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1. Effectiveness and safety of COVID-19 vaccines on maternal and perinatal outcomes: a systematic review and meta-analysis

Author

Mercedes Bonet, Olufemi T Oladapo, Madelon van Wely, Shakila Thangaratinam, Kate Walker, Heinke Kunst, Vanessa Brizuela, Sami L Gottlieb, Javier Zamora, Asma Khalil, John Allotey, Magnus Yap, Shaunak Chatterjee, Tania Kew, Luke Debenham, Anna Clavé Llavall, Anushka Dixit, Dengyi Zhou, Rishab Balaji, Elizabeth van Leeuwen, Elena Kostova, Edna Kara, Caron Rahn Kim, Anna Thorson, Lynne Mofenson, Jameela Sheikh, Heidi Lawson, Kehkashan Ansari, Keelin O’Donoghue, Kathryn Barry, Ngawai Moss, Wentin Chen, Halimah Khalil, Silvia Fernández-García, Megan Littmoden, Yasmin King, Adeolu Banjoko, Alya Khashaba, Meghnaa Hebbar, Millie Manning, Ankita Gupta, Shruti Attarde, Damilola Akande, Dharshini Sambamoorthi, Anoushka Ramkumar, Helen Fraser, Sophie Maddock, Tanisha Rajah, Massa Mamey, Sangamithra Ravi, Maurie Kumaran, Laura del Campo-Albendea, Karen Lau, Nana Osei-Lah, Harshitha Naidu, Nicole Stoney, Paul Sundaram, Paulomi Sengupta, Samay Mehta, Zainita Meherally, Andriya Punnoose, Chloe Knight, Eyna Sadeqa, and Jiya Cherian

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

Objective To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes.Design Systematic review and meta-analysis.Data sources Major databases between December 2019 and January 2023.Study selection Nine pairs of reviewers contributed to study selection. We included test-negative designs, comparative cohorts and randomised trials on effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Non-comparative cohort studies reporting reactogenicity outcomes were also included.Quality assessment, data extraction and analysis Two reviewers independently assessed study quality and extracted data. We undertook random-effects meta-analysis and reported findings as HRs, risk ratios (RRs), ORs or rates with 95% CIs.Results Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women).Conclusion COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women.PROSPERO registration number CRD42020178076.

Published
2024
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2. Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country’s income status: a meta-analysis

Author

Gianfranco Spiteri, Olufemi T Oladapo, Nathalie Broutet, Xiu Qiu, Shakila Thangaratinam, Hector Pardo-Hernandez, Heinke Kunst, Vanessa Brizuela, Javier Zamora, Asma Khalil, Simon Tiberi, John Allotey, Elena Stallings, Magnus Yap, Shaunak Chatterjee, Tania Kew, Luke Debenham, Anna Clavé Llavall, Anushka Dixit, Dengyi Zhou, Rishab Balaji, Siang Ing Lee, Mingyang Yuan, Dyuti Coomar, Elena Kostova, Edna Kara, Caron Rahn Kim, Anna Thorson, Lynne Mofenson, Pura Rayco-Solon, Jameela Sheikh, Heidi Lawson, Kehkashan Ansari, Ramón Escuriet, Van T Tong, Kathryn Barry, Wentin Chen, Halimah Khalil, Silvia Fernández-García, Megan Littmoden, Yasmin King, Gurimaan Sandhu, Adeolu Banjoko, Alya Khashaba, Meghnaa Hebbar, Millie Manning, Ankita Gupta, Andrea Gaetano-Gil, Shruti Attarde, Damilola Akande, Dharshini Sambamoorthi, Anoushka Ramkumar, Helen Fraser, Sophie Maddock, Tanisha Rajah, Massa Mamey, Madelon van Wely, Elizabeth van Leeuwen, Sascha Ellington, Julien Beaute, Uma Ram, and Ajith S Nair

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

Introduction The prevalence of COVID-19 and its impact varied between countries and regions. Pregnant women are at high risk of COVID-19 complications compared with non-pregnant women. The magnitude of variations, if any, in SARS-CoV-2 infection rates and its health outcomes among pregnant women by geographical regions and country’s income level is not known.Methods We performed a random-effects meta-analysis as part of the ongoing PregCOV-19 living systematic review (December 2019 to April 2021). We included cohort studies on pregnant women with COVID-19 reporting maternal (mortality, intensive care admission and preterm birth) and offspring (mortality, stillbirth, neonatal intensive care admission) outcomes and grouped them by World Bank geographical region and income level. We reported results as proportions with 95% confidence intervals (CI).Results We included 311 studies (2 003 724 pregnant women, 57 countries). The rates of SARS-CoV-2 infection in pregnant women varied significantly by region (p

