associated with an increase in the geminin/Ki67 ratio, signifying a shortening of G1 phase in breast cancer cells. Ki67, Mcm2 and the Mcm2/Ki67 ratio are statistically significantly associated with the Nottingham Prognostic Index (NPI), but geminin and the geminin/Ki67 ratio are not. Ki67, Mcm2 and Mcm2/Ki67 are highly correlated with one another, with Mcm2 being the single most important predictor of NPI score (P<0.001). However, only 12% of variation in NPI is explained by Mcm2, as the labelling index for this marker is approaching 100% for many of the high-grade tumours. The origin licensing phenotypes of normal breast and breast cancers therefore relate to their cellular differentiation status, and high-level MCM expression in more poorly differentiat
Kingsbury SR, Loddo M, Fanshawe T, et al., 2005, Repression of DNA replication licensing in quiescence is independent of geminin and may define the cell cycle state of progenitor cells, EXPERIMENTAL CELL RESEARCH, Vol: 309, Pages: 56-67, ISSN: 0014-4827
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- Citations: 42
Östör AJK, Richards CA, Prevost AT, et al., 2005, Diagnosis and relation to general health of shoulder disorders presenting to primary care, RHEUMATOLOGY, Vol: 44, Pages: 800-805, ISSN: 1462-0324
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- Citations: 221
Eward KL, Obermann EC, Shreeram S, et al., 2004, DNA replication licensing in somatic and germ cells, JOURNAL OF CELL SCIENCE, Vol: 117, Pages: 5875-5886, ISSN: 0021-9533
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- Citations: 65
Williams K, Prevost AT, Griffin S, et al., 2004, The proactive trial protocol - a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766], BMC Public Health, Vol: 4, Pages: 1-12, ISSN: 1471-2458
BackgroundIncreasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem. While previous evaluations of interventions to increase physical activity have involved communities or individuals with established disease, less attention has been given to interventions for individuals at risk of disease.Methods/designProActiveaims to evaluate the efficacy of a theoretical, evidence- and family-based intervention programme to increase physical activity in a sedentary population, defined as being at-risk through having a parental family history of diabetes. Primary care diabetes or family history registers were used to recruit 365 individuals aged 30–50 years, screened for activity level. Participants were assigned by central randomisation to three intervention programmes: brief written advice (comparison group), or a psychologically based behavioural change programme, delivered either by telephone (distance group) or face-to-face in the family home over one year. The protocol-driven intervention programme is delivered by trained facilitators, and aims to support increases in physical activity through the introduction and facilitation of a range of self-regulatory skills (e.g. goal setting). The primary outcome is daytime energy expenditure and its ratio to resting energy expenditure, measured at baseline and one year using individually calibrated heart rate monitoring. Secondary measures include self-report of individual and family activity, psychological mediators of behaviour change, physiological and biochemical correlates, acceptability, and costs, measured at baseline, six months and one year. The primary intention to treat analysis will compare groups at one-year post randomisation. Estimation of the impact on diabetes incidence will be modelled using data from a parallel ten-year cohort study using similar measures.DiscussionProActiveis the first efficacy trial of an intervention programme to promo
Ostor AJK, Richards CA, Prevost AT, et al., 2004, Interrater reproducibility of clinical tests for rotator cuff lesions, ANNALS OF THE RHEUMATIC DISEASES, Vol: 63, Pages: 1288-1292, ISSN: 0003-4967
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- Citations: 42
Williams GH, Swinn R, Prevost AT, et al., 2004, Diagnosis of oesophageal cancer by detection of minichromosome maintenance 5 protein in gastric aspirates, British Journal of Cancer, Vol: 91, Pages: 714-719, ISSN: 0007-0920
Symptomatic oesophageal cancer is usually advanced and the prognosis poor. Lethality of symptomatic oesophageal cancer has motivated screening for these diseases earlier in their evolution, but reliable methods for early diagnosis remain elusive. We have demonstrated that dysregulated expression of minichromosome maintenance (MCM) proteins 2–7 is characteristic of early epithelial carcinogenesis, and that these key DNA replication initiation factors can be used as diagnostic markers for cervical and genito-urinary tract cancer. In this study, we investigated whether minichromosome maintenance protein 5 (Mcm5) can be used to detect oesophageal cancer cells in gastric aspirates. Two monoclonal antibodies raised against His-tagged human Mcm5 were used in a time-resolved immunofluorometric assay to measure Mcm5 levels in cells isolated from gastric aspirates of 40 patients undergoing gastroscopy for suspected or known oesophageal carcinoma or symptoms of dyspepsia. The test discriminated with high specificity and sensitivity between patients with and without oesophageal cancer (85% sensitivity (95% confidence interval (CI)=62–97%), 85% specificity (CI=66–96%)), as demonstrated by the large area under the receiver operating characteristics curve (0.93 (95% CI=0.85–0.99)). Elevated levels of Mcm5 in gastric aspirates are highly predictive of oesophageal cancer. This simple test for oesophageal cancer is readily automated with potential applications in primary diagnosis, surveillance and screening.
