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Aim: To establish and quantify the association between abuse‐deterrent formulation (ADF) oxycodone and 1‐year risk of opioid‐related harm. Design Propensity score‐matched cohort study of electronic medical records for years 2014–18, with patients followed up for 1 year after their index health‐care visit. Setting: More than 70 million patients from 56 US health‐care organizations. Participants: Patients aged 18–64 years at index health‐care visit with any indication for an oral opioid analgesic, with no past 12‐month history of oral oxycodone use or substance use disorder, and who were alive at the end of the 1‐year follow‐up (new episode of prescription oral ADF oxycodone [OxyContin], n = 45 045; new episode of non‐ADF oxycodone opioid preparation, n = 1 377 359). Measurements International Classification of Diseases diagnoses of any opioid‐related disorder or non‐fatal opioid poisoning within 1 year of the index health‐care visit. Pooled odds ratios (OR) with 95% confidence intervals (95% CI). Findings After propensity score matching, 89 802 patients with a mean age of 44 [standard deviation (SD) = 11] years (62% women, 68% white) were included. During 1‐year follow‐up, 1445 diagnoses of opioid use disorder or opioid poisoning occurred in the ADF oxycodone cohort (34.8/1000 person‐years) and 765 occurred in the non‐ADF oxycodone cohort (18.2/1000 person‐years). The odds of opioid‐related adverse outcomes were increased in the ADF oxycodone cohort compared with the non‐ADF oxycodone opioid cohort, including for opioid use disorders (OR = 2.02; 95% CI = 1.83, 2.23) and opioid poisoning (OR = 1.64 95% CI = 1.35, 1.99). Conclusions: Patients with a new prescription of abuse‐deterrent formulation oxycodone may be at increased risk of opioid‐related harm. [ABSTRACT FROM AUTHOR]

Objectives Concern has been raised in the rheumatology community regarding recent regulatory warnings that HCQ used in the coronavirus disease 2019 pandemic could cause acute psychiatric events. We aimed to study whether there is risk of incident depression, suicidal ideation or psychosis associated with HCQ as used for RA. Methods We performed a new-user cohort study using claims and electronic medical records from 10 sources and 3 countries (Germany, UK and USA). RA patients ≥18 years of age and initiating HCQ were compared with those initiating SSZ (active comparator) and followed up in the short (30 days) and long term (on treatment). Study outcomes included depression, suicide/suicidal ideation and hospitalization for psychosis. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate database-specific calibrated hazard ratios (HRs), with estimates pooled where I2 <40%. Results A total of 918 144 and 290 383 users of HCQ and SSZ, respectively, were included. No consistent risk of psychiatric events was observed with short-term HCQ (compared with SSZ) use, with meta-analytic HRs of 0.96 (95% CI 0.79, 1.16) for depression, 0.94 (95% CI 0.49, 1.77) for suicide/suicidal ideation and 1.03 (95% CI 0.66, 1.60) for psychosis. No consistent long-term risk was seen, with meta-analytic HRs of 0.94 (95% CI 0.71, 1.26) for depression, 0.77 (95% CI 0.56, 1.07) for suicide/suicidal ideation and 0.99 (95% CI 0.72, 1.35) for psychosis. Conclusion HCQ as used to treat RA does not appear to increase the risk of depression, suicide/suicidal ideation or psychosis compared with SSZ. No effects were seen in the short or long term. Use at a higher dose or for different indications needs further investigation. Trial registration Registered with EU PAS (reference no. EUPAS34497; http://www.encepp.eu/encepp/viewResource.htm? id=34498). The full study protocol and analysis source code can be found at https://github.com/ohdsi-studies/Covid19EstimationHydroxychloroquine2. [ABSTRACT FROM AUTHOR]

This article presents the findings from a study trip to Kaiser Permanente (KP), a private healthcare provider in the USA. The aim of the trip was to understand how healthcare integration is managed in KP and how this might help patients in the UK with motor neurone disease (MND). This article makes reference to the American and British healthcare systems, identifying the simple differences between health economies, and their impact on health care, with specific reference to MND. The trip was undertaken as part of the author's ongoing work on how patients with MND rate services delivered by the multidisciplinary team (MDT) in the UK. The author's community matron role involves caring for patients with long-term conditions (LTCs) including long-term neurological conditions (LTNCs). In executing this role and in service delivery to patients with LTNCs, specifically MND, the author noticed a lack of robust integration, highlighting the need to consider and address the various contributory factors. This article presents a literature review and analyses the role of the MDT including specialist neurological professionals in executing duties and in delivering healthcare services to patients diagnosed with MND. The implications for practice are also presented along with areas for practice development. [ABSTRACT FROM AUTHOR]

In this article the author discusses the article "Improving Quality and Safety of Care Using 'Technovigilance': An Ethnographic Case Study of Secondary Use of Data from an Electronic Prescribing and Decision Support System" by Mary Dixon-Woods et al. He is supportive of several points which are raised in Dixon-Woods et al.'s article and of having hospitals utilize technological tools to improve the quality and safety of medical care which they provide to patients.