Published
2022
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3. The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

Author

Oliver Patrick Devine, Andrew Christopher Harborne, Hugo Layard Horsfall, Tobin Joseph, Tess Marshall-Andon, Ryan Samuels, Joshua William Kearsley, Nadine Abbas, Hassan Baig, Joseph Beecham, Natasha Benons, Charlie Caird, Ryan Clark, Thomas Cope, James Coultas, Luke Debenham, Sarah Douglas, Jack Eldridge, Thomas Hughes-Gooding, Agnieszka Jakubowska, Oliver Jones, Eve Lancaster, Calum MacMillan, Ross McAllister, Wassim Merzougui, Ben Phillips, Simon Phillips, Omar Risk, Adam Sage, Aisha Sooltangos, Robert Spencer, Roxanne Tajbakhsh, Oluseyi Adesalu, Ivan Aganin, Ammar Ahmed, Katherine Aiken, Alimatu-Sadia Akeredolu, Ibrahim Alam, Aamna Ali, Richard Anderson, Jia Jun Ang, Fady Sameh Anis, Sonam Aojula, Catherine Arthur, Alena Ashby, Ahmed Ashraf, Emma Aspinall, Mark Awad, Abdul-Muiz Azri Yahaya, Shreya Badhrinarayanan, Soham Bandyopadhyay, Sam Barnes, Daisy Bassey-Duke, Charlotte Boreham, Rebecca Braine, Joseph Brandreth, Zoe Carrington, Zoe Cashin, Shaunak Chatterjee, Mehar Chawla, Chung Shen Chean, Chris Clements, Richard Clough, Jessica Coulthurst, Liam Curry, Vinnie Christine Daniels, Simon Davies, Rebecca Davis, Hanelie De Waal, Nasreen Desai, Hannah Douglas, James Druce, Lady-Namera Ejamike, Meron Esere, Alex Eyre, Ibrahim Talal Fazmin, Sophia Fitzgerald-Smith, Verity Ford, Sarah Freeston, Katherine Garnett, Whitney General, Helen Gilbert, Zein Gowie, Ciaran Grafton-Clarke, Keshni Gudka, Leher Gumber, Rishi Gupta, Chris Harlow, Amy Harrington, Adele Heaney, Wing Hang Serene Ho, Lucy Holloway, Christina Hood, Eleanor Houghton, Saba Houshangi, Emma Howard, Benjamin Human, Harriet Hunter, Ifrah Hussain, Sami Hussain, Richard Thomas Jackson-Taylor, Bronwen Jacob-Ramsdale, Ryan Janjuha, Saleh Jawad, Muzzamil Jelani, David Johnston, Mike Jones, Sadhana Kalidindi, Savraj Kalsi, Asanish Kalyanasundaram, Anna Kane, Sahaj Kaur, Othman Khaled Al-Othman, Qaisar Khan, Sajan Khullar, Priscilla Kirkland, Hannah Lawrence-Smith, Charlotte Leeson, Julius Elisabeth Richard Lenaerts, Kerry Long, Simon Lubbock, Jamie Mac Donald Burrell, Rachel Maguire, Praveen Mahendran, Saad Majeed, Prabhjot Singh Malhotra, Vinay Mandagere, Angelos Mantelakis, Sophie McGovern, Anjola Mosuro, Adam Moxley, Sophie Mustoe, Sam Myers, Kiran Nadeem, Reza Nasseri, Tom Newman, Richard Nzewi, Rosalie Ogborne, Joyce Omatseye, Sophie Paddock, James Parkin, Mohit Patel, Sohini Pawar, Stuart Pearce, Samuel Penrice, Julian Purdy, Raisa Ramjan, Ratan Randhawa, Usman Rasul, Elliot Raymond-Taggert, Rebecca Razey, Carmel Razzaghi, Eimear Reel, Elliot John Revell, Joanna Rigbye, Oloruntobi Rotimi, Abdelrahman Said, Emma Sanders, Pranoy Sangal, Nora Sangvik Grandal, Aadam Shah, Rahul Atul Shah, Oliver Shotton, Daniel Sims, Katie Smart, Martha Amy Smith, Nick Smith, Aninditya Salma Sopian, Matthew South, Jessica Speller, Tom J. Syer, Ngan Hong Ta, Daniel Tadross, Benjamin Thompson, Jess Trevett, Matthew Tyler, Roshan Ullah, Mrudula Utukuri, Shree Vadera, Harriet Van Den Tooren, Sara Venturini, Aradhya Vijayakumar, Melanie Vine, Zoe Wellbelove, Liora Wittner, Geoffrey Hong Kiat Yong, Farris Ziyada, and I. C. McManus

Subjects
Medical school differences, Teaching styles, Problem-based learning, Timetables, Lectures, Tutorials, Medicine
Abstract

Abstract Background What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). Method The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. Results A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. Discussion UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.