Sparkes V, Prevost AT, Hunter JO, et al., 2004, Can symptoms alone identify patients who are likely to have musculoskeletal etiology for their abdominal pain?, Evidence-Based Gastroenterology, Vol: 5, Pages: 48-49, ISSN: 1527-8557
Turner RA, Prevost AT, Thompson SG, 2004, Allowing for imprecision of the intracluster correlation coefficient in the design of cluster randomized trials, STATISTICS IN MEDICINE, Vol: 23, Pages: 1195-1214, ISSN: 0277-6715
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- Citations: 41
Braithwaite D, Emery J, Walter F, et al., 2004, Psychological impact of genetic counseling for familial cancer: A systematic review and meta-analysis, JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, Vol: 96, Pages: 122-133, ISSN: 0027-8874
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- Citations: 123
Dowson J, Bazanis E, Rogers R, et al., 2004, Impulsivity in patients with borderline personality disorder, COMPREHENSIVE PSYCHIATRY, Vol: 45, Pages: 29-36, ISSN: 0010-440X
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- Citations: 37
Sparkes V, Prevost AT, Hunter JO, 2003, Derivation and identification of questions that act as predictors of abdominal pain of musculoskeletal origin., Eur J Gastroenterol Hepatol, Vol: 15, Pages: 1021-1027, ISSN: 0954-691X
OBJECTIVE: Although most causes of abdominal pain have a visceral origin, the musculoskeletal system must be considered when the cause is not obvious. This prospective study aimed to identify questions that would aid the diagnosis of patients with abdominal pain of musculoskeletal origin. DESIGN: Assessment of consecutive patients with abdominal pain recruited from gastroenterological outpatient clinics to develop diagnostic pointers to identify abdominal pain arising from musculoskeletal disorders. PARTICIPANTS: Subjects with benign abdominal pain, with or without a change in bowel habit, were recruited from gastroenterological clinics. Patients with inflammatory or neoplastic disease were excluded. SETTING: The study was conducted in the Physiotherapy Department, Addenbrooke's NHS Trust Hospital, Cambridge. MAIN OUTCOME MEASURES: A set of questions developed to indicate a musculoskeletal cause of a patient's abdominal symptoms. RESULTS The questions 'Does taking a deep breath aggravate your symptoms?' and 'Does twisting your back aggravate your symptoms?' had a significant positive indication of abdominal symptoms of musculoskeletal origin. The questions 'Has there been any change in bowel habit since onset of your symptoms?', 'Does eating foods aggravate your symptoms?' and 'Has there been any weight change since onset of symptoms?' had a significant negative indication for abdominal symptoms not of musculoskeletal origin. A combination of these questions gave 96% specificity and 67% sensitivity. CONCLUSION: These questions may help with the early identification of patients with abdominal pain of musculoskeletal origin and will be tested in further studies.