The collection of perinatal data within Queensland, A ustralia, has traditionally been achieved via a paper form completed by midwives after each birth. Recently, with an increase in the use of e-health systems in healthcare, perinatal data collection has migrated to an online system. It is suggested that this move from paper to an ehealth platform has resulted in improvement to error rates, completion levels, timeliness of data transfer from healthcare institutions to the perinatal data collection and subsequent publication of data items. Worldwide, perinatal data are collected utilising a variety of methods, but essentially data are used for similar purposes: to monitor outcome patterns within obstetrics and midwifery. T his paper discusses current practice in relation to perinatal data collection worldwide and within Australia, with a specific focus on Queensland, highlights relevant issues for midwives, and points to the need for further research into the efficient use of an e-health platform for perinatal data collection. [ABSTRACT FROM AUTHOR]

The article discusses a study which analyzed the concept of personal health records (PHRs) in selected countries and Iran. Topics covered include the benefits of PHRs, the use of a descriptive-comparative method in investigating the gaps between Iran and more advanced countries and the need to develop the necessary knowledge and rules before PHRs can be profitably used in the health administration of a developing country.

The theme of the 2017 WCPG Meeting, "Genes in Context," highlights the essential insights that become apparent when individual risk genes are considered in the context of polygenic background, epigenetic modifications in the cell, and environmental conditions and development. Similarly, the large-scale collection of genetic material integrated with the increasing availability of expansive phenotype information ("phenome") from electronic medical records (EMR) allows a broader context in which to study the genetics of neuropsychiatric phenotypes. Identifying correlated phenotypes and assessing the broader role of implicated variants/genes are only a few of the many ways in which these studies could provide a unique lens through which to interpret genetic findings. The potential for these datasets to scale (e.g. 500k individuals for UK biobank) and the comprehensiveness of the captured phenome offers opportunities that are difficult to achieve in disease focused cohort studies. Initial work on these extraordinary datasets is already yielding exciting new findings with promising translational implications. Rigorous analysis of biobank data requires integrating multiple disciplines including genomics, epidemiology, informatics, ethics and the clinical domain of interest. We have assembled a diverse roster of researchers who bring expertise in these areas as speakers in this session. Co-chair Dr. Douglas Ruderfer, will introduce the session by presenting the opportunities, challenges and some initial successes of utilizing these resources. Next, Dr. Lea Davis will describe development of EMR-based algorithms for detection of neurodevelopmental disorders, results of an EMR-enabled biomarker discovery approach using Vanderbilt's 270,000 patient biobank (BioVU), and community-engaged efforts to develop a more complete understanding of genomic privacy concerns related to participation in biobanks. Dr. Gerome Breen will then discuss general applicability of using the 500k-individual UK Biobank, along with details of a study in anorexia nervosa. Dr. Beate St. Pourcain will describe new results from her work examining genetic factors that contribute to the developmental trajectory of behavioral traits using the Avon Longitudinal Study of Parents and Children (ALSPAC) data set, and highlight implications when assessing trait-disorder overlap. Finally, Dr. Zhengming Chen will describe results of ongoing PheWAS of functional variants to assess causal associations (e.g. alcohol) in the 500K-person Kadoorie Biobank. Following the speakers, Dr. Jordan Smoller will lead a discussion focused on efforts currently underway to combine biobank resources through the psychEMERGE consortium and future resources available from the NIH All of Us project. Topics for discussion include genome-informed machine learning approaches to prediction models, structural equation models using genetic relationship data in cohorts, challenges to algorithmic portability, and opportunities for immediate translation of genomic findings. Symposium attendees will become familiar with (a) potential resources that are available to them, (b) strategies for maximizing the utility of such resources, (c) challenges in utilizing these resources, and (d) ethical issues related to genomic privacy in the context of biobanks. Finally, attendees will learn about novel discoveries emerging from biobank and registry resources in the United States, United Kingdom, and China. [ABSTRACT FROM AUTHOR]

The article presents a debate on whether doctors should encourage their patients to record consultations in Great Britain. It states that recording the process will foster better practice and shared decision making for health care. However, it suggests that it could risk the doctor-patient relationship and could lead to defensive practice.

The article presents the study which examined the risk of falling in older individuals following hospital discharge. In the study, two logistic regression models were developed to analyze hospital readmission due to fall injury within two years after the index hospital discharge. The study was carried out in two hospitals in the New England region in the U.S.