Published
2020
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4. Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

Author

I. C. McManus, Andrew Christopher Harborne, Hugo Layard Horsfall, Tobin Joseph, Daniel T. Smith, Tess Marshall-Andon, Ryan Samuels, Joshua William Kearsley, Nadine Abbas, Hassan Baig, Joseph Beecham, Natasha Benons, Charlie Caird, Ryan Clark, Thomas Cope, James Coultas, Luke Debenham, Sarah Douglas, Jack Eldridge, Thomas Hughes-Gooding, Agnieszka Jakubowska, Oliver Jones, Eve Lancaster, Calum MacMillan, Ross McAllister, Wassim Merzougui, Ben Phillips, Simon Phillips, Omar Risk, Adam Sage, Aisha Sooltangos, Robert Spencer, Roxanne Tajbakhsh, Oluseyi Adesalu, Ivan Aganin, Ammar Ahmed, Katherine Aiken, Alimatu-Sadia Akeredolu, Ibrahim Alam, Aamna Ali, Richard Anderson, Jia Jun Ang, Fady Sameh Anis, Sonam Aojula, Catherine Arthur, Alena Ashby, Ahmed Ashraf, Emma Aspinall, Mark Awad, Abdul-Muiz Azri Yahaya, Shreya Badhrinarayanan, Soham Bandyopadhyay, Sam Barnes, Daisy Bassey-Duke, Charlotte Boreham, Rebecca Braine, Joseph Brandreth, Zoe Carrington, Zoe Cashin, Shaunak Chatterjee, Mehar Chawla, Chung Shen Chean, Chris Clements, Richard Clough, Jessica Coulthurst, Liam Curry, Vinnie Christine Daniels, Simon Davies, Rebecca Davis, Hanelie De Waal, Nasreen Desai, Hannah Douglas, James Druce, Lady-Namera Ejamike, Meron Esere, Alex Eyre, Ibrahim Talal Fazmin, Sophia Fitzgerald-Smith, Verity Ford, Sarah Freeston, Katherine Garnett, Whitney General, Helen Gilbert, Zein Gowie, Ciaran Grafton-Clarke, Keshni Gudka, Leher Gumber, Rishi Gupta, Chris Harlow, Amy Harrington, Adele Heaney, Wing Hang Serene Ho, Lucy Holloway, Christina Hood, Eleanor Houghton, Saba Houshangi, Emma Howard, Benjamin Human, Harriet Hunter, Ifrah Hussain, Sami Hussain, Richard Thomas Jackson-Taylor, Bronwen Jacob-Ramsdale, Ryan Janjuha, Saleh Jawad, Muzzamil Jelani, David Johnston, Mike Jones, Sadhana Kalidindi, Savraj Kalsi, Asanish Kalyanasundaram, Anna Kane, Sahaj Kaur, Othman Khaled Al-Othman, Qaisar Khan, Sajan Khullar, Priscilla Kirkland, Hannah Lawrence-Smith, Charlotte Leeson, Julius Elisabeth Richard Lenaerts, Kerry Long, Simon Lubbock, Jamie Mac Donald Burrell, Rachel Maguire, Praveen Mahendran, Saad Majeed, Prabhjot Singh Malhotra, Vinay Mandagere, Angelos Mantelakis, Sophie McGovern, Anjola Mosuro, Adam Moxley, Sophie Mustoe, Sam Myers, Kiran Nadeem, Reza Nasseri, Tom Newman, Richard Nzewi, Rosalie Ogborne, Joyce Omatseye, Sophie Paddock, James Parkin, Mohit Patel, Sohini Pawar, Stuart Pearce, Samuel Penrice, Julian Purdy, Raisa Ramjan, Ratan Randhawa, Usman Rasul, Elliot Raymond-Taggert, Rebecca Razey, Carmel Razzaghi, Eimear Reel, Elliot John Revell, Joanna Rigbye, Oloruntobi Rotimi, Abdelrahman Said, Emma Sanders, Pranoy Sangal, Nora Sangvik Grandal, Aadam Shah, Rahul Atul Shah, Oliver Shotton, Daniel Sims, Katie Smart, Martha Amy Smith, Nick Smith, Aninditya Salma Sopian, Matthew South, Jessica Speller, Tom J. Syer, Ngan Hong Ta, Daniel Tadross, Benjamin Thompson, Jess Trevett, Matthew Tyler, Roshan Ullah, Mrudula Utukuri, Shree Vadera, Harriet Van Den Tooren, Sara Venturini, Aradhya Vijayakumar, Melanie Vine, Zoe Wellbelove, Liora Wittner, Geoffrey Hong Kiat Yong, Farris Ziyada, and Oliver Patrick Devine