Iles R, Legh-Smith J, Drummond M, et al., 2003, Economic evaluation of Tobramycin nebuliser solution in cystic fibrosis., J Cyst Fibros, Vol: 2, Pages: 120-128, ISSN: 1569-1993
BACKGROUND: The cost effectiveness of inhaled TOBIR tobramycin nebuliser solution (TNS) in CF and chronic pulmonary Pseudomonas aeruginosa infection has been shown in US but not in European studies. METHODS: An economic evaluation of TNS was undertaken in children and adults. Lung function and resource utilisation were recorded for 24 months before and during TNS therapy. Interventions were costed. RESULTS: Forty-one patients received TNS; 30 of them matched with a paired control on usual therapy. TNS cases received more inhaled and IV antibiotics in the year before TNS than controls, and were hospitalised more. In the TNS treated group mean days in hospital before and after (change) were 32.0, 24.2 (-7.8); days on IV antibiotics 55.4, 38.9 (-16.4); total cost 22,102 pounds, 28,394 pounds (+ 6292 pounds), composed of cost of TNS 0 pounds, 10,010 pounds (+ 10,010 pounds), cost of hospitalisation 10,897 pounds, 8552 pounds (- 2345 pounds), cost of drugs 11,205 pounds, 9832 pounds (- 1374 pounds). In 19 patients aged < 18 the change in days hospitalised was -10.7 and days on IVs -20.2. Incremental cost was 3830 pounds. CONCLUSIONS: TNS was associated with clinically and socially important reductions of hospital attendances and parenteral antibiotics. This would improve patients' quality of life and reduce interference with work and schooling. Its maximal acquisition cost of 10,010 pounds may be reduced by delays in prescribing and dispensing, and was offset by savings of approximately 3500-6200 pounds.
Brown PJB, Warmington V, Laurence M, et al., 2003, A methodology for the functional comparison of coding schemes in primary care, A British Computer Society Conference 2003, Publisher: BCS, The Chartered Institute for IT, Pages: 145-148, ISSN: 1476-0320
There has been massive investment in the development of clinical terminologies for use in electronic patient records. However, there has been little published evidence for the added value for primary care that implementation of such a terminology would offer. This paper outlines a methodology that has been used to compare two existing coding schemes (Read codes 5 byte set and Clinical Terms Version 3-CTV3) and demonstrates their relative performance using a certainty-agreement diagram. In the study described, CTV3 offers improved accuracy and consistency with improved usability. The potential advantages of the recently released terminology, SNOMED Clinical Terms, are briefly considered in this context.
Brown PJB, Warmington V, Laurence M, et al., 2003, Randomised crossover trial comparing the performance of Clinical Terms Version 3 and Read Codes 5 byte set coding schemes in general practice, BMJ-BRITISH MEDICAL JOURNAL, Vol: 326, Pages: 1127-1130, ISSN: 1756-1833
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- Citations: 20
Whitford DL, Griffin SJ, Prevost AT, 2003, Influences on the variation in prevalence of type 2 diabetes between general practices: practice, patient or socioeconomic factors?, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 53, Pages: 9-14, ISSN: 0960-1643
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- Citations: 30
Ng CS, Doyle TC, Pinto EM, et al., 2002, Evaluation of CT in identifying colorectal carcinoma in the frail and disabled patient, EUROPEAN RADIOLOGY, Vol: 12, Pages: 2988-2997, ISSN: 0938-7994
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- Citations: 22
Bister D, Edler RJ, Tom BDM, et al., 2002, Natural head posture - considerations of reproducibility, EUROPEAN JOURNAL OF ORTHODONTICS, Vol: 24, Pages: 457-470, ISSN: 0141-5387
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- Citations: 31
Stoeber K, Swinn R, Prevost AT, et al., 2002, Diagnosis of genito-urinary tract cancer by detection of minichromosome maintenance 5 protein in urine sediments, JOURNAL OF THE NATIONAL CANCER INSTITUTE, Vol: 94, Pages: 1071-1079, ISSN: 0027-8874
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- Citations: 101
Parker TJ, Woolner JT, Prevost AT, et al., 2001, Irritable bowel syndrome: is the search for lactose intolerance justified?, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 13, Pages: 219-225, ISSN: 0954-691X
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- Citations: 83
Delaney G, Gebski V, Langlands A, 2001, To BTE or not BTE: That is the question, CLINICAL ONCOLOGY, Vol: 13, Pages: 311-312, ISSN: 0936-6555
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- Citations: 1
Burnet NG, Routsis DS, Murrell P, et al., 2001, A tool to measure radiotherapy complexity and workload: Derivation from the basic treatment equivalent (BTE) concept, CLINICAL ONCOLOGY, Vol: 13, Pages: 14-23, ISSN: 0936-6555
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- Citations: 21
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