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1. Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease and internally validated in a large UK birth cohort

Author: Mulick, AR, Mansfield, KE, Silverwood, RJ, Budu‐Aggrey, A, Roberts, A, Custovic, A, Pearce, N, Irvine, AD, Smeeth, L, Abuabara, K, and Langan, SM
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Genetics, 2.1 Biological and endogenous factors, Aetiology, Adolescent, Child, Child, Preschool, Dermatitis, Atopic, Eczema, Female, Filaggrin Proteins, Humans, Infant, Intermediate Filament Proteins, Longitudinal Studies, Male, Mutation, Severity of Illness Index, United Kingdom, Oncology and Carcinogenesis, Dermatology & Venereal Diseases, Clinical sciences
Abstract: BackgroundAtopic dermatitis (AD) disease activity and severity is highly variable during childhood. Early attempts to identify subtypes based on disease trajectory have assessed AD presence over time without incorporating severity.ObjectivesTo identify childhood AD subtypes from symptom severity and trajectories, and determine associations with genetic risk factors, comorbidities and demographic and environmental variables.MethodsWe split data from children in the Avon Longitudinal Study of Parents and Children birth cohort into development and validation sets. To identify subtypes, we ran latent class analyses in the development set on AD symptom reports up to age 14 years. We regressed identified subtypes on nongenetic variables in mutually adjusted, multiply imputed (genetic: unadjusted, complete case) multinomial regression analyses. We repeated analyses in the validation set and report confirmed results.ResultsThere were 11 866 children who contributed to analyses. We identified one Unaffected/Rare class (66% of children) and four AD subtypes: Severe-Frequent (4%), Moderate-Frequent (7%), Moderate-Declining (11%) and Mild-Intermittent (12%). Symptom patterns within the first two subtypes appeared more homogeneous than the last two. Filaggrin (FLG) null mutations, an AD polygenic risk score (PRS), being female, parental AD and comorbid asthma were associated with higher risk for some or all subtypes; FLG, AD-PRS and asthma associations were stronger along a subtype gradient arranged by increasing severity and frequency; FLG and AD-PRS further differentiated some phenotypes from each other.ConclusionsConsidering severity and AD trajectories leads to four well-defined and recognizable subtypes. The differential associations of risk factors among and between subtypes is novel and requires further research.
Published: 2021

2. Anxiety and Depression in People with Eczema or Psoriasis: A Comparison of Associations in UK Biobank and Linked Primary Care Data

Author: Matthewman J, Mansfield KE, Hayes JF, Adesanya EI, Smith CH, Roberts A, Langan SM, and Henderson AD
Subjects: eczema, psoriasis, anxiety, depression, ascertainment, cross-sectional study, data linkage, uk biobank, electronic health records, Infectious and parasitic diseases, RC109-216
Abstract: Julian Matthewman,1 Kathryn E Mansfield,1 Joseph F Hayes,2 Elizabeth I Adesanya,1 Catherine H Smith,3 Amanda Roberts,1 Sinéad M Langan,1 Alasdair D Henderson1 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 2Division of Psychiatry, University College London, London, UK; 3St John’s Institute of Dermatology, Kings College London, London, UKCorrespondence: Julian Matthewman, Email julian.matthewman1@lshtm.ac.ukIntroduction: Previous research has shown associations between eczema and psoriasis and anxiety and depression. We investigated whether associations are consistent across different settings of ascertainment for depression and anxiety, including interview and survey responses from UK Biobank (a large longitudinal cohort recruiting individuals aged 40– 69 years between 2006– 2010), and linked primary care data, with the aim of drawing more reliable conclusions through triangulation.Methods: In cross-sectional studies, we estimated associations between eczema or psoriasis and anxiety or depression, defining anxiety or depression as 1) self-reported previous diagnosis at UK Biobank recruitment interview; 2) PHQ-9/GAD-7 score indicating depression or anxiety from a UK Biobank mental health follow-up survey in 2016; and 3) diagnosis in linked primary care electronic health record data.Results: We analysed 230,047 people with linked Biobank and primary care data. We found poor agreement between the data sources for eczema, psoriasis, anxiety, and depression. Eg, 9474 had a previous eczema diagnosis in primary care data, 4069 self-reported previous eczema diagnosis at the UK biobank interview, and 1536 had eczema in both data sources (for depression 40,455; 13,320; and 9588 respectively). Having eczema or psoriasis (recorded in primary care or baseline interview) was associated with higher odds of anxiety and depression. Eg, the adjusted odds ratio for depression comparing those with eczema to those without was greater than 1 when defining the outcome from 1) the recruitment interview (1.36, 95% confidence interval 1.27– 1.45); 2) the follow-up survey (1.24, 1.09– 1.39), and 3) primary care records (1.56, 1.50– 1.62).Discussion: Our findings support increased prevalence of mental illness in people with psoriasis and eczema across multiple data sources, which should be considered in planning of mental health services. However, we found poor agreement in disease ascertainment between settings, with implications for data interpretation in electronic health records.Keywords: eczema, psoriasis, anxiety, depression, ascertainment, cross-sectional study, data linkage, UK Biobank, electronic health records
Published: 2023

3. Severe Mental Illness Among Adults with Atopic Eczema or Psoriasis: Population-Based Matched Cohort Studies within UK Primary Care

Author: Adesanya EI, Henderson AD, Matthewman J, Bhate K, Hayes JF, Mulick A, Mathur R, Smith C, Carreira H, Rathod SD, Langan SM, and Mansfield KE
Subjects: epidemiology, dermatology, psychology, Infectious and parasitic diseases, RC109-216
Abstract: Elizabeth I Adesanya,1 Alasdair D Henderson,1 Julian Matthewman,1 Ketaki Bhate,1 Joseph F Hayes,2 Amy Mulick,1 Rohini Mathur,1 Catherine Smith,3 Helena Carreira,1 Sujit D Rathod,4 Sinéad M Langan,1 Kathryn E Mansfield1 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; 2Division of Psychiatry, University College London, London, UK; 3St John’s Institute of Dermatology, Guys and St Thomas’ Foundation Trust and King’s College London, London, UK; 4Department of Population Health, London School of Hygiene & Tropical Medicine, London, UKCorrespondence: Elizabeth I Adesanya, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK, Email elizabeth.adesanya@lshtm.ac.ukBackground: Existing research exploring associations between atopic eczema (AE) or psoriasis, and severe mental illness (SMI – ie, schizophrenia, bipolar disorder, other psychoses) is limited, with longitudinal evidence particularly scarce. Therefore, temporal directions of associations are unclear. We aimed to investigate associations between AE or psoriasis and incident SMI among adults.Methods: We conducted matched cohort studies using primary care electronic health records (January 1997 to January 2020) from the UK Clinical Practice Research Datalink GOLD. We identified two cohorts: 1) adults (≥ 18 years) with and without AE and 2) adults with and without psoriasis. We matched (on age, sex, general practice) adults with AE or psoriasis with up to five adults without. We used Cox regression, stratified by matched set, to estimate hazard ratios (HRs) comparing incident SMI among adults with and without AE or psoriasis.Results: We identified 1,023,232 adults with AE and 4,908,059 without, and 363,210 with psoriasis and 1,801,875 without. After adjusting for matching variables (age, sex, general practice) and potential confounders (deprivation, calendar period) both AE and psoriasis were associated with at least a 17% increased hazard of SMI (AE: HR=1.17,95% CI=1.12– 1.22; psoriasis: HR=1.26,95% CI=1.18– 1.35). After additionally adjusting for potential mediators (comorbidity burden, harmful alcohol use, smoking status, body mass index, and, in AE only, sleep problems and high-dose glucocorticoids), associations with SMI did not persist for AE (HR=0.98,95% CI=0.93– 1.04), and were attenuated for psoriasis (HR=1.14,95% CI=1.05– 1.23).Conclusion: Our findings suggest adults with AE or psoriasis are at increased risk of SMI compared to matched comparators. After adjusting for potential mediators, associations with SMI did not persist for AE, and were attenuated for psoriasis, suggesting that the increased risk may be explained by mediating factors (eg, sleep problems). Our research highlights the importance of monitoring mental health in adults with AE or psoriasis.Keywords: epidemiology, dermatology, psychology
Published: 2023

4. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data

Author: Dizon, MP, Yu, AM, Singh, RK, Wan, J, Chren, M‐M, Flohr, C, Silverberg, JI, Margolis, DJ, Langan, SM, and Abuabara, K
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Brain Disorders, Good Health and Well Being, Adult, Algorithms, Child, Clinical Coding, Data Collection, Dermatitis, Atopic, Electronic Health Records, Female, Humans, Male, Prevalence, Terminology as Topic, Oncology and Carcinogenesis, Dermatology & Venereal Diseases, Clinical sciences
Abstract: BackgroundRoutinely collected electronic health data obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in routinely collected electronic health data differ, and it is unknown how this might affect study results.ObjectivesTo evaluate how patients with AD have been identified in studies using routinely collected electronic health data, to determine whether these methods were validated and to estimate how the method for identifying patients with AD affected variability in prevalence estimates.MethodsWe systematically searched PubMed, Embase and Web of Science for studies using routinely collected electronic health data that reported on AD as a primary outcome. Studies of localized AD and other types of dermatitis were excluded. The protocol for this review was registered in PROSPERO (CRD42016037968).ResultsIn total, 59 studies met eligibility criteria. Medical diagnosis codes for inclusion and exclusion, number of occasions of a code, type of provider associated with a code and prescription data were used to identify patients with AD. Only two studies described validation of their methods and no study reported on disease severity. Prevalence estimates ranged from 0·18% to 38·33% (median 4·91%) and up to threefold variation in prevalence was introduced by differences in the method for identifying patients with AD.ConclusionsThis systematic review highlights the need for clear reporting of methods for identifying patients with AD in routinely collected electronic health data to allow for meaningful interpretation and comparison of results.
Published: 2018

5. The prevalence of atopic dermatitis beyond childhood: A systematic review and meta-analysis of longitudinal studies.

Author: Abuabara, K, Yu, AM, Okhovat, J-P, Allen, IE, and Langan, SM
Subjects: Humans, Dermatitis, Atopic, Prevalence, Longitudinal Studies, Adolescent, Adult, Child, Child, Preschool, Infant, Female, Male, Young Adult, atopic dermatitis, atopic eczema, eczema, natural history, prevalence, Dermatitis, Atopic, Preschool, Allergy, Immunology
Abstract: BackgroundThere are sparse and conflicting data regarding the long-term clinical course of atopic dermatitis (AD). Although often described as a childhood disease, newer population-based estimates suggest the prevalence of pediatric and adult disease may be similar.MethodsOur objective was to determine whether there is a decline in the prevalence of AD in population-based cohorts of patients followed longitudinally beyond childhood. We conducted a systematic review and meta-analysis including studies assessing AD prevalence across 3 or more points in time. The primary outcome was weighted overall risk difference (percentage decrease in AD prevalence).ResultsOf 2080 references reviewed, 7 studies with 13 515 participants were included. Participants were assessed at 3-6 time points, ranging from age 3 months to 26 years. The percentage decrease in prevalence after age 12 was 1%, which was not significantly different from zero (95% confidence interval -2%-5%). Similar results were found with other age cut-offs.ConclusionThe prevalence of AD in longitudinal birth cohort studies is similar in childhood and adolescence/early adulthood.
Published: 2018

6. 228 The prevalence of eczema beyond childhood: A systematic review and meta-analysis of longitudinal studies