Subjects
Medical school differences, Teaching styles, National Student Survey, National Training Study, Postgraduate qualifications, Fitness to practise, Medicine
Abstract

Abstract Background Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. Method Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. Results Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p

Published
2020
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5. Breath Analysis of COVID-19 Patients in a Tertiary UK Hospital by Optical Spectrometry: The E-Nose CoVal Study

Author

Steven Laird, Luke Debenham, Danny Chandla, Cathleen Chan, Emma Daulton, Johnathan Taylor, Palashika Bhat, Lisa Berry, Peter Munthali, and James A. Covington

Subjects
breath analysis, COVID-19, SARS-CoV-2, electronic nose, optical spectrometry, Biotechnology, TP248.13-248.65
Abstract

Throughout the SARS-CoV-2 pandemic, diagnostic technology played a crucial role in managing outbreaks on a national and global level. One diagnostic modality that has shown promise is breath analysis, due to its non-invasive nature and ability to give a rapid result. In this study, a portable FTIR (Fourier Transform Infra-Red) spectrometer was used to detect chemical components in the breath from Covid positive symptomatic and asymptomatic patients versus a control cohort of Covid negative patients. Eighty-five patients who had a nasopharyngeal polymerase chain reaction (PCR) test for the detection of SARS-CoV-2 within the last 5 days were recruited to the study (36 symptomatic PCR positive, 23 asymptomatic PCR positive and 26 asymptomatic PCR negative). Data analysis indicated significant difference between the groups, with SARS-CoV-2 present on PCR versus the negative PCR control group producing an area under the curve (AUC) of 0.87. Similar results were obtained comparing symptomatic versus control and asymptomatic versus control. The asymptomatic results were higher than the symptomatic (0.88 vs. 0.80 AUC). When analysing individual chemicals, we found ethanol, methanol and acetaldehyde were the most important, with higher concentrations in the COVID-19 group, with symptomatic patients being higher than asymptomatic patients. This study has shown that breath analysis can provide significant results that distinguish patients with or without COVID-19 disease/carriage.

Published
2023
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6. Clinical manifestations, prevalence, risk factors, outcomes, transmission, diagnosis and treatment of COVID-19 in pregnancy and postpartum: a living systematic review protocol

Author

James Thomas, Mercedes Bonet, Caron Kim, Nathalie Broutet, Madelon van Wely, Xiu Qiu, Shakila Thangaratinam, Hector Pardo-Hernandez, Heinke Kunst, Vanessa Brizuela, Javier Zamora, Asma Khalil, Simon Tiberi, John Allotey, Elena Stallings, Magnus Yap, Tania Kew, Luke Debenham, Anushka Dixit, Dengyi Zhou, Rishab Balaji, Siang Ing Lee, Mingyang Yuan, Dyuti Coomar, Elena Kostova, Edna Kara, Anna Thorson, Lynne Mofenson, Shaunak Rhiju Chatterjee, Anna Clavé Llavall, Elisabeth van Leeuwen, Pura Rayco-Solon, and Olufemi Taiwo Oladapo

Subjects
Medicine
Abstract

Introduction Rapid, robust and continually updated evidence synthesis is required to inform management of COVID-19 in pregnant and postpartum women and to keep pace with the emerging evidence during the pandemic.Methods and analysis We plan to undertake a living systematic review to assess the prevalence, clinical manifestations, risk factors, rates of maternal and perinatal complications, potential for mother-to-child transmission, accuracy of diagnostic tests and effectiveness of treatment for COVID-19 in pregnant and postpartum women (including after miscarriage or abortion). We will search Medline, Embase, WHO COVID-19 database, preprint servers, the China National Knowledge Infrastructure system and Wanfang databases from 1 December 2019. We will supplement our search with studies mapped by Cochrane Fertility and Gynaecology group, Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), COVID-19 study repositories, reference lists and social media blogs. The search will be updated every week and not be restricted by language. We will include observational cohort (≥10 participants) and randomised studies reporting on prevalence of COVID-19 in pregnant and postpartum women, the rates of clinical manifestations and outcomes, risk factors in pregnant and postpartum women alone or in comparison with non-pregnant women with COVID-19 or pregnant women without COVID-19 and studies on tests and treatments for COVID-19. We will additionally include case reports and series with evidence on mother-to-child transmission of SARS-CoV-2 in utero, intrapartum or postpartum. We will appraise the quality of the included studies using appropriate tools to assess the risk of bias. At least two independent reviewers will undