Imperial College London

Dr Thomas Cowling

Faculty of MedicineSchool of Public Health

Honorary Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 7456t.cowling Website

 
 
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Location

 

322Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
to

60 results found

Cowling TE, Forbes H, Wing K, Tazare J, Schultze A, Morton CE, Bacon S, MacKenna B, Walker AJ, Hulme W, Bates C, Mehrkar A, Curtis H, Evans D, Inglesby P, Davy S, Cockburn J, Parry J, Hester F, Harper S, Douglas IJ, Evans SJW, Bhaskaran K, Williamson EJ, Eggo RM, Goldacre B, Tomlinson LAet al., 2023, Association between living with children, vaccination, and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England during 2021–22, Wellcome Open Research, Vol: 8, Pages: 293-293

<ns4:p><ns4:bold>Background:</ns4:bold> Living with children has been associated with greater risks of SARS-CoV-2 infection, COVID-19 hospitalisation, and COVID-19 death. We examined how these associations varied during 2021–22 and according to the COVID-19 vaccination status of adults.</ns4:p><ns4:p> <ns4:bold>Methods</ns4:bold>: We carried out a population-based cohort study, with the approval of NHS England. Primary care data and pseudonymously-linked hospital and death records from England, between 20<ns4:sup>th</ns4:sup> December 2020 and 21<ns4:sup>st</ns4:sup> February 2022, were used for adults (≥18 years) registered at a general practice on 20<ns4:sup>th</ns4:sup> December 2020. Adjusted hazard ratios (HRs) for SARS-CoV-2 infection, COVID-19 hospitalisation, or COVID-19 death, by presence of children in the household were calculated.</ns4:p><ns4:p> <ns4:bold>Results: </ns4:bold>The cohort included 9,417,278 adults aged ≤65 years and 2,866,602 adults aged &gt;65 years. Adults aged ≤65 years living with children of any age (<ns4:italic>versus</ns4:italic> no children) had greater risks of SARS-CoV-2 infection and COVID-19 hospitalisation (but not COVID-19 death), both when schools were open and closed (<ns4:italic>e.g.</ns4:italic> HR=1.50, 95% CI:1.49-1.51, for SARS-CoV-2 infection in the ‘Omicron dominant’ period, when schools were open, in adults living with children aged 0–11 years only). These associations also existed for adults aged &gt;65 years, and there was some evidence that adults living with children also had greater risks of COVID-19 death. Vaccinated adults living with children had greater risks of SARS-CoV-2 infection, but lower risks of COVID-19 hospitalisation and death, than unvaccinated adults not living with children.</ns4:p><ns4:p> <ns4:bold>Conclusions<

Journal article

Fankhauser CD, Ali A, Cowling TE, Nossiter J, Sujenthiran A, Berry B, Morris M, Aggarwal A, Payne H, Clarke NWet al., 2023, A low prostate specific antigen predicts a worse outcome in high but not in low/intermediate-grade prostate cancer, EUROPEAN JOURNAL OF CANCER, Vol: 181, Pages: 70-78, ISSN: 0959-8049

Journal article

Boyle JM, van der Meulen J, Kuryba A, Cowling TE, Booth C, Fearnhead NS, Braun MS, Walker K, Aggarwal Aet al., 2023, Measuring variation in the quality of systemic anti-cancer therapy delivery across hospitals: A national population- based evaluation, EUROPEAN JOURNAL OF CANCER, Vol: 178, Pages: 191-204, ISSN: 0959-8049

Journal article

Ivanics T, Wallace D, Abreu P, Claasen MPAW, Callaghan C, Cowling T, Walker K, Heaton N, Mehta N, Sapisochin G, van der Meulen Jet al., 2022, Survival After Liver Transplantation: An International Comparison Between the United States and the United Kingdom in the Years 2008-2016, TRANSPLANTATION, Vol: 106, Pages: 1390-1400, ISSN: 0041-1337

Journal article

Boyle JM, Cowling TE, Kuryba A, Fearnhead NS, van der Meulen J, Braun MS, Walker K, Aggarwal Aet al., 2022, Development and validation of a coding framework to identify severe acute toxicity from systemic anti-cancer therapy using hospital administrative data, CANCER EPIDEMIOLOGY, Vol: 77, ISSN: 1877-7821