Author: Yu, AM, Okhovat, J, Allen, IE, Langan, SM, and Abuabara, K
Subjects: Pediatric, Brain Disorders, Prevention, Neurodegenerative, 2.4 Surveillance and distribution, Aetiology, Adolescent, Adult, Child, Child, Preschool, Dermatitis, Atopic, Female, Humans, Infant, Longitudinal Studies, Male, Prevalence, Young Adult, atopic dermatitis, atopic eczema, eczema, natural history, prevalence, Clinical Sciences, Oncology and Carcinogenesis, Dermatology & Venereal Diseases
Abstract: BackgroundThere are sparse and conflicting data regarding the long-term clinical course of atopic dermatitis (AD). Although often described as a childhood disease, newer population-based estimates suggest the prevalence of pediatric and adult disease may be similar.MethodsOur objective was to determine whether there is a decline in the prevalence of AD in population-based cohorts of patients followed longitudinally beyond childhood. We conducted a systematic review and meta-analysis including studies assessing AD prevalence across 3 or more points in time. The primary outcome was weighted overall risk difference (percentage decrease in AD prevalence).ResultsOf 2080 references reviewed, 7 studies with 13 515 participants were included. Participants were assessed at 3-6 time points, ranging from age 3 months to 26 years. The percentage decrease in prevalence after age 12 was 1%, which was not significantly different from zero (95% confidence interval -2%-5%). Similar results were found with other age cut-offs.ConclusionThe prevalence of AD in longitudinal birth cohort studies is similar in childhood and adolescence/early adulthood.
Published: 2017

7. Retraction of COVID-19 Pharmacoepidemiology Research Could Have Been Avoided by Effective Use of Reporting Guidelines

Author: Benchimol EI, Moher D, Ehrenstein V, and Langan SM
Subjects: covid-19, journalology, peer review, pharmacoepidemiology, reporting guidelines, routinely collected health data., Infectious and parasitic diseases, RC109-216
Abstract: Eric I Benchimol,1– 3 David Moher,4,5 Vera Ehrenstein,6 Sinéad M Langan7 1Department of Paediatrics, University of Toronto, Toronto, Canada; 2Child Health Evaluative Sciences, SickKids Research Institute, and Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Canada; 3ICES, Toronto, Canada; 4School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; 5Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; 6Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; 7Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UKCorrespondence: Eric I BenchimolDivision of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, CanadaTel +1 416813-1500Fax +1 416813-4972Email eric.benchimol@sickkids.caIntroduction: Two recent high-profile publications (and subsequent retractions) of pharmacoepidemiology studies reporting the effectiveness and risk of hydroxychloroquine in COVID-19 patients received international media attention. Transparent and complete reporting of these studies could have provided peer reviewers and editors with sufficient information to question the methods used and the validity of results. Since these studies used routinely collected health data, the guidelines for the REporting of studies Conducted using Observational Routinely collected health Data (RECORD) should have been applied to ensure complete reporting of the research.Methods: We evaluated the two retracted articles for completeness of reporting using the RECORD for Pharmacoepidemiology (RECORD-PE) checklist, which includes the checklists for the STengthening the Reporting of OBservational studies in Epidemiology (STROBE) and RECORD. We compared the proportion of STROBE, RECORD and RECORD-PE items adequately reported using Chi-squared statistics.Results: In the article published by The Lancet, 29 of 34 STROBE items (85.3%) were adequately reported, compared with 3.5 of 13 RECORD items (26.9%) and 9.5 of 15 RECORD-PE items (63.3%)(χ2 = 14.839, P < 0.001). Similarly, the article published in NEJM reported 24 of 34 STROBE items (70.6%), two of 13 RECORD items (15.4%), and 7.5 of 15 RECORD-PE items (50.0%) (χ2 = 11.668, P = 0.003). Important aspects of the methods unique to research using routinely collected health data were not reported, including variables used to identify exposure, outcome and confounders, validation of the coding or algorithms, a description of the underlying database population and the accuracy of data linkage methods.Discussion: While STROBE items were generally adequately reported, RECORD and RECORD-PE items were not. Reporting guidelines should be effectively implemented in order for transparency and completeness of research manuscripts, allowing for adequate evaluation by editors and peer reviewers.Keywords: COVID-19, journalology, peer review, pharmacoepidemiology, reporting guidelines, routinely collected health data
Published: 2020

8. Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study

Author: Langan, SM, Mulick, AR, Rutter, CE, Silverwood, R, Asher, I, García-Marcos, L, Ellwood, E, Bissell, K, Chiang, CY, Sony, AE, Ellwood, P, Marks, G, Mortimer, K, Martínez-Torres, AE, Morales, E, Perez-Fernandez, V, Robertson, S, Williams, H, Strachan, DP, Pearce, N, Marks, Masekela, R, Martinez-Torres, AE, Silverwood, RJ, Mallol, J, Soto-Martinez, ME, Cabrera Aguilar, A, Douros, K, Mohammed, S, Singh, M, Singh, V, Sukumaran, TU, Awasthi, S, Kabra, SK, Salvi, S, Mérida-Palacio, JV, González-Díaz, SN, Navarrete-Rodriguez, EM, Sánchez, JF, Falade, AG, Zar, HJ, López-Silvarrey Varela, A, González Díaz, C, Nour, M, Dib, G, Mohammad, Y, Huang, JL, Chinratanapisit, S, Soto-Quirós, ME, El-Sony, A, Vichyanond, P, Aguilar, P, Barba, S, Kumar, L, Sharma, SK, Hanumante, NM, García-Almaráz, R, Del-Río-Navarro, BE, Linares-Zapién, FJ, Onadeko, BO, Musa, OAA, Aguirre, V, Baeza-Bacab, M, Mohammad, S, Cortéz, E, Gratziou, CH, Chopra, K, Nelson, H, Rubio, AD, Hsieh, KH, Shah, J, Langan, SM [0000-0002-7022-7441], Mulick, AR [0000-0002-4009-2080], García-Marcos, L [0000-0002-0925-3851], Morales, E [0000-0003-3145-7022], and Apollo - University of Cambridge Repository
Subjects: global estimates, atopic dermatitis, flexural rash, prevalence, eczema
Abstract: Background: Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology. Methods: The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allergies in Children (ISAAC). Using surveys, we assessed eczema prevalence, severity, and lifetime prevalence, in global centres participating in GAN Phase I (2015–2020) and one/ both of ISAAC Phase I (1993–1995) and Phase III (2001–2003). We fitted linear mixed models to estimate 10‐yearly prevalence trends, by age group, income, and region. Results: We analysed GAN Phase I data from 27 centres in 14 countries involving 74,361 adolescents aged 13–14 and 47,907 children aged 6–7 (response rate 90%, 79%). A median of 6% of children and adolescents had symptoms of current eczema, with 1.1% and 0.6% in adolescents and children, respectively, reporting symptoms of severe eczema. Over 27 years, after adjusting for world region and income, we estimated small overall 10‐year increases in current eczema prevalence (adolescents: 0.98%, 95% CI 0.04%–1.92%; children: 1.21%, 95% CI 0.18%–2.24%), and severe eczema (adolescents: 0.26%, 95% CI 0.06%–0.46%; children: 0.23%, 95% CI 0.02%–0.45%) with larger increases in lifetime prevalence (adolescents: 2.71%, 95% CI 1.10%–4.32%; children: 3.91%, 95% CI 2.07%–5.75%). There was substantial heterogeneity in 10‐year change between centres (standard deviations 2.40%, 0.58%, and 3.04%), and strong evidence that some of this heterogeneity was explained by region and income level, with increases in some outcomes in high‐income children and middle‐income adolescents. Conclusions: There is substantial variation in changes in eczema prevalence over time by income and region. Understanding reasons for increases in some regions and decreases in others will help inform prevention strategies.
Published: 2023

9. The RECORD reporting guidelines: meeting the methodological and ethical demands of transparency in research using routinely-collected health data

Author: Nicholls SG, Langan SM, Sørensen HT, Petersen I, and Benchimol EI
Subjects: Guidelines, Infectious and parasitic diseases, RC109-216
Abstract: Stuart G Nicholls,1,2 Sinead M Langan,3 Henrik Toft Sørensen,4 Irene Petersen,4,5 Eric I Benchimol1,6 1Children’s Hospital of Eastern Ontario (CHEO) Research Institute, 2School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 3London School of Hygiene and Tropical Medicine, London, UK; 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 5Department of Primary Care and Population Health, University College London, London, UK; 6Department of Pediatrics and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada Abstract: Routinely-collected health data (RCD) are now used for a wide range of studies, including observational studies, comparative effectiveness research, diagnostics, studies of adverse effects, and predictive analytics. At the same time, limitations inherent in using data collected without specific a priori research questions are increasingly recognized. There is also a growing awareness of the suboptimal quality of reports presenting research based on RCD. This has created a perfect storm of increased interest and use of RCD for research, together with inadequate reporting of the strengths and weaknesses of these data resources. The REporting of studies Conducted using Observational Routinely-collected Data (RECORD) statement was developed to address these limitations and to help researchers using RCD to meet their ethical obligations of complete and accurate reporting, as well as improve the utility of research conducted using RCD. The RECORD statement has been endorsed by more than 15 journals, including Clinical Epidemiology. This journal now recommends that authors submit the RECORD checklist together with any manuscript reporting on research using RCD. Keywords: observational studies, standards, research waste, assessment, publication
Published: 2016

10. Implementation of COVID-19 Preventive Measures and Staff Well-Being in a Sample of English Schools 2020-2021

Author: Sundaram, N, Abramsky, T, Oswald, WE, Cook, S, Halliday, KE, Nguipdop-Djomo, P, Sturgess, J, Ireland, G, Ladhani, SN, Mangtani, P, Langan, SM, Hargreaves, JR, Bonell, C, and COVID-19 Schools Infection Survey Study Group
Subjects: Philosophy, Public Health, Environmental and Occupational Health, Education
Abstract: BACKGROUND: We examined fidelity and feasibility of implementation of COVID-19 preventive measures in schools, and explored associations between adherence to these measures and staff well-being, to inform policy on sustainable implementation and staff wellbeing. METHODS: Surveys were conducted across 128 schools in England with 107 headteachers and 2698 staff-members with reference to autumn term 2020, examining school-level implementation of preventive measures, adherence, and teacher burnout (response rates for headteacher and staff surveys were 84% and 59%, respectively). RESULTS: The median number of measures implemented in primary and secondary schools was 33 (range 23-41), and 32 (range 22-40), respectively; most measures presented challenges. No differences were found regarding number of measures implemented by school-level socio-economic disadvantage. High adherence was reported for staff wearing face-coverings, staff regularly washing their hands, (secondary only) desks facing forwards, and (primary only) increased cleaning of surfaces and student hand-washing. Adherence to most measures was reported as higher in primary than secondary schools. Over half of school leaders and 42% (517/1234) of other teaching staff suffered from high emotional exhaustion. Higher teacher-reported school-wide adherence with measures was consistently associated with lower burnout for leaders and other teaching staff. CONCLUSIONS: Findings indicate a tremendous effort in implementing preventive measures and an urgent need to support investments in improving teacher wellbeing.
Published: 2022

11. Risk of severe COVID-19 associated with immune-modifying drugs: Data from PsoProtect and Global Rheumatology Alliance registries.

