Publications
570 results found
Spencer S, Quint J, Morton B, 2023, Use of hospital services by patients with chronic conditions in sub-Saharan Africa: a systematic review and meta-analysis, Bulletin of the World Health Organization, ISSN: 0042-9686
costello R, Quint J, 2023, Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY, EClinicalMedicine, ISSN: 2589-5370
Massen GM, Stewart I, Quint JK, 2023, Response to: Consensus and agreements on the classification of fibrotic diseases, QJM: an international journal of medicine, ISSN: 1460-2393
Pikoula M, Kallis C, Madjiheurem S, et al., 2023, Evaluation of data processing pipelines on real-world electronic health records data for the purpose of measuring patient similarity, PLOS ONE, Vol: 18, ISSN: 1932-6203
Shah R, 2023, Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review, BMJ Open Respiratory Research, Vol: 10, Pages: 1-11, ISSN: 2052-4439
Interstitial lung disease (ILD) is a collective term representing a diverse group of pulmonary fibrotic and inflammatory conditions. Due to the diversity of ILD conditions, paucity of guidance and updates to diagnostic criteria over time, it has been challenging to precisely determine ILD incidence and prevalence. This systematic review provides a synthesis of published data at a global level and highlights gaps in the current knowledge base. Medline and Embase databases were searched systematically for studies reporting incidence and prevalence of various ILDs. Randomised controlled trials, case reports and conference abstracts were excluded. 80 studies were included, the most described subgroup was autoimmune-related ILD, and the most studied conditions were rheumatoid arthritis (RA)-associated ILD, systemic sclerosis associated (SSc) ILD and idiopathic pulmonary fibrosis (IPF). The prevalence of IPF was mostly established using healthcare datasets, whereas the prevalence of autoimmune ILD tended to be reported in smaller autoimmune cohorts. The prevalence of IPF ranged from 7 to 1650 per 100 000 persons. Prevalence of SSc ILD and RA ILD ranged from 26.1% to 88.1% and 0.6% to 63.7%, respectively. Significant heterogeneity was observed in the reported incidence of various ILD subtypes. This review demonstrates the challenges in establishing trends over time across regions and highlights a need to standardise ILD diagnostic criteria.PROSPERO registration number: CRD42020203035.
Zheng B, Vivaldi G, Daines L, et al., 2023, Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls, The Lancet Regional Health. Europe, Vol: 29, Pages: 1-13, ISSN: 2666-7762
BackgroundThe risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea.MethodsWe used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.FindingsWe included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).InterpretationFactors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19.FundingPHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publica
Massen GM, Allen RJ, Leavy OC, et al., 2023, Classifying the unclassifiable – A Delphi study to reach consensus on the fibrotic nature of diseases, QJM: an international journal of medicine, Vol: 116, Pages: 429-435, ISSN: 1460-2393
BackgroundTraditionally, clinical research has focused on individual fibrotic diseases or fibrosis in a particular organ. However, it is possible for people to have multiple fibrotic diseases. While multi-organ fibrosis may suggest shared pathogenic mechanisms, yet there is no consensus on what constitutes a fibrotic disease and therefore fibrotic multimorbidity.AimA Delphi study was performed to reach consensus on which diseases may be described as fibrotic.MethodsParticipants were asked to rate a list of diseases, sub-grouped according to eight body regions, as ‘fibrotic manifestation always present’, ‘can develop fibrotic manifestations’, ‘associated with fibrotic manifestations’ or ‘not fibrotic nor associated’. Classifications of ‘fibrotic manifestation always present’ and ‘can develop fibrotic manifestations’ were merged and termed ‘fibrotic’. Clinical consensus was defined according to the interquartile range, having met a minimum number of responses. Clinical agreement was used for classification where diseases did not meet the minimum number of responses (required for consensus measure), were only classified if there was 100% consensus on disease classification.ResultsAfter consulting experts, searching the literature and coding dictionaries, a total of 323 non-overlapping diseases which might be considered fibrotic were identified; 92 clinical specialists responded to the first round of the survey. Over three survey rounds, 240 diseases were categorized as fibrotic via clinical consensus and 25 additional diseases through clinical agreement.ConclusionUsing a robust methodology, an extensive list of diseases was classified. The findings lay the foundations for studies estimating the burden of fibrotic multimorbidity, as well as investigating shared mechanisms and therapies.
Halpin DMG, Dickens AP, Skinner D, et al., 2023, Identification of key opportunities for optimising the management of high-risk COPD patients in the UK using the CONQUEST quality standards: an observational longitudinal study, LANCET REGIONAL HEALTH-EUROPE, Vol: 29, ISSN: 2666-7762
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- Citations: 2
Sureshkumar S, Mustapha F, Yusoff H, et al., 2023, An Online Survey of the Perceptions of Clinical and Non-Clinical Professionals on Healthcare for Non-Communicable Diseases and COVID-19 Measures During the Pandemic in Malaysia, INTERNATIONAL JOURNAL OF PUBLIC HEALTH, Vol: 68, ISSN: 1661-8556
Meme H, Amukoye E, Bowyer C, et al., 2023, Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya, THORAX, ISSN: 0040-6376
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- Citations: 2
Zhang X, Ding R, Zhang Z, et al., 2023, Medication adherence in people with asthma: a qualitative systematic review of patient and health professional perspectives, Journal of Asthma and Allergy, Vol: 16, Pages: 515-527, ISSN: 1178-6965
Background: Increased medication adherence leads to better asthma control and health outcomes. However, many studies have found that patient adherence to maintenance medication is poor.Aim: We undertook a meta-synthesis of qualitative studies, to investigate asthma patient and healthcare professionals’ perspectives of medication adherence.Methods: This systematic review was reported by following the PRISMA guidelines. The Joanna Briggs Institute (JBI) meta-aggregative approach was used for the qualitative synthesis. The protocol was registered in PROSPERO (CRD42022346831).Results: In total, 12 articles were included in the review. These articles reported findings from 433 participants in total, which included 315 patients and 118 healthcare professionals. Four synthesised findings with sub-themes were identified from the reviewed studies. These synthesised findings were described as: 1) The role of relationship and communication with/between Healthcare Professionals in medication adherence; 2) Insufficient information from Healthcare Professionals acting as a barrier for adherence; 3) How patient’s attitude/beliefs effect their adherence to medication; and 4) Patients’ personal behaviour and other relevant barriers.Conclusion: The synthesized findings provide a strong evidence-base of patient and health professionals’ perspectives and behaviours toward medication adherence, which helps to identify and address non-adherence. Healthcare providers can use these findings to support patients’ adherence to asthma medications. The findings suggest that empowering people to make informed decisions around medication adherence rather than “adherence controlling” by health professionals is very important. Effective dialogue and appropriate education are critical approaches to increase medication adherence.
Zhang X, Ellis A, Ioannides AE, et al., 2023, Survey-identified Experiences of Pre-diagnosis and Diagnosis Processes Amongst Patients With COPD, Asthma, Interstitial Lung Disease and Bronchiectasis, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Stone P, Osen M, Ellis A, et al., 2023, Prevalence and Description of Chronic Obstructive Pulmonary Disease Cohorts From 2000 to 2019, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Whittaker H, Rothnie KJ, Quint JK, 2023, Investigating the Impact of Using Definitions of Exacerbation of COPD of Varying Validity on Study Findings in Routinely Collected Electronic Healthcare Records, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Morgan AD, Massen GM, George PM, et al., 2023, Use of Inhaled Corticosteroids and the Risk of Mortality and Hospitalisation for Pneumonia in a UK Cohort of Patients With Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Cook S, Hatam S, Scully S, et al., 2023, Comparing the Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD) in England and Wales (2004-2019) Using a Harmonised Approach in the Clinical Practice Research Datalink (CPRD) and Secure Anonymised Information Linkage (SAIL) Databank, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Massen G, Morgan AD, George PM, et al., 2023, Does Antacid Therapy in Idiopathic Pulmonary Fibrosis Patients Increase Risk of Pneumonia? An Observational Cohort Study, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Shah R, Morgan AD, George PM, et al., 2023, Validation of Coding of Idiopathic Pulmonary Fibrosis in Primary and Secondary Health Records in the UK, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Ioannides AE, Whittaker H, Quint JK, 2023, The Association Between Inhaled Corticosteroid Therapy and Future Cardiovascular Events in People With Chronic Obstructive Pulmonary Disease (COPD), International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Das N, Happaerts S, Gyselinck I, et al., 2023, Collaboration between explainable artificial intelligence and pulmonologists improves the accuracy of pulmonary function test interpretation, European Respiratory Journal, Vol: 61, ISSN: 0903-1936
Background Few studies have investigated the collaborative potential between artificial intelligence (AI) and pulmonologists for diagnosing pulmonary disease. We hypothesised that the collaboration between a pulmonologist and AI with explanations (explainable AI (XAI)) is superior in diagnostic interpretation of pulmonary function tests (PFTs) than the pulmonologist without support.Methods The study was conducted in two phases, a monocentre study (phase 1) and a multicentre intervention study (phase 2). Each phase utilised two different sets of 24 PFT reports of patients with a clinically validated gold standard diagnosis. Each PFT was interpreted without (control) and with XAI's suggestions (intervention). Pulmonologists provided a differential diagnosis consisting of a preferential diagnosis and optionally up to three additional diagnoses. The primary end-point compared accuracy of preferential and additional diagnoses between control and intervention. Secondary end-points were the number of diagnoses in differential diagnosis, diagnostic confidence and inter-rater agreement. We also analysed how XAI influenced pulmonologists’ decisions.Results In phase 1 (n=16 pulmonologists), mean preferential and differential diagnostic accuracy significantly increased by 10.4% and 9.4%, respectively, between control and intervention (p<0.001). Improvements were somewhat lower but highly significant (p<0.0001) in phase 2 (5.4% and 8.7%, respectively; n=62 pulmonologists). In both phases, the number of diagnoses in the differential diagnosis did not reduce, but diagnostic confidence and inter-rater agreement significantly increased during intervention. Pulmonologists updated their decisions with XAI's feedback and consistently improved their baseline performance if AI provided correct predictions.Conclusion A collaboration between a pulmonologist and XAI is better at interpreting PFTs than individual pulmonologists reading without XAI support or XAI alone.
Adamson A, Kallis C, Douglas I, et al., 2023, Accuracy of the Recording of Pneumonia Events in UK Electronic Healthcare Record Data in Patients With Chronic Obstructive Pulmonary Disease, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Whittaker H, Kallis C, Wood A, et al., 2023, Risk of Cardiovascular Events Post-COVID-19 in People With Pre-existing Chronic Respiratory Diseases, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Kallis C, Kaura A, Samuel N, et al., 2023, The Relationship Between Cardiac Troponin in Hospitalised Exacerbating Chronic Obstructive Pulmonary Disease (COPD) Patients With Major Adverse Cardiac Events (MACE) and COPD Readmissions, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
, 2023, 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG) (vol 43, pg 3618, 2022), EUROPEAN HEART JOURNAL, Vol: 44, Pages: 1312-1312, ISSN: 0195-668X
Ratnakumar R, Sabarwal K, Derbyshire J, et al., 2023, Developing a regional hub- and-spoke model for volumetric assessment of indeterminate pulmonary nodules supports efficient and effective management of pulmonary nodule pathways, Publisher: ELSEVIER IRELAND LTD, Pages: S6-S7, ISSN: 0169-5002
Nordon C, Rhodes K, Quint JK, et al., 2023, EXAcerbations of COPD and their OutcomeS on CardioVascular diseases (EXACOS-CV) Programme: protocol of multicountry observational cohort studies, BMJ OPEN, Vol: 13, ISSN: 2044-6055
Humbert M, Kovacs G, Hoeper MM, et al., 2023, 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension, GIORNALE ITALIANO DI CARDIOLOGIA, Vol: 24, Pages: E1-E116, ISSN: 1827-6806
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Ratnakumar R, Derbyshire J, Morris K, et al., 2023, Process mining as a research tool to evaluate care pathways for patients with an indeterminate pulmonary nodule demonstrates the high variability between patient pathways across a region, Publisher: ELSEVIER IRELAND LTD, Pages: S6-S6, ISSN: 0169-5002
Quint J, 2023, Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya, The Pan African Medical Journal, ISSN: 1937-8688
Stewart I, Molyneaux PL, Fabbri L, et al., 2023, Residual lung abnormalities following COVID-19 hospitalization: interim analysis of the UKILD Post-COVID study, American Journal of Respiratory and Critical Care Medicine, Vol: 207, Pages: 693-703, ISSN: 1073-449X
Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage.Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post–COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata.Methods: The PHOSP–COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP–COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up.Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83–155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05–1.40), percent predicted DlCO less than 80% (RR, 1.25; 95% CrI, 1.00–1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07–1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6–9.5), rising to 11.7% (95% CrI, 10.3–13.1) in the sensitivity analysis.Conclusions: Residual lung abnormalities were estimated in up to 11% of
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