Journal article

Parry MG, Skolarus TA, Nossiter J, Sujenthiran A, Morris M, Cowling TE, Berry B, Aggarwal A, Payne H, Cathcart P, Clarke NW, van der Meulen Jet al., 2022, Urinary incontinence and use of incontinence surgery after radical prostatectomy: a national study using patient-reported outcomes, BJU INTERNATIONAL, Vol: 130, Pages: 84-91, ISSN: 1464-4096

Journal article

Wallace D, Cowling TE, Suddle A, Gimson A, Rowe I, Callaghan C, Sapisochin G, Ivanics T, Claasen M, Mehta N, Heaton N, van der Meulen J, Walker Ket al., 2022, National time trends in mortality and graft survival following liver transplantation from circulatory death or brainstem death donors, BRITISH JOURNAL OF SURGERY, Vol: 109, Pages: 79-88, ISSN: 0007-1323

Journal article

Briggs G, Wallace D, Flasche S, Walker K, Cowling T, Heaton N, van der Meulen J, Samyn M, Joshi Det al., 2021, Inferior outcomes in young adults undergoing liver transplantation - a UK and Ireland cohort study, TRANSPLANT INTERNATIONAL, Vol: 34, Pages: 2274-2285, ISSN: 0934-0874

Journal article

Boyle JM, Kuryba A, Cowling TE, van der Meulen J, Fearnhead NS, Walker K, Braun MS, Aggarwal Aet al., 2021, Survival outcomes associated with completion of adjuvant oxaliplatin-based chemotherapy for stage III colon cancer: A national population-based study, INTERNATIONAL JOURNAL OF CANCER, Vol: 150, Pages: 335-346, ISSN: 0020-7136

Journal article

Nossiter J, Morris M, Cowling TE, Parry MG, Sujenthiran A, Aggarwal A, Payne H, van der Meulen J, Clarke NW, Cathcart Pet al., 2021, Hospital volume and outcomes after radical prostatectomy: a national population-based study using patient-reported urinary continence and sexual function, PROSTATE CANCER AND PROSTATIC DISEASES, ISSN: 1365-7852

Journal article

Wallace D, Cowling TE, Walker K, Suddle A, Gimson A, Rowe I, Callaghan C, Heaton N, van der Meulen J, Bernal Wet al., 2021, The Impact of Performance Status on Length of Hospital Stay and Clinical Complications Following Liver Transplantation, TRANSPLANTATION, Vol: 105, Pages: 2037-2044, ISSN: 0041-1337

Journal article

Ivanics T, Wallace D, Abreu P, Heaton N, Cowling T, Walker K, Mehta N, van der Meulen JHP, Sapisochin Get al., 2021, Survival after liver transplantation; an international comparison between the United States and the United Kingdom and Ireland, International Congress of ILTS, ELITA and LICAGE, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 140-140, ISSN: 0041-1337

Conference paper

Boyle JM, Kuryba A, Braun MS, Aggarwal A, van der Meulen J, Cowling TE, Walker Ket al., 2021, Validity of chemotherapy information derived from routinely collected healthcare data: A national cohort study of colon cancer patients, CANCER EPIDEMIOLOGY, Vol: 73, ISSN: 1877-7821

Journal article

Parry MG, Nossiter J, Sujenthiran A, Cowling TE, Patel RN, Morris M, Berry B, Cathcart P, Clarke NW, van der Meulen J, Aggarwal Aet al., 2021, In Reply to Langley et al., Int J Radiat Oncol Biol Phys, Vol: 110, Pages: 913-914

Journal article

Boyle JM, Kuryba A, Cowling TE, van der Meulen J, Fearnhead NS, Walker K, Braun M, Aggarwal Aet al., 2021, Real-world survival outcomes associated with completion of adjuvant chemotherapy for stage III colon cancer., Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X

Conference paper

Parry MG, Nossiter J, Sujenthiran A, Cowling TE, Patel RN, Morris M, Berry B, Cathcart P, Clarke NW, Payne H, van der Meulen J, Aggarwal Aet al., 2021, Impact of High-Dose-Rate and Low-Dose-Rate Brachytherapy Boost on Toxicity, Functional and Cancer Outcomes in Patients Receiving External Beam Radiation Therapy for Prostate Cancer: A National Population-Based Study, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol: 109, Pages: 1219-1229, ISSN: 0360-3016

Journal article

Parry MG, Nossiter J, Cowling TE, Sujenthiran A, Berry B, Cathcart P, Clarke NW, Payne H, van der Meulen J, Aggarwal Aet al., 2021, Patient-reported functional outcomes following external beam radiation therapy for prostate cancer with and without a high-dose rate brachytherapy boost: A national population-based study, RADIOTHERAPY AND ONCOLOGY, Vol: 155, Pages: 48-55, ISSN: 0167-8140

Journal article

Cowling TE, Cromwell DA, Bellot A, Sharples LD, van der Meulen Jet al., 2021, Logistic regression and machine learning predicted patient mortality from large sets of diagnosis codes comparably, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 133, Pages: 43-52, ISSN: 0895-4356

Journal article

Cowling TE, Cromwell DA, Sharples LD, van der Meulen Jet al., 2020, A novel approach selected small sets of diagnosis codes with high prediction performance in large healthcare datasets, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 128, Pages: 20-28, ISSN: 0895-4356

Journal article

Parry MG, Nossiter J, Cowling TE, Sujenthiran A, Berry B, Cathcart P, Clarke NW, Payne H, van der Meulen J, Aggarwal Aet al., 2020, Toxicity of Pelvic Lymph Node Irradiation With Intensity Modulated Radiation Therapy for High-Risk and Locally Advanced Prostate Cancer: A National Population-Based Study Using Patient-Reported Outcomes, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol: 108, Pages: 1196-1203, ISSN: 0360-3016

Journal article

Cowling TE, Bellot A, Boyle J, Walker K, Kuryba A, Galbraith S, Aggarwal A, Braun M, Sharples LD, van der Meulen Jet al., 2020, One-year mortality of colorectal cancer patients: development and validation of a prediction model using linked national electronic data, BRITISH JOURNAL OF CANCER, Vol: 123, Pages: 1474-1480, ISSN: 0007-0920

Journal article

Wallace D, Cowling TE, Walker K, Suddle A, Gimson A, Rowe I, Callaghan C, Sapisochin G, Mehta N, Heaton N, van der Meulen J, Wallace D, Cowling TE, Walker K, Suddle A, Gimson A, Rowe I, Callaghan C, Sapisochin G, Mehta N, Heaton N, Meulen JVDet al., 2020, Liver transplantation outcomes after transarterial chemotherapy for hepatocellular carcinoma, BRITISH JOURNAL OF SURGERY, Vol: 107, Pages: 1183-1191, ISSN: 0007-1323

Journal article

Berry B, Parry MG, Sujenthiran A, Nossiter J, Cowling TE, Aggarwal A, Cathcart P, Payne H, van der Meulen J, Clarke Net al., 2020, Comparison of complications after transrectal and transperineal prostate biopsy: a national population-based study, BJU INTERNATIONAL, Vol: 126, Pages: 97-103, ISSN: 1464-4096

Journal article

Wallace D, Cowling T, McPhail MJ, Brown SE, Aluvihare V, Suddle A, Auzinger G, Heneghan MA, Rowe IA, Walker K, Heaton N, van Der Meulen J, Bernal Wet al., 2020, Assessing the Time-Dependent Impact of Performance Status on Outcomes After Liver Transplantation, HEPATOLOGY, Vol: 72, Pages: 1341-1352, ISSN: 0270-9139

Journal article

Lee TY, Zhao Y, Atun R, Oldenburg B, McPake B, Tang S, Mercer S, Cowling T, Sum G, Qin VMet al., 2020, Physical multimorbidity, health service use and catastrophic health expenditure by socio-economic groups in China: a population-based panel data analysis, The Lancet Global Health, Vol: 8, Pages: e840-e849, ISSN: 2214-109X