Author: Mahil, S, Schaefer, M, Dand, N, Yiu, Z, Hyrich, K, Strangfeld, A, Yates, M, Carmona, L, Gossec, L, Mateus, E, Lawson-Tovey, S, Wiek, D, Jacobsohn, L, Isnardi, C, Quintana, R, Soriano, E, Wallace, Z, Bhana, S, Gore-Massey, M, Grainger, R, Hausmann, J, Liew, J, Sirotich, E, Mason, K, Tsakok, T, Meynell, F, Coker, B, Vincent, A, Urmston, D, Mcateer, H, Vesty, A, Kelly, J, Lancelot, C, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Di Meglio, P, Contreras, C, Choon, S, Capon, F, Torres, T, Naldi, L, Weinman, J, Brown, M, Galloway, J, Norton, S, Lambert, J, Spuls, P, Van Huizen, A, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Langan, S, Sufka, P, Robinson, P, Yazdany, J, Griffiths, C, Barker, J, Machado, P, Smith, C, Mahil SK, Schaefer M, Dand N, Yiu ZZN, Hyrich KL, Strangfeld A, Yates M, Carmona L, Gossec L, Mateus EF, Lawson-Tovey S, Wiek D, Jacobsohn L, Isnardi CA, Quintana R, Soriano ER, Wallace ZS, Bhana S, Gore-Massey M, Grainger R, Hausmann JS, Liew JW, Sirotich E, Mason KJ, Tsakok T, Meynell F, Coker B, Vincent A, Urmston D, McAteer H, Vesty A, Kelly J, Lancelot C, Moorhead L, Mackenzie T, Rossi MT, Rivera R, Mahe E, Carugno A, Magnano M, Rech G, Balogh EA, Feldman SR, De La Cruz C, Di Meglio P, Contreras CR, Choon SE, Capon F, Torres T, Naldi L, Weinman J, Brown MA, Galloway JB, Norton S, Lambert J, Spuls P, Van Huizen AM, Jullien D, Bachelez H, McMahon DE, Freeman EE, Gisondi P, Puig L, Warren RB, Langan SM, Sufka P, Robinson PC, Yazdany J, Griffiths CEM, Barker JN, Machado PM, Smith CH., Mahil, S, Schaefer, M, Dand, N, Yiu, Z, Hyrich, K, Strangfeld, A, Yates, M, Carmona, L, Gossec, L, Mateus, E, Lawson-Tovey, S, Wiek, D, Jacobsohn, L, Isnardi, C, Quintana, R, Soriano, E, Wallace, Z, Bhana, S, Gore-Massey, M, Grainger, R, Hausmann, J, Liew, J, Sirotich, E, Mason, K, Tsakok, T, Meynell, F, Coker, B, Vincent, A, Urmston, D, Mcateer, H, Vesty, A, Kelly, J, Lancelot, C, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Di Meglio, P, Contreras, C, Choon, S, Capon, F, Torres, T, Naldi, L, Weinman, J, Brown, M, Galloway, J, Norton, S, Lambert, J, Spuls, P, Van Huizen, A, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Langan, S, Sufka, P, Robinson, P, Yazdany, J, Griffiths, C, Barker, J, Machado, P, Smith, C, Mahil SK, Schaefer M, Dand N, Yiu ZZN, Hyrich KL, Strangfeld A, Yates M, Carmona L, Gossec L, Mateus EF, Lawson-Tovey S, Wiek D, Jacobsohn L, Isnardi CA, Quintana R, Soriano ER, Wallace ZS, Bhana S, Gore-Massey M, Grainger R, Hausmann JS, Liew JW, Sirotich E, Mason KJ, Tsakok T, Meynell F, Coker B, Vincent A, Urmston D, McAteer H, Vesty A, Kelly J, Lancelot C, Moorhead L, Mackenzie T, Rossi MT, Rivera R, Mahe E, Carugno A, Magnano M, Rech G, Balogh EA, Feldman SR, De La Cruz C, Di Meglio P, Contreras CR, Choon SE, Capon F, Torres T, Naldi L, Weinman J, Brown MA, Galloway JB, Norton S, Lambert J, Spuls P, Van Huizen AM, Jullien D, Bachelez H, McMahon DE, Freeman EE, Gisondi P, Puig L, Warren RB, Langan SM, Sufka P, Robinson PC, Yazdany J, Griffiths CEM, Barker JN, Machado PM, and Smith CH.
Published: 2022

12. Vaccine hesitancy and access to psoriasis care in the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey.

Author: Bechman, K, primary, Cook, ES, additional, Dand, N, additional, Yiu, ZZN, additional, Tsakok, T, additional, Meynell, F, additional, Coker, B, additional, Vincent, A, additional, Bachelez, H, additional, Barbosa, I, additional, Brown, MA, additional, Capon, F, additional, Contreras, CR, additional, De La Cruz, C, additional, Di Meglio, P, additional, Gisondi, P, additional, Jullien, D, additional, Kelly, J, additional, Lambert, J, additional, Lancelot, C, additional, Langan, SM, additional, Mason, KJ, additional, McAteer, H, additional, Moorhead, L, additional, Naldi, L, additional, Norton, S, additional, Puig, L, additional, Spuls, P, additional, Torres, T, additional, Urmston, D, additional, Vesty, A, additional, Warren, RB, additional, Waweru, H, additional, Weinman, J, additional, Griffiths, CEM, additional, Barker, JN, additional, Smith, CH, additional, Galloway, JB, additional, and Mahil, SK, additional
Published: 2022
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13. Setting the RECORD straight: developing a guideline for the REporting of studies Conducted using Observational Routinely collected Data

Author: Langan SM, Benchimol EI, Guttmann A, Moher D, Petersen I, Smeeth L, Sørensen HT, Stanley F, and Von Elm E
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Sinéad M Langan,1 Eric I Benchimol,2,3 Astrid Guttmann,2 David Moher,4 Irene Petersen,5 Liam Smeeth,1 Henrik Toft Sørensen,6 Fiona Stanley,7 Erik Von Elm81Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; 2Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Canada; 3Department of Pediatrics and Epidemiology and Community Medicine University of Ottawa, Ottawa, Canada; 4Ottawa Hospital Research Institute, Ottawa, Canada; 5Department of Primary Care and Population Health, University College London, London, United Kingdom; 6Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark; 7Telethon Department of Child Health, University of Western Australia, Perth, Australia; 8Institut Universitaire de Médecine Sociale et Préventive, University of Lausanne, Switzerland Recent technological developments in recording health care delivery have led to major research opportunities for epidemiologists and others. There has been a dramatic increase in the availability of "routine data" for research purposes, including data from electronic medical records, administrative data for billing purposes, disease registries, and sources of sociodemographic data. Examples of routine data include data from medical records in the UK in the Clinical Practice Research Database, administrative data from Surveillance, Epidemiology and End Results Medicare, and registry data from the Danish National Registry of Patients. The key aspect that differentiates routine data from other research data sources is the reasons for which the data were collected, since routine data are not specifically collected for research purposes. These data are increasingly available from various health care settings and geographic locations. They present innovative, efficient, and cost-effective prospects with which to answer key research questions. However, use of these data for research leads to specific challenges for researchers and for policymakers and clinicians in using studies based on such data.
Published: 2013

14. A study protocol for the development of a SPIRIT extension for trials conducted using cohorts and routinely collected data (SPIRIT-ROUTINE) [version 1; peer review: 2 approved]

Author: McCarthy, M, O'Keeffe, L, Williamson, PR, Sydes, MR, Farrin, A, Lugg-Widger, F, Davies, G, Avery, K, Chan, A-W, Kwakkenbos, L, Thombs, BD, Watkins, A, Hemkens, LG, Gale, C, Zwarenstein, M, Langan, SM, Thabane, L, Juszczak, E, Moher, D, Kearney, PM, and Canadian Institutes of Health Research
Subjects: routinely collected data, electronic health records, registry-based randomised controlled trial, education, registries, Medicine, SPIRIT, cohort, reporting guideline, humanities, electronic patient records
Abstract: Background: Protocols are an essential document for conducting randomised controlled trials (RCTs). However, the completeness of the information provided is often inadequate. To help improve the content of trial protocols, an international group of stakeholders published the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Initiative in 2013. Presently, there is increasing use of cohorts and routinely collected data (RCD) for RCTs because these data have the potential to improve efficiencies by facilitating recruitment, simplifying, and reducing the cost of data collection. Reporting guidelines have been shown to improve the quality of reporting, but there is currently no specific SPIRIT guidance on protocols for trials conducted using cohorts and RCD. This protocol outlines steps for developing SPIRIT-ROUTINE, which aims to address this gap by extending the SPIRIT guidance to protocols for trials conducted using cohorts and RCD. Methods: The development of the SPIRIT-ROUTINE extension comprises five stages. Stage 1 consists of a project launch and a meeting to finalise the membership of the steering group and scope of the extension. In Stage 2, a rapid review will be performed to identify possible modifications to the original SPIRIT 2013 checklist. Other key reporting guidelines will be reviewed to identify areas where additional items may be needed, such as the Consolidated Standards of Reporting Trials (CONSORT) extension for trials conducted using cohorts and RCD (CONSORT-ROUTINE). Stage 3 will involve an online Delphi exercise, consisting of two rounds and involving key international stakeholders to gather feedback on the preliminary checklist items. In Stage 4, a consensus meeting of the SPIRIT-ROUTINE steering group will finalise the items to include in the extension. Stage 5 will involve the publication preparation and dissemination of the final checklist. Conclusion: The SPIRIT-ROUTINE extension will contribute to improving design of trials using cohorts and RCD and transparency of reporting.
Published: 2021

15. Implementation of preventive measures to prevent COVID-19: a national study of English primary schools in summer 2020

Author: Sundaram, N, Bonell, C, Ladhani, S, Langan, SM, Baawuah, F, Okike, I, Ahmad, S, Beckmann, J, Garstang, J, Brent, BE, Brent, AJ, Amin-Chowdhury, Z, Aiano, F, and Hargreaves, J
Abstract: We examined the feasibility of implementing preventive measures to prevent SARS-CoV-2 transmission across 105 English primary schools in summer 2020 via a survey and interviews with headteachers. High rates of implementation of most recommended measures were noted with the exception of requiring 2 m distance for students, fitting hand sanitizers in classrooms and introducing one-way systems in school corridors. Measures such as regular handwashing and stopping assemblies were considered easy to implement. Majorly challenging measures included distancing between individuals (for students: 51%, N = 99; for staff: 34%; N = 98; for parents: 26%, N = 100), spacing out desks (34%, N = 99), keeping same staff assigned to each student group (33%, N = 97) and staggering break times (25%, N = 99). Rapid implementation was facilitated by staff commitment and communication among stakeholders, but hampered by limitations with guidance received, physical environments, resources, parental adherence and balancing preventive measures with learning. Difficulties with distancing for younger children suggest that smaller bubbles with fewer distancing requirements within these may be a policy option. Schools require further financial, human resource and other support for effective implementation of preventive measures.
Published: 2021

16. Inflammatory skin diseases and the risk of chronic kidney disease: population-based case-control and cohort analyses

Author: Schonmann, Y, Mansfield, KE, Mulick, A, Roberts, A, Smeeth, L, Langan, SM, and Nitsch, D
Abstract: BACKGROUND: Emerging evidence suggests an association between common inflammatory skin diseases and chronic kidney disease (CKD). OBJECTIVES: To explore the association between CKD stages 3-5 (CKD3-5) and atopic eczema, psoriasis, rosacea and hidradenitis suppurativa. METHODS: We undertook two complementary analyses; a prevalent case-control study and a cohort study using routinely collected primary care data [UK Clinical Practice Research Datalink (CPRD)]. We matched individuals with CKD3-5 in CPRD in March 2018 with up to five individuals without CKD for general practitioner practice, age and sex. We compared the prevalence of CKD3-5 among individuals with and without each inflammatory skin disease. We included individuals in CPRD with diabetes mellitus (2004-2018) in a cohort analysis to compare the incidence of CKD3-5 among people with and without atopic eczema and psoriasis. RESULTS: Our study included 56 602 cases with CKD3-5 and 268 305 controls. Cases were more likely than controls to have a history of atopic eczema [odds ratio (OR) 1·14, 99% confidence interval (CI) 1·11-1·17], psoriasis (OR 1·13, 99% CI 1·08-1·19) or hidradenitis suppurativa (OR 1·49, 99% CI 1·19-1·85), but were slightly less likely to have been diagnosed with rosacea (OR 0·92, 99% CI 0·87-0·97), after adjusting for age, sex, practice (matching factors), index of multiple deprivation, diabetes, smoking, harmful alcohol use and obesity. Results remained similar after adjusting for hypertension and cardiovascular disease. In the cohort with diabetes (N = 335 827), there was no evidence that CKD3-5 incidence was associated with atopic eczema or psoriasis. CONCLUSIONS: Atopic eczema, psoriasis and hidradenitis suppurativa are weakly associated with CKD3-5. Future research is needed to elucidate potential mechanisms and the clinical significance of our findings.
Published: 2021

17. Priority research questions in atopic dermatitis: an International Eczema Council eDelphi consensus

Author: Abuabara, K, Nicholls, SG, Langan, SM, Guttman-Yassky, E, Reynolds, NJ, Paller, AS, Brown, SJ, and International Eczema Council Priority Research Group
Subjects: body regions
Abstract: Recent advances in understanding the complex pathogenesis of atopic dermatitis (AD, also known as eczema or atopic eczema), coupled with the development of new treatments, have led to increased interest from multiple stakeholders. There is a need to prioritize areas for research to inform a coordinated approach to advancing science and patient care.
Published: 2021

18. Describing the burden of the COVID-19 pandemic in people with psoriasis: findings from a global cross-sectional study

Author: Mahil, SK, primary, Yates, M, additional, Yiu, ZZN, additional, Langan, SM, additional, Tsakok, T, additional, Dand, N, additional, Mason, KJ, additional, McAteer, H, additional, Meynell, F, additional, Coker, B, additional, Vincent, A, additional, Urmston, D, additional, Vesty, A, additional, Kelly, J, additional, Lancelot, C, additional, Moorhead, L, additional, Bachelez, H, additional, Capon, F, additional, Contreras, CR, additional, De La Cruz, C, additional, Meglio, P Di, additional, Gisondi, P, additional, Jullien, D, additional, Lambert, J, additional, Naldi, L, additional, Norton, S, additional, Puig, L, additional, Spuls, P, additional, Torres, T, additional, Warren, RB, additional, Waweru, H, additional, Weinman, J, additional, Brown, MA, additional, Galloway, JB, additional, Griffiths, CM, additional, Barker, JN, additional, and Smith, CH, additional
Published: 2021
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19. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990-2017

Author: Laughter, MR, Maymone, MBC, Mashayekhi, S, Arents, BWM, Karimkhani, C, Langan, SM, Dellavalle, RP, and Flohr, C
Abstract: BACKGROUND: The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease-related morbidity and mortality worldwide. OBJECTIVES: Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. METHODS: Data on the burden of AD were obtained from the GBD Study. RESULTS: Atopic dermatitis (AD) ranks 15th among all nonfatal diseases and has the highest disease burden among skin diseases as measured by disability-adjusted life-years (DALYs). Overall, the global DALY rate for AD in 1990 was 121 [95% uncertainty interval (UI) 65·4-201] and remained similar in 2017 at 123 (95% UI 66·8-205). The three countries with the highest DALY rates of AD were Sweden (327, 95% UI 178-547), the UK (284, 95% UI 155-478) and Iceland (277, 95% UI 149-465), whereas Uzbekistan (85·1, 95% UI 45·2-144), Armenia (85·1, 95% UI 45·8-143) and Tajikistan (85·1, 95% UI 46·1-143) ranked lowest. CONCLUSIONS: The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence among young adults, and a second peak in middle-aged and older populations. We also found a moderate positive correlation between a country's gross domestic product and disease burden. GBD data confirm the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as ultraviolet exposure, to understand better the geographical and age-related variations in disease burden.
Published: 2020

20. The association of smoking and socioeconomic status on cutaneous melanoma: a population-based, data-linkage, case-control study

Author: Gibson, JAG, Dobbs, TD, Griffiths, R, Song, J, Akbari, A, Whitaker, S, Watkins, A, Langan, SM, Hutchings, HA, Lyons, RA, and Whitaker, IS
Abstract: BACKGROUND: Previous studies have identified an inverse association between melanoma and smoking; however, data from population-based studies are scarce. OBJECTIVES: To determine the association between smoking and socioeconomic (SES) on the risk of development of melanoma. Furthermore, we sought to determine the implications of smoking and SES on survival. METHODS: We conducted a population-based case-control study. Cases were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU) during 2000-2015 and controls from the general population. Smoking and SES were obtained from data linkage with other national databases. The association of smoking status and SES on the incidence of melanoma were assessed using binary logistic regression. Multivariate survival analysis was performed on a melanoma cohort using a Cox proportional hazard model using survival as the outcome. RESULTS: During 2000-2015, 9636 patients developed melanoma. Smoking data were obtained for 7124 (73·9%) of these patients. There were 26 408 controls identified from the general population. Smoking was inversely associated with melanoma incidence [odds ratio (OR) 0·70, 95% confidence interval (CI) 0·65-0·76]. Smoking was associated with an increased overall mortality [hazard ratio (HR) 1·30, 95% CI 1·09-1·55], but not associated with melanoma-specific mortality. Patients with higher SES had an increased association with melanoma incidence (OR 1·58, 95% CI 1·44-1·73). Higher SES was associated with an increased chance of both overall (HR 0·67, 95% CI 0·56-0·81) and disease-specific survival (HR 0·69, 95% CI 0·53-0·90). CONCLUSIONS: Our study has demonstrated that smoking appeared to be associated with reduced incidence of melanoma. Although smoking increases overall mortality, no association was observed with melanoma-specific mortality. Further work is required to determine if there is a biological mechanism underlying this relationship or an alternative explanation, such as survival bias. What's already known about this topic? Previous studies have been contradictory with both negative and positive associations between smoking and the incidence of melanoma reported. Previous studies have either been limited by publication bias because of selective reporting or underpowered. What does this study add? Our large study identified an inverse association between smoking status and melanoma incidence. Although smoking status was negatively associated with overall disease survival, no significant association was noted in melanoma-specific survival. Socioeconomic status remains closely associated with melanoma. Although higher socioeconomic populations are more likely to develop the disease, patients with lower socioeconomic status continue to have a worse prognosis.
Published: 2020

21. Partner bereavement and risk of chronic urticaria, alopecia areata and vitiligo: cohort studies in the UK and Denmark

Author: Wong, AYS, Kjaersgaard, A, Frøslev, T, Forbes, HJ, Mansfield, KE, Silverwood, RJ, Sørensen, HT, Smeeth, L, Schmidt, SAJ, and Langan, SM
Subjects: body regions, integumentary system, skin and connective tissue diseases
Abstract: The pathogeneses of skin diseases are not fully understood. Psychological stress has been proposed to be associated with skin diseases, but the epidemiological evidence is limited [1, 2]. We have recently reported the associations between partner bereavement (an extreme life stressor) and psoriasis, atopic eczema and melanoma [3, 4]. In this study, we further investigated whether partner bereavement was associated with urticaria, alopecia areata, or vitiligo.
Published: 2020

22. The association between partner bereavement and melanoma: cohort studies in the U.K. and Denmark

Author: Wong, AYS, Frøslev, T, Dearing, L, Forbes, HJ, Mulick, A, Mansfield, KE, Silverwood, RJ, Kjaersgaard, A, Sørensen, HT, Smeeth, L, Lewin, A, Schmidt, SAJ, and Langan, SM
Abstract: BACKGROUND: Psychological stress is commonly cited as a risk factor for melanoma, but clinical evidence is limited. OBJECTIVES: This study aimed to evaluate the association between partner bereavement and (i) first-time melanoma diagnosis and (ii) mortality in patients with melanoma. METHODS: We conducted two cohort studies using data from the U.K. Clinical Practice Research Datalink (1997-2017) and Danish nationwide registries (1997-2016). In study 1, we compared the risk of first melanoma diagnosis in bereaved vs. matched nonbereaved people using stratified Cox regression. In study 2 we estimated hazard ratios (HRs) for death from melanoma in bereaved compared with nonbereaved individuals with melanoma using Cox regression. We estimated HRs separately for the U.K. and for Denmark, and then pooled the data to perform a random-effects meta-analysis. RESULTS: In study 1, the pooled adjusted HR for the association between partner bereavement and melanoma diagnosis was 0·88 [95% confidence interval (CI) 0·84-0·92] across the entire follow-up period. In study 2, we observed increased melanoma-specific mortality in people experiencing partner bereavement across the entire follow-up period (HR 1·17, 95% CI 1·06-1·30), with the peak occurring during the first year of follow-up (HR 1·31, 95% CI 1·07-1·60). CONCLUSIONS: We found decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. These findings may be partly explained by delayed detection resulting from the loss of a partner who could notice skin changes. Stress may play a role in melanoma progression. Our findings indicate the need for a low threshold for skin examination in individuals whose partners have died. What is already known about this topic? Psychological stress has been proposed as a risk factor for the development and progression of cancer, including melanoma, but evidence is conflicting. Clinical evidence is limited by small sample sizes, potential recall bias associated with self-report, and heterogeneous stress definitions. What does this study add? We found a decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. While stress might play a role in the progression of melanoma, an alternative explanation is that bereaved people no longer have a close person to help notice skin changes, leading to delayed melanoma detection. Linked Comment: Talaganis et al. Br J Dermatol 2020; 183:607-608.
Published: 2020

23. Five insights from the Global Burden of Disease Study 2019

Author: Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, Elsharkawy, A, Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, and Elsharkawy, A
Abstract: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.
Published: 2020

24. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, Elsharkawy, A, Shariful Islam, Sheikh, Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, Elsharkawy, A, and Shariful Islam, Sheikh
Published: 2020

25. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, Elsharkawy, A, Islam, Shariful, Abbafati, C, Machado, DB, Cislaghi, B, Salman, OM, Karanikolos, M, McKee, M, Abbas, KM, Brady, OJ, Larson, HJ, Trias-Llimós, S, Cummins, S, Langan, SM, Sartorius, B, Hafiz, A, Jenabi, E, Mohammad Gholi Mezerji, N, Borzouei, S, Azarian, G, Khazaei, S, Abbasi, M, Asghari, B, Masoumi, S, Komaki, H, Taherkhani, A, Adabi, M, Abbasifard, M, Bazmandegan, G, Kamiab, Z, Vakilian, A, Anjomshoa, M, Mokari, A, Sabour, S, Shahbaz, M, Saeedi, R, Ahmadieh, H, Yousefinezhadi, T, Haj-Mirzaian, A, Nikbakhsh, R, Safi, S, Asgari, S, Irvani, SN, Jahanmehr, N, Ramezanzadeh, K, Abbasi-Kangevari, M, Khayamzadeh, M, Abbastabar, H, Shirkoohi, R, Fazlzadeh, M, Janjani, H, Hosseini, M, Mansournia, M, Tohidinik, H, Bakhtiari, A, Fazaeli, A, Mousavi, S, Hasanzadeh, A, Nabavizadeh, B, Malekzadeh, R, Hashemian, M, Pourshams, A, Salimzadeh, H, Sepanlou, SG, Afarideh, M, Esteghamati, A, Esteghamati, S, Ghajar, A, Heidari, B, Rezaei, N, Mohamadi, E, Rahimi-Movaghar, A, Rahim, F, Eskandarieh, S, Sahraian, M, Mohebi, F, Aminorroaya, A, Ebrahimi, H, Farzadfar, F, Mohajer, B, Pishgar, F, Saeedi Moghaddam, S, Shabani, M, Zarafshan, H, Abolhassani, H, Hafezi-Nejad, N, Heidari-Soureshjani, R, Abdollahi, M, Farahmand, M, Salamati, P, Mehrabi Nasab, E, Tajdini, M, Aghamir, S, Mirzaei, R, Dibaji Forooshani, Z, Khater, MM, Abd-Allah, F, Abdelalim, A, Abualhasan, A, El-Jaafary, SI, Hassan, A, Elsharkawy, A, and Islam, Shariful
Published: 2020

26. Risk mitigating behaviours in people with inflammatory joint and skin disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey

Author: Mahil, SK, primary, Yates, M, additional, Langan, SM, additional, Yiu, ZZN, additional, Tsakok, T, additional, Dand, N, additional, Mason, KJ, additional, McAteer, H, additional, Meynell, F, additional, Coker, B, additional, Vincent, A, additional, Urmston, D, additional, Vesty, A, additional, Kelly, J, additional, Lancelot, C, additional, Moorhead, L, additional, Bachelez, H, additional, Bruce, IN, additional, Capon, F, additional, Contreras, CR, additional, Cope, AP, additional, De La Cruz, C, additional, Di Meglio, P, additional, Gisondi, P, additional, Hyrich, K, additional, Jullien, D, additional, Lambert, J, additional, Waweru, H, additional, Marzo-Ortega, H, additional, McKinnes, I, additional, Naldi, L, additional, Norton, S, additional, Puig, L, additional, Sengupta, R, additional, Spuls, P, additional, Torres, T, additional, Warren, RB, additional, Weinman, J, additional, Griffiths, CM, additional, Barker, JN, additional, Brown, MA, additional, Galloway, JB, additional, and Smith, CH, additional
Published: 2020
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27. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Kyu, Hh, Abate, D, Abate, Kh, Abay, Sm, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, Rs, Abebe, M, Abebe, Z, Abil, Oz, Aboyans, V, Abrham, Ar, Abu-Raddad, Lj, Abu-Rmeileh, Nme, Accrombessi, Mmk, Acharya, D, Acharya, P, Ackerman, In, Adamu, Aa, Adebayo, Om, Adekanmbi, V, Ademi, Z, Adetokunboh, Oo, Adib, Mg, Adsuar, Jc, Afanvi, Ka, Afarideh, M, Afshin, A, Agarwal, G, Agesa, Km, Aggarwal, R, Aghayan, Sa, Agrawal, A, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, Mb, Ahmed, S, Aichour, An, Aichour, I, Aichour, Mte, Akinyemiju, T, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Mekhlafi, Hm, Al-Raddadi, Rm, Alahdab, F, Alam, K, Alam, T, Alashi, A, Alavian, Sm, Alene, Ka, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, Sm, Alkerwi, A, Alla, F, Allebeck, P, Alonso, J, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Aminde, Ln, Amini, E, Amiresmaili, M, Ammar, W, Amoako, Ya, Anber, Nh, Andrei, Cl, Androudi, S, Animut, Md, Anjomshoa, M, Ansha, Mg, Antonio, Cat, Anwari, P, Arabloo, J, Aremu, O, Ärnlöv, J, Arora, A, Arora, M, Artaman, A, Aryal, Kk, Asayesh, H, Ataro, Z, Ausloos, M, Avila-Burgos, L, Avokpaho, Efga, Awasthi, A, Ayala, Quintanilla, Ayer, R, Azzopardi, Ps, Babazadeh, A, Badali, H, Balakrishnan, K, Bali, Ag, Banach, M, Banoub, Jam, Barac, A, Barboza, Ma, Barker-Collo, Sl, Bärnighausen, Tw, Barquera, S, Barrero, Lh, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Behzadifar, M, Bekele, Bb, Bekru, Et, Belachew, Ab, Belay, Ya, Bell, Ml, Bello, Ak, Bennett, Da, Bensenor, Im, Berhane, A, Bernabe, E, Bernstein, Rs, Beuran, M, Beyranvand, T, Bhala, N, Bhatt, S, Bhaumik, S, Bhutta, Za, Biadgo, B, Biehl, Mh, Bijani, A, Bikbov, B, Bilano, V, Bililign, N, Bin, Sayeed, Bisanzio, D, Bjørge, T, Bleyer, A, Bobasa, Em, Bou-Orm, Ir, Boufous, S, Bourne, R, Brady, Oj, Brant, Lc, Brayne, C, Brazinova, A, Breitborde, Njk, Brenner, H, Briant, Ps, Briko, An, Britton, G, Brugha, T, Buchbinder, R, Busse, R, Butt, Za, Cahuana-Hurtado, L, Campuzano, 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Patil, Snehal T, Patle, Ajay, Patton, George C, Paturi, Vishnupriya Rao, Paudel, Deepak, Paulson, Katherine R, Pearce, Neil, Pereira, Alexandre, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Pham, Hai Quang, Phillips, Michael R, Pigott, David M, Pillay, Julian David, Piradov, Michael A, Pirsaheb, Meghdad, Pishgar, Farhad, Plana-Ripoll, Oleguer, Polinder, Suzanne, Popova, Svetlana, Postma, Maarten J, Pourshams, Akram, Poustchi, Hossein, Prabhakaran, Dorairaj, Prakash, Swayam, Prakash, V., Prasad, Narayan, Purcell, Caroline A, Qorbani, Mostafa, Quistberg, D Alex, Radfar, Amir, Rafay, Anwar, Rafiei, Alireza, Rahim, Fakher, Rahimi, Kazem, Rahimi, Zohreh, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajati, Fatemeh, Ranjan, Prabhat, Rao, Puja C, Rasella, Davide, Rawaf, David Laith, Rawaf, Salman, Reddy, K Srinath, Reiner, Robert C, Reitsma, Marissa Bettay, Remuzzi, Giuseppe, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Satar, Rezai, Mohammad Sadegh, Ribeiro, Antonio Luiz P, Roberts, Nicholas L S, Robinson, Stephen R, Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Roth, Gregory A, Rothenbacher, Dietrich, Rubagotti, Enrico, Sachdev, Perminder S, Sadat, Nafi, Sadeghi, Ehsan, Saeedi Moghaddam, Sahar, Safari, Hosein, Safari, Yahya, Safari-Faramani, Roya, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salam, Nasir, Salama, Joseph S, Salamati, Payman, Saleem, Zikria, Salimi, Yahya, Salimzadeh, Hamideh, Salomon, Joshua A, Salvi, Sundeep Santosh, Salz, Inbal, Samy, Abdallah M, Sanabria, Juan, Sanchez-Niño, Maria Dolore, Santomauro, Damian Francesco, Santos, Itamar S, Santos, João Vasco, Santric Milicevic, Milena M, Sao Jose, Bruno Piassi, Sardana, Mayank, Sarker, Abdur Razzaque, Sarmiento-Suárez, Rodrigo, Sarrafzadegan, Nizal, Sartorius, Benn, Sarvi, Shahabeddin, Sathian, Brijesh, Satpathy, Maheswar, Sawant, Arundhati R, Sawhney, Monika, Saxena, Sonia, Schaeffner, Elke, Schmidt, Maria Inê, Schneider, Ione J C, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Scott, James G, Sekerija, Mario, Sepanlou, Sadaf G, Serván-Mori, Edson, Seyedmousavi, Seyedmojtaba, Shabaninejad, Hosein, Shafieesabet, Azadeh, Shahbazi, Mehdi, Shaheen, Amira A, Shaikh, Masood Ali, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Sharafi, Heidar, Sharafi, Kiomar, Sharif, Mehdi, Sharif-Alhoseini, Mahdi, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shi, Peilin, Shibuya, Kenji, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, Shokoohinia, Yalda, Shokraneh, Farhad, Shoman, Haitham, Shrime, Mark G, Si, Si, Siabani, Soraya, Sibai, Abla Mehio, Siddiqi, Tariq J, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Silva, João Pedro, Silveira, Dayane Gabriele Alve, Singam, Narayana Sarma Venkata, Singh, Jasvinder A, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Skirbekk, Vegard, Sliwa, Karen, Smith, David L, Smith, Mari, Soares Filho, Adauto Martin, Sobaih, Badr Hasan, Sobhani, Soheila, Soofi, Moslem, Sorensen, Reed J D, Soyiri, Ireneous N, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Starodubov, Vladimir I, Stein, Dan J, Steiner, Caitlyn, Steiner, Timothy J, Stokes, Mark A, Stovner, Lars Jacob, Subart, Michelle L, Sudaryanto, Agu, Sufiyan, Mu'awiyyah Babale, Sulo, Gerhard, Sunguya, Bruno F, Sur, Patrick John, Sykes, Bryan L, Sylaja, P.N., Sylte, Dillon O, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Tandon, Nikhil, Tassew, Segen Gebremeskel, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tehrani-Banihashemi, Arash, Tekalign, Tigist Gashaw, Tekelemedhin, Shishay Wahdey, Tekle, Merhawi Gebremedhin, Temsah, Mohamad-Hani, Temsah, Omar, Terkawi, Abdullah Sulieman, Tessema, Belay, Teweldemedhin, Mebrahtu, Thankappan, Kavumpurathu Raman, Theis, Andrew, Thirunavukkarasu, Sathish, Thomas, Nihal, Tilahun, Binyam, To, Quyen G, Tonelli, Marcello, Topor-Madry, Roman, Torre, Anna E, Tortajada-Girbés, Miguel, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Towbin, Jeffrey A, Tran, Bach Xuan, Tran, Khanh Bao, Troeger, Christopher E, Tsadik, Afewerki Gebremeskel, Tsoi, Derrick, Tudor Car, Lorainne, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Ullah, Irfan, Undurraga, Eduardo A, Updike, Rachel L, Usman, Muhammad Shariq, Uthman, Olalekan A, Vaduganathan, Muthiah, Vaezi, Afsane, Valdez, Pascual R, Varavikova, Elena, Varughese, Santosh, Vasankari, Tommi Juhani, Venketasubramanian, Narayanaswamy, Villafaina, Santo, Violante, Francesco S, Vladimirov, Sergey Konstantinovitch, Vlassov, Vasily, Vollset, Stein Emil, Vos, Theo, Vosoughi, Kia, Vujcic, Isidora S, Wagnew, Fasil Shiferaw, Waheed, Yasir, Wang, Yafeng, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Weldegebreal, Fitsum, Weldegwergs, Kidu Gidey, Werdecker, Andrea, West, T Eoin, Westerman, Ronny, Whiteford, Harvey A, Widecka, Justyna, Wijeratne, Tissa, Williams, Hywel C, Wilner, Lauren B, Wilson, Shadrach, Winkler, Andrea Sylvia, Wiyeh, Alison B, Wiysonge, Charles Shey, Wolfe, Charles D A, Woolf, Anthony D, Wyper, Grant M A, Xavier, Deni, Xu, Gelin, Yadgir, Simon, Yahyazadeh Jabbari, Seyed Hossein, Yamada, Tomohide, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yasin, Yasin Jemal, Yeshaneh, Alex, Yimer, Ebrahim M, Yip, Paul, Yisma, Engida, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yousefifard, Mahmoud, Yu, Chuanhua, Zadnik, Vesna, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zandian, Hamed, Zar, Heather J, Zenebe, Zerihun Menlkalew, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zucker, Inbar, Zuhlke, Liesl Joanna, and Murray, Christopher J L
Subjects: Male, Health Status, health statu, HALE, mortality rate, communicable disease, DALYs, Global Burden of Disease, Risk Factors, Prevalence, Medicine and Health Sciences, Singapore, OUTCOMES, disability-adjusted life year, international cooperation, Medicine (all), 11 Medical And Health Sciences, Central African Republic, newborn disease, IRON-DEFICIENCY, AIDS, priority journal, Bahrain, disease severity, Female, Quality-Adjusted Life Years, cerebrovascular accident, Ukraine, Life Sciences & Biomedicine, INTERVENTIONS, Slovakia, DISORDERS, Burundi, WEIGHTS, GBD 2017 DALYs and HALE Collaborators, Communicable Diseases, Article, STYLE, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Disabled Persons, human, Healthy Lifestyle, HALE, DALYs, global burden of disease, Mortality, Aged, Science & Technology, Mortality, Premature, HIV, ischemic heart disease, major clinical study, PREVENTION, non communicable disease, GBD, disability-adjusted life-years, age, sex factor, Socioeconomic Factors, Algeria, Federation of Bosnia and Herzegovina, lower respiratory tract infection, Wounds and Injuries, GENDER, Human medicine, trend study, chronic obstructive lung disease
Abstract: Background How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7.4 years (95% uncertainty interval 74-7.8), from 65.6 years (65.3-65- 8) in 1990 to 73.0 years (72.7-73.3) in 2017. The increase in years of life varied from 5.1 years (5.0-5.3) in high SDI countries to 12.0 years (11.3-12.8) in low SDI countries. Of the additional years of life expected at birth, 26.3% (20.1-33.1) were expected to be spent in poor health in high SDI countries compared with 11.7% (8.8-15.1) in low-middle SDI countries. HALE at birth increased by 6.3 years (5.9-6.7), from 57.0 years (54.6-59.1) in 1990 to 63.3 years (60.5-65.7) in 2017. The increase varied from 3.8 years (3.4-4.1) in high SDI countries to 10.5 years (9.8-11.2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1.0 year (0.4-1.7) in Saint Vincent and the Grenadines (62.4 years [59.9-64.7] in 1990 to 63.5 years [60.9-65.8] in 2017) to 23.7 years (21.9-25.6) in Eritrea (30.7 years [28.9-32.2] in 1990 to 54.4 years [51.5-57.1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1.4 years (0.6-2.3) in Algeria to 11.9 years (10.9-12.9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75.8 years [72.4-78.7]) and males (72.6 years [69 " 8-75.0]) and the lowest estimates were in Central African Republic (47.0 years [43.7-50.2] for females and 42.8 years [40.1-45.6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41.3% (38.8-43.5) for communicable diseases and by 49"8% (47.9-51.6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40.1% (36.8-43.0), although age-standardised DALY rates decreased by 18.1% (16.0-20.2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low S DI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.
Published: 2018

28. Clinical onset of atopic eczema: Results from two nationally representative British birth cohorts followed through mid-life

Author: Abuabara, K, Ye, M, McCulloch, CE, Sullivan, A, Margolis, DJ, Strachan, DP, Paternoster, L, Yew, YW, Williams, HC, and Langan, SM
Subjects: body regions, immune system diseases, otorhinolaryngologic diseases, skin and connective tissue diseases
Abstract: Background\ud Atopic eczema onset is described primarily in early childhood; the frequency and characteristics of adult-onset disease remain controversial.\ud \ud Objective\ud To determine the proportion of individuals who report atopic eczema symptoms between birth and mid adulthood, and to examine demographic, immunologic, and genetic factors associated with period of symptom onset.\ud \ud Methods\ud We conducted a longitudinal study using data from two nationally representative community-based birth cohorts from the United Kingdom: the British Cohort Studies 1958 and 1970. Individuals were followed from birth through age 42-50. The primary outcome was the age period of self-reported atopic eczema symptom onset based on repeated measures of self-reported atopic eczema at each survey wave.\ud \ud Results\ud The annual period prevalence of atopic eczema ranged from 5-15% in two cohorts of over 17,000 participants each followed from birth through mid-age. There was no clear trend in prevalence by age, and among adults reporting active atopic eczema during a given year, only 38% had symptom onset reported in childhood. When compared with individuals whose eczema started in childhood, those with adult-onset disease were more likely to be women, from Scotland or Northern England, of lower childhood socio-economic group, smokers in adulthood, and less likely to have a history of asthma. In a sub-analysis using data from the 1958 cohort only, genetic mutations previously associated with atopic eczema, including filaggrin null mutations, and allergen-specific IgE were more common among those with childhood-onset disease.\ud \ud Conclusion\ud Rates of self-reported atopic eczema remain high after childhood, and adult-onset atopic eczema has different risk factor associations than childhood-onset eczema.
Published: 2019

29. Epidemiology of basal and cutaneous squamous cell carcinoma in the U.K. 2013-15: a cohort study

Author: Venables, ZC, Nijsten, T, Wong, KF, Autier, P, Broggio, J, Deas, A, Harwood, CA, Hollestein, LM, Langan, SM, Morgan, E, Proby, CM, Rashbass, J, and Leigh, IM
Abstract: BACKGROUND: Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), together known as keratinocyte cancers (KCs), are the commonest cancer in white ethnic populations. Recent improvements to registry data collection in England has allowed more accurate analysis of the epidemiology of BCC and cSCC and for the first time we are able to provide an accurate (representative) tumour burden for KC in the U.K. OBJECTIVES: To estimate the incidence of BCC and cSCC in the U.K. METHODS: A cohort of patients with KCs between 2013 and 2015 were identified using linkage to diagnostic codes derived from pathology reports collected into the national cancer registry. Data from England's cancer registry were combined with data from Scotland, Northern Ireland and Wales. European age-standardized incidence rates (EASRs) of the first BCC and cSCC per patient per annum (PPPA) were calculated. RESULTS: In the U.K, the EASR of the first BCC and cSCC PPPA in 2013-15 were 285 and 77 per 100 000 person years, respectively (211 120 KCs total in 2015). The mean annual percentage increase was 5% between 2013 and 2015 for both BCC and cSCC. By counting the first KC PPPA, we include an additional 51% KCs compared with the previous reporting technique which counts only the first BCC and cSCC in a patient's lifetime, yet it represents a probable underestimation of 5-11% of the true tumour count. CONCLUSIONS: Based on an improved methodology, a more representative incidence of KC is presented, which is essential to healthcare planning and will lead to improved understanding of the epidemiology of KC. What's already known about this topic? Keratinocyte cancers (KCs) are the most common cancers affecting white ethnic populations. The incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) is increasing worldwide including the U.K., most commonly in elderly male Caucasian patients. These cancers are traditionally substantially underreported and frequently excluded from national cancer statistics. What does this study add? Using improved data collection methods in England and validated tumour-reporting techniques, we report the most accurate BCC and cSCC incidence data for the U.K. ever published. Identifying the first BCC and cSCC per patient per annum, the incidence of BCC and cSCC in the U.K. (excluding Wales) was 285 and 77 per 100 000 person years, respectively, between 2013 and 2015, with more than 210 000 KCs in the U.K. in 2015.
Published: 2019

30. Are environmental factors for atopic eczema in ISAAC Phase Three due to reverse causation?

Author: Rutter, C, Silverwood, RJ, Williams, HC, Ellwood, P, Asher, I, Garcia-Marcos, L, Strachan, DP, Pearce, N, Langan, SM, and ISAAC Phase 3 Study Group
Abstract: Some previously described environmental associations for atopic eczema (AE) may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple AE risk factors.\ud ISAAC Phase Three surveyed children within schools (the sampling unit) on AE symptoms and potential risk factors. We assessed the effect of these risk factors on AE symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence.\ud 546,348 children from 53 countries were included. At age 6-7 the strongest individual-level associations were with current paracetamol use (odds ratio=1.45, 95% confidence interval 1.37-1.54), which persisted at school-level (1.55, 1.10-2.21), antibiotics (1.41, 1.34-1.48) and early life paracetamol use (1.28, 1.21-1.36) with the former persisting at school-level while the latter was no longer observed (1.35, 1.00-1.82 and 0.94, 0.69-1.28 respectively). At age\ud 13-14 the strongest associations at individual-level were with current paracetamol use (1.57, 1.51-1.63) and open-fire cooking (1.46, 1.33-1.62); both were stronger at school-level (2.57, 1.84-3.59 and 2.38, 1.52-3.73 respectively). Association with exposure to heavy traffic (1.31, 1.27-1.36) also persisted at school-level (1.40, 1.07-1.82).\ud Most individual- and school level effects were consistent tending to exclude reverse causation.
Published: 2019

31. Atopic dermatitis, educational attainment and psychological functioning: a national cohort study

Author: Smirnova, J, von Kobyletzki, LB, Lindberg, M, Svensson, Å, Langan, SM, and Montgomery, S
Abstract: BACKGROUND: Atopic dermatitis (AD) might adversely affect academic performance, possibly through influences on psychological functioning such as stress resilience. OBJECTIVES: To investigate the association of atopic dermatitis with stress resilience, cognitive function and educational attainment. METHODS: We used data from a national cohort of men who underwent a military conscription examination at ages 17-20 years in Sweden between 1969 and 1976. All potential conscripts met a physician who assessed current or previous history of AD. Stress resilience was measured by a psychologist using a semistructured interview. The conscription assessment included a written cognitive function test. The highest level of education achieved was identified through record linkage. RESULTS: The study population included 234 715 men, 1673 (0·7%) of whom had a diagnosis of AD. AD was associated with a greater risk of low stress resilience [adjusted relative risk ratio (RRR) 1·60, 95% confidence interval (CI) 1·38-1·86]. AD was associated with higher cognitive function (β-coefficient 0·15, 95% CI 0·05-0·24) and higher educational level (RRR 1·29, 95% CI 1·13-1·47). However, adjustment for socioeconomic characteristics of the family of origin attenuated the magnitude of the associations and eliminated the statistical significance (β-coefficient 0·06, 95% CI -0·03 to 0·15; RRR 1·16, 95% CI 1·00-1·35). CONCLUSIONS: Swedish men with AD had lower stress resilience in late adolescence but did not have lower cognitive function or poorer educational attainment. The lower stress resilience associated with AD is consistent with an increased risk of possible long-term adverse health outcomes.
Published: 2018

32. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

Author: Chalmers, JR, Thomas, KS, Apfelbacher, C, Williams, HC, Prinsen, CA, Spuls, PI, Simpson, E, Gerbens, LAA, Boers, M, Barbarot, S, Stalder, JF, Abuabara, K, Aoki, V, Ardeleanu, M, Armstrong, J, Bang, B, Berents, TL, Burton, T, Butler, L, Chubachi, T, Cresswell-Melville, A, DeLozier, A, Eckert, L, Eichenfield, L, Flohr, C, Futamura, M, Gadkari, A, Gjerde, ES, van Halewijn, KF, Hawkes, C, Howells, L, Howie, L, Humphreys, R, Ishii, HA, Kataoka, Y, Katayama, I, Kouwenhoven, W, Langan, SM, Leshem, YA, Merhand, S, Mina-Osorio, P, Murota, H, Nakahara, T, Nunes, FP, Nygaard, U, Nygårdas, M, Ohya, Y, Ono, E, Rehbinder, E, Rogers, NK, Romeijn, GLE, Schuttelaar, MLA, Sears, AV, Simpson, MA, Singh, JA, Srour, J, Stuart, B, Svensson, Å, Talmo, G, Talmo, H, Teixeira, HD, Thyssen, JP, Todd, G, Torchet, F, Volke, A, von Kobyletzki, L, Weisshaar, E, Wollenberg, A, and Zaniboni, M
Abstract: This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
Published: 2018

33. Understanding asthma phenotypes: the World Asthma Phenotypes (WASP) international collaboration

Author: Pembrey, L, Barreto, ML, Douwes, J, Cooper, P, Henderson, J, Mpairwe, H, Ardura-Garcia, C, Chico, M, Brooks, C, Cruz, AA, Elliott, AM, Figueiredo, CA, Langan, SM, Nassanga, B, Ring, S, Rodrigues, L, and Pearce, N
Subjects: Study Protocol
Abstract: The World Asthma Phenotypes (WASP) study started in 2016 and has been conducted in five centres, in the UK, New Zealand, Brazil, Ecuador and Uganda. The objectives of this study are to combine detailed biomarker and clinical information in order to 1) better understand and characterise asthma phenotypes in high-income countries (HICs) and low and middle-income countries (LMICs), and in high and low prevalence centres; 2) compare phenotype characteristics, including clinical severity; 3) assess the risk factors for each phenotype; and 4) assess how the distribution of phenotypes differs between high prevalence and low prevalence centres. Here we present the rationale and protocol for the WASP study to enable other centres around the world to carry out similar analyses using a standardised protocol. Large collaborative and integrative studies like this are essential to further our understanding of asthma phenotypes. The findings of this study will help elucidate the aetiological mechanisms of asthma and might potentially identify new causes and guide the development of new treatments, thereby enabling better management and prevention of asthma in both HICs and LMICs., A protocol for the World Asthma Phenotypes study to better understand and characterise asthma phenotypes in five centres in the UK, New Zealand, Brazil, Ecuador and Uganda http://ow.ly/71CR30ldsU4
Published: 2018
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34. Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol

Author: Von Kobyletzki, LB, Beckman, L, Smeeth, L, McKee, M, Quint, JK, Abuabara, K, and Langan, SM
Subjects: Employment, food hypersensitivity, Adolescent, education, Clinical Sciences, systematic review, Clinical Research, Hypersensitivity, Humans, Child, Pediatric, Academic Success, allergic rhinitis, Other Medical and Health Sciences, Prevention, Public Health, Global Health, Social Medicine and Epidemiology, asthma, allergy, Quality Education, Causality, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Research Design, Public Health and Health Services, eczema, Systematic Reviews as Topic
Abstract: INTRODUCTION: Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the association between specific allergic diseases and educational attainment. The aim of this study is to systematically review the literature on allergic diseases, educational attainment and occupational status, and if possible, calculate meta-analytic summary estimates for the associations. METHODS: Systematic electronic searches in Medline, EMBASE, Cochrane, Cumulative Index to Nursing & Allied Health Literature (CINAHL), PsycINFO and education Resources Information Center (ERIC); hand search in reference lists of included papers and conference reports; search for unpublished studies in clinical trial registers and the New York Academy of Medicine Grey Literature Report; data extraction; and study quality assessment (Newcastle-Ottawa Scale) will be performed. ANALYSIS: Data will be summarised descriptively, and meta-analysis including meta-regression to explore sources of heterogeneities will be performed if possible. ETHICS AND DISSEMINATION: Dissemination in a peer-reviewed, open-access, international scientific journal is planned. PROSPERO REGISTRATION NUMBER: CRD42017058036.
Published: 2017

35. The prevalence of atopic dermatitis beyond childhood: A systematic review and meta-analysis of longitudinal studies

Author: Abuabara, K, Yu, AM, Okhovat, J-P, Allen, IE, and Langan, SM
Subjects: Pediatric, Adult, Male, atopic dermatitis, Adolescent, Allergy, Prevention, atopic eczema, prevalence, Immunology, Infant, Dermatitis, Neurodegenerative, Atopic, Brain Disorders, Young Adult, natural history, Humans, Female, eczema, Longitudinal Studies, Aetiology, Child, Preschool, 2.4 Surveillance and distribution
Abstract: BackgroundThere are sparse and conflicting data regarding the long-term clinical course of atopic dermatitis (AD). Although often described as a childhood disease, newer population-based estimates suggest the prevalence of pediatric and adult disease may be similar.MethodsOur objective was to determine whether there is a decline in the prevalence of AD in population-based cohorts of patients followed longitudinally beyond childhood. We conducted a systematic review and meta-analysis including studies assessing AD prevalence across 3 or more points in time. The primary outcome was weighted overall risk difference (percentage decrease in AD prevalence).ResultsOf 2080 references reviewed, 7 studies with 13515 participants were included. Participants were assessed at 3-6 time points, ranging from age 3months to 26years. The percentage decrease in prevalence after age 12 was 1%, which was not significantly different from zero (95% confidence interval -2%-5%). Similar results were found with other age cut-offs.ConclusionThe prevalence of AD in longitudinal birth cohort studies is similar in childhood and adolescence/early adulthood.
Published: 2017

36. Development and Validation of an Algorithm to Accurately Identify Atopic Eczema Patients in Primary Care Electronic Health Records from the UK

Author: Abuabara, K, Magyari, AM, Hoffstad, O, Jabbar-Lopez, ZK, Smeeth, L, Williams, HC, Gelfand, JM, Margolis, DJ, and Langan, SM
Subjects: Adult, Male, The Health Improvement Network, Time Factors, Databases, Factual, Adolescent, diagnosis, THIN, The Health Improvement Network, Clinical Sciences, Oncology and Carcinogenesis, atopic eczema, prevalence, Dermatitis, PPV, Article, Atopic, Dermatitis, Atopic, Databases, Young Adult, Surveys and Questionnaires, Humans, Electronic Health Records, THIN, Child, Factual, Positive Predictive Value, routinely collected data, validation, Primary Health Care, atopic dermatitis, Dermatology & Venereal Diseases, Confidence interval, CI, PPV, positive predictive value, United Kingdom, CI, confidence interval, Female, eczema, AE, atopic eczema, Algorithms, Follow-Up Studies
Abstract: Electronic health records hold great promise for clinical and epidemiologic research. Undertaking atopic eczema (AE) research using such data is challenging because of its episodic and heterogeneous nature. We sought to develop and validate a diagnostic algorithm that identifies AE cases based on codes used for electronic records used in the UK Health Improvement Network. We found that at least one of five diagnosis codes plus two treatment codes for any skin-directed therapy were likely to accurately identify patients with AE. To validate this algorithm, a questionnaire was sent to the physicians of 200 randomly selected children and adults. The primary outcome, positive predictive value for a physician-confirmed diagnosis of AE, was 86% (95% confidence interval= 80-91). Additional criteria increased the PPV up to 95% but would miss up to 89% of individuals with physician-confirmed AE. The first and last entered diagnosis codes for individuals showed good agreement with the physician-confirmed age at onset and last disease activity; the mean difference was 0.8 years (95% confidence interval= -0.3 to 1.9) and -1.3 years (95% confidence interval= -2.5 to -0.1), respectively. A combination of diagnostic and prescription codes can be used to reliably estimate the diagnosis and duration of AE from The Health Improvement Network primary care electronic health records in the UK.
Published: 2017

37. Psoriasis and comorbid diseases: Implications for management

Author: Takeshita, J, Grewal, S, Langan, SM, Mehta, NN, Ogdie, A, Van Voorhees, AS, and Gelfand, JM
Abstract: As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article.
Published: 2017

38. Global Skin Disease Morbidity and Mortality An Update From the Global Burden of Disease Study 2013

Author: Karimkhani, C, Dellavalle, RP, Coffeng, Luc, Flohr, C, Hay, RJ, Langan, SM, Nsoesie, EO, Ferrari, AJ, Erskine, HE, Silverberg, JI, Vos, T, Naghavi, M, and Public Health
Published: 2017

39. Antibiotics and acne: an emerging iceberg of antibiotic resistance?

Author: Sinnott, S-J, Bhate, K, Margolis, DJ, and Langan, SM
Published: 2016

40. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author: Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Murray, CJL, Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL
Published: 2017

41. Statin use and the risk of herpes zoster: a nested case-control study using primary care data from the U.K. Clinical Research Practice Datalink

Author: Matthews, A, Turkson, M, Forbes, H, Langan, SM, Smeeth, L, and Bhaskaran, K
Subjects: nutritional and metabolic diseases, cardiovascular diseases
Abstract: BACKGROUND: Statins are commonly prescribed worldwide and recent evidence suggests that they may increase the risk of herpes zoster (HZ). OBJECTIVES: To quantify the effect of statin exposure on the risk of HZ in the U.K. METHODS: A matched case-control study was conducted using data from U.K. primary care and hospital records. Patients > 18 years with an incident diagnosis of HZ were matched to up to four controls for age, sex and general practice. Patients were included in the statin exposure group if they had ever used a statin, and the daily dosage of the most recent statin prescription and the time since the most recent statin prescription were also recorded. The primary outcome was an incident diagnosis of HZ. Odds ratios (ORs) were estimated from conditional logistic regression and adjusted for potential confounders. RESULTS: A total of 144 959 incident cases of HZ were matched to 549 336 controls. Adjusted analysis suggested strong evidence for an increase in the risk of HZ related to statin exposure (OR 1·13, 95% confidence interval 1·11-1·15). There was also an increased risk when dosages were increased for patients who were currently or had recently been receiving statin treatment (Ptrend < 0·001), and we found an attenuation of the increased risk of HZ in previous statin users as the time since last statin exposure increased (Ptrend < 0·001). CONCLUSIONS: These findings are consistent with the hypothesis that statin therapy leads to an increase in the risk of HZ.
Published: 2016

42. The need to improve reporting of routinely collected dermatology data for patient benefit

Author: Langan, SM and Benchimol, EI
Published: 2016

43. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

Author: GBD 2015 HIV Collaborators, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NM, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Lami, FH, Al-Aly, Z, Alam, K, Alam, NK, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Mohammad, R, Al-Raddadi, S, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CA, Anwari, P, Ärnlöv, J, Artaman, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EF, Awasthi, A, Quintanilla, BP, Bacha, U, Badawi, A, Barac, A, Bärnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJ, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cárdenas, R, Carrero, JJ, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Chang, HY, Chang, JC, Chavan, L, Chen, W, Chiang, PP, Chibalabala, M, Chisumpa, VH, Choi, JY, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, Das Neves, J, De Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, ID, Farinha, CS, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, SM, Fernandes, JC, Fischer, F, Fitchett, JR, Foigt, N, Fullman, N, Fürst, T, Gankpé, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MD, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, YH, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, McKee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GV, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, De Dieu Ngirabega, J, Nguyen, QL, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, IH, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, HY, Park, JH, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, CC, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MH, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Silva, DA, Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJ, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Tran, BX, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CD, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, SJ, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MELS, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, and Murray, CJ
Subjects: GBD 2015 HIV Collaborators
Abstract: BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding: We thank the countless individuals who have contributed to the Global Burden of Disease (GBD) Study 2015 in various capacities. We specifically thank Jeffrey Eaton and John Stover. HW and CJLM received funding for this study from the Bill & Melinda Gates Foundation; the National Institute of Mental Health, National Institutes of Health (NIH; R01MH110163); and the National Institute on Aging, NIH (P30AG047845). LJAR acknowledges the support of Qatar National Research Fund (NPRP 04-924-3-251) who provided the main funding for generating the data provided to the GBD-Institute for Health Metrics and Evaluation effort. BPAQ acknowledges institutional support from PRONABEC (National Program of Scholarship and Educational Loan), provided by the Peruvian government. DB is supported by the Bill & Melinda Gates Foundation (grant number OPP1068048). JDN was supported in his contribution to this work by a Fellowship from Fundacao para a Ciencia e a Tecnologia, Portugal (SFRH/BPD/92934/2013). KD is supported by a Wellcome Trust Fellowship in Public Health and Tropical Medicine (grant number 099876). TF received financial support from the Swiss National Science Foundation (SNSF; project number P300P3-154634). AG acknowledges funding from Sistema Nacional de Investigadores de Panama-SNI. PJ is supported by Wellcome Trust-DBT India Alliance Clinical and Public Health Intermediate Fellowship. MK receives research support from the Academy of Finland, the Swedish Research Council, Alzheimerfonden, Alzheimer's Research & Prevention Foundation, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, AXA Research Fund, Wallenberg Clinical Scholars Award from the Knut och Alice Wallenbergs Foundation, and the Sheika Salama Bint Hamdan Al Nahyan Foundation. AK's work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R&D&I and funded by the ISCIII (General Branch Evaluation and Promotion of Health Research), and the European Regional Development Fund (ERDF-FEDER). SML is funded by a National Institute for Health Research (NIHR) Clinician Scientist Fellowship (grant number NIHR/CS/010/014). HJL reports grants from the NIHR, EU Innovative Medicines Initiative, Centre for Strategic & International Studies, and WHO. WM is Program analyst, Population and Development, in the Peru Country Office of the United Nations Population Fund, which does not necessarily endorse this study. For UOM, funding from the German National Cohort Consortium (O1ER1511D) is gratefully acknowledged. KR reports grants from NIHR Oxford Biomedical Research Centre, NIHR Career Development Fellowship, and Oxford Martin School during the conduct of the study. GR acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group supported by the International Society of Nephrology (ISN). ISS reports grants from FAPESP (Brazilian public agency). RSS receives institutional support from Universidad de Ciencias Aplicadas y Ambientales, UDCA, Bogota Colombia. SS receives postdoctoral funding from the Fonds de la recherche en sante du Quebec (FRSQ), including its renewal. RTS was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI14/00894 from ISCIII-FEDER. PY acknowledges support from Strategic Public Policy Research (HKU7003-SPPR-12).
Published: 2016

44. Inequalities in zoster disease burden: a population-based cohort study to identify social determinants using linked data from the U.K. Clinical Practice Research Datalink

Author: Jain, A, van Hoek, AJ, Walker, JL, Forbes, HJ, Langan, SM, Root, A, Smeeth, L, and Thomas, SL
Subjects: 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Dermatology, 3. Good health
Abstract: BACKGROUND: Zoster vaccination was introduced in England in 2013, where tackling health inequalities is a statutory requirement. However, specific population groups with higher zoster burden remain largely unidentified. OBJECTIVES: To evaluate health inequalities in zoster disease burden prior to zoster vaccine introduction in England. METHODS: This population-based cohort study used anonymized U.K. primary care data linked to hospitalization and deprivation data. Individuals aged ≥ 65 years without prior zoster history (N = 862 470) were followed from 1 September 2003 to 31 August 2013. Poisson regression was used to obtain adjusted rate ratios (ARRs) for the association of sociodemographic factors (ethnicity, immigration status, individuals' area-level deprivation, care home residence, living arrangements) with first zoster episode. Possible mediation by comorbidities and immunosuppressive medications was also assessed. RESULTS: There were 37 014 first zoster episodes, with an incidence of 8·79 [95% confidence interval (CI) 8·70-8·88] per 1000 person-years at risk. In multivariable analyses, factors associated with higher zoster rates included care home residence (10% higher vs. those not in care homes), being a woman (16% higher vs. men), nonimmigrants (~30% higher than immigrants) and white ethnicity (for example, twice the rate compared with those of black ethnicity). Zoster incidence decreased slightly with increasing deprivation (ARR most vs. least deprived 0·96 (95% CI 0·92-0·99) and among those living alone (ARR 0·96, 95% CI 0·94-0·98). Mediating variables made little difference to the ARR of social factors but were themselves associated with increased zoster burden (ARR varied from 1·11 to 3·84). CONCLUSIONS: The burden of zoster was higher in specific sociodemographic groups. Further study is needed to ascertain whether these individuals are attending for zoster vaccination.
Published: 2018

45. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015

Author: Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SFS, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, RMS, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CAT, Anwari, P, Arnlov, J, Al, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Barac, A, Barnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJK, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cardenas, R, Carrero, JJ, Castaneda-Orjuela, CA, Rivas, JC, Catala-Lopez, F, Chang, H-Y, Chang, J-C, Chavan, L, Chen, W, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Choi, J-YJ, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, das Neves, J, de Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, IDA, Sofia e Sa Farinha, C, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Foigt, N, Fullman, N, Furst, T, Gankpe, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MDC, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, Y-H, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, Mckee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GVS, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, Ngirabega, JDD, Quyen, LN, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, H-Y, Park, J-H, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Santos Silva, DA, Alves Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJD, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabares-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Bach, XT, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CDA, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MES, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SFS, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, RMS, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CAT, Anwari, P, Arnlov, J, Al, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Barac, A, Barnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJK, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cardenas, R, Carrero, JJ, Castaneda-Orjuela, CA, Rivas, JC, Catala-Lopez, F, Chang, H-Y, Chang, J-C, Chavan, L, Chen, W, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Choi, J-YJ, Christopher, DJ, 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Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, Y-H, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, Mckee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, 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Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Santos Silva, DA, Alves Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJD, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabares-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Bach, XT, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CDA, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MES, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, and Murray, CJL
Abstract: BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 mi
Published: 2016

46. Setting the RECORD straight: developing a guideline for the REporting of studies Conducted using Observational Routinely collected Data.

Author: Langan, SM, Benchimol, EI, Guttmann, A, Moher, D, Petersen, I, Smeeth, L, Sørensen, HT, Stanley, F, Von Elm, E, Langan, SM, Benchimol, EI, Guttmann, A, Moher, D, Petersen, I, Smeeth, L, Sørensen, HT, Stanley, F, and Von Elm, E
Published: 2013

47. Renal failure with herpes simplex

Author: Langan, SM, primary, Clair, J, additional, and Lyons, JF, additional
Published: 2006
Full Text: View/download PDF

48. Bullous pemphigoid and pemphigus vulgaris -- incidence and mortality in the UK: population based cohort study.

Author: Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJP, and West J
Published: 2008
Full Text: View/download PDF

49. Vitamin E, vitamin A and essential fatty acid status of patients hospitalized for anorexia nervosa

Author: Langan, SM, primary and Farrell, PM, additional
Published: 1985
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50. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Dicker, Daniel, Nguyen, Grant, Abate, Degu, Abate, Kalkidan Hassen, Abay, Solomon M, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abdurahman, Ahmed Abdulahi, Abebe, Haftom Temesgen, Abebe, Molla, Abebe, Zegeye, Abebo, Teshome Abuka, Aboyans, Victor, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Pawan, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshin, Ashkan, Agarwal, Gina, Aggarwal, Rakesh, Aghayan, Sargis Aghasi, Agrawal, Sutapa, Agrawal, Anurag, Ahmadi, Mehdi, Ahmadi, Alireza, Ahmadieh, Hamid, Ahmed, Mohamed Lemine Cheikh brahim, Ahmed, Sayem, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alebel, Animut, Aleman, Alicia V, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine A, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla Hamed, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Anlay, Degefaye Zelalem, Ansari, Hossein, Ansariadi, Ansariadi, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Appiah, Seth Christopher Yaw, Aremu, Olatunde, Areri, Habtamu Abera, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna K, Asadi-Lari, Mohsen, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Assadi, Reza, Ataro, Zerihun, Atey, Tesfay Mehari Mehari, Athari, Seyyed Shamsadin, Atique, Suleman, Atre, Sachin R, Atteraya, Madhu Sudhan, Attia, Engi F, Ausloos, Marcel, Avila-Burgos, Leticia, Avokpaho, Euripide F G A, Awasthi, Ashish, Awuah, Baffour, Ayala Quintanilla, Beatriz Paulina, Ayele, Henok Tadesse, Ayele, Yohanes, Ayer, Rakesh, Ayuk, Tambe B, Azzopardi, Peter S, Azzopardi-Muscat, Natasha, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Banach, Maciej, Banstola, Amrit, Barac, Aleksandra, Barboza, Miguel A, Barquera, Simon, Barrero, Lope H, Basaleem, Huda, Bassat, Quique, Basu, Arindam, Basu, Sanjay, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Belachew, Abate Bekele, Belay, Aregawi Gebreyesus, Belay, Ezra, Belay, Saba Abraham, Belay, Yihalem Abebe, Bell, Michelle L, 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Younis, Mustafa Z, Yousefifard, Mahmoud, Yu, Chuanhua, Zachariah, Geevar, Zadnik, Vesna, Zafar, Shamsa, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zare, Zohreh, Zeeb, Hajo, Zeleke, Mulugeta Molla, Zenebe, Zerihun Menlkalew, Zerfu, Taddese Alemu, Zhang, Kai, Zhang, Xueying, Zhou, Maigeng, Zhu, Jun, Zodpey, Sanjay, Zucker, Inbar, Zuhlke, Liesl Joanna J, Lopez, Alan D, Gakidou, Emmanuela, and Murray, Christopher J L
Subjects: Child mortality, Alnæmi, Dánartíðni, Heilsufar, GBD, Börn, Dauði, Almennar lyflækningar, Fullorðnir, General & Internal Medicine, parasitic diseases, Psychology, age-specific mortality, Estimating adult mortality, Medicine (all), HIV, 11 Medical And Health Sciences, General Medicine, All-cause mortality, humanities, Countries, Death, mortality, national, Sálfræði, Health, GBD, mortality, Human medicine, Trends
Abstract: The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Data for this research was provided by MEASURE Evaluation, funded by the United States Agency for International Development (USAID). Views expressed do not necessarily reflect those of USAID, the US Government, or MEASURE Evaluation. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with licence no. SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law-2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data., Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing., Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, St. Jude Children's Research Hospital, the National Institute on Aging of the National Institutes of Health (award P30AG047845), and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163).
Published: 2018

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