Background Multimorbidity, the presence of two or more mental or physical chronic non-communicable diseases (NCDs), is a major challenge for the health system in China, which faces unprecedented ageing of its population. This study examined: (1) the distribution of physical multimorbidity in relation to socio-economic status, (2) the relationships between physical multimorbidity, healthcare service use, and catastrophic health expenditures, and (3) whether these relationships varied by socio-economic groups and social health insurance schemes. Methods Panel data study design utilized three waves of the nationally-representative China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, 2015), which included 11 718 participants aged ≥50 years, and 11 physical NCDs. Findings Overall, 62% of participants had physical multimorbidity in China in 2015. Multimorbidity increased with age, female gender, higher per capita household expenditure, and higher educational level. However, multimorbidity was more common in poorer regions compared with the most affluent regions. An additional chronic NCD was associated with an increase in the number of outpatient visits of 28.8% (IRR=1.29, 95% CI: 1.27 to 1.31), and days of hospitalisation (IRR=1.38, 95% CI: 1.35 to 1.41). There were similar effects in different socio-economic groups and among those covered by different social health insurance programmes. Overall, multimorbidity was associated with a substantially greater odds of experiencing CHE (AOR=1·29 for the overall population, 95% CI=1·26, 1·32). The effect of multimorbidity on catastrophic health expenditures persisted even among the higher socio-economic groups and those with more generous health insurance coverage.Interpretation Multimorbidity was associated with higher levels of health service use and greater financial burden. Concerted efforts are needed to reduce health inequalities that arise due to multimorbidity, and its adverse econom

Journal article

Parry MG, Cowling TE, Sujenthiran A, Nossiter J, Berry B, Cathcart P, Aggarwal A, Payne H, van der Meulen J, Clarke NW, Gnanapragasam VJet al., 2020, Risk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation, BMC MEDICINE, Vol: 18, ISSN: 1741-7015

Journal article

qin VM, McPake B, Raban M, Cowling T, Alshamsan R, Chia KS, Smith PC, Atun R, Lee TYet al., 2020, Rural and urban differences in health system performance among older Chinese adults: cross-sectional analysis of a national sample, BMC Health Services Research, Vol: 20, ISSN: 1472-6963

Background Despite improvement in health outcomes over the past few decades, china still experiences striking urban-rural health inequalities. There is limited research on the rural-urban differences in health system performance in China. Method We conducted a cross-sectional analysis to compare health system performance between rural and urban areas in five key domains of the health system: effectiveness, cost, access, patient-centredness and equity, using data from the WHO Study on Global AGEing and adult health (SAGE), China. Multiple logistic and linear regression models were used to assess the first four domains, adjusting for individual characteristics, and a relative index of inequality (RII) was used to measure the equity domain. Findings Compared to urban areas, rural areas had poorer performance in the management and control of hypertension and diabetes, with more than 50% lower odds of having breast (AOR= 0.44; 95% CI: 0.30, 0.64) and cervical cancer screening (AOR= 0.49; 95% CI: 0.29, 0.83). There was better performance in rural areas in the patient-centredness domain, with more than twice higher odds of getting prompt attention, respect, clarity of the communication with health provider and involvement in decision making of the treatment in inpatient care (AOR=2.56, 2.15, 2.28, 2.28). Although rural residents incurred relatively less out-of-pocket expenditures (OOPE) for outpatient and inpatient services than urban residents, they were more likely to incur catastrophic expenditures on health (AOR=1.30; 95% CI 1.16, 1.44). Wealth inequality was found in many indicators related to the effectiveness, costs and access domains in both rural and urban areas. Rural areas had greater inequalities in the management of hypertension and coverage of cervical cancer (RII=7.45 vs 1.64).ConclusionOur findings suggest that urban areas have achieved better prevention and management of non-communicable disease than rural areas, but access to healthcare was equivalent. A

Journal article

Boyle JM, Kuryba A, Cowling TE, Aggarwal A, Hill J, van der Meulen J, Walker K, Braun MSet al., 2020, Determinants of Variation in the Use of Adjuvant Chemotherapy for Stage III Colon Cancer in England, CLINICAL ONCOLOGY, Vol: 32, Pages: E135-E144, ISSN: 0936-6555

Journal article

Wallace D, Cowling TE, Walker K, Suddle A, Rowe I, Callaghan C, Gimson A, Bernal W, Heaton N, van der Meulen Jet al., 2020, Short- and long-term mortality after liver transplantation in patients with and without hepatocellular carcinoma in the UK, BRITISH JOURNAL OF SURGERY, Vol: 107, Pages: 896-905, ISSN: 0007-1323

Journal article

Nossiter J, Sujenthiran A, Cowling TE, Parry MG, Charman SC, Cathcart P, Clarke NW, Payne H, van der Meulen J, Aggarwal Aet al., 2020, Patient-Reported Functional Outcomes After Hypofractionated or Conventionally Fractionated Radiation for Prostate Cancer: A National Cohort Study in England, JOURNAL OF CLINICAL ONCOLOGY, Vol: 38, Pages: 744-+, ISSN: 0732-183X

Journal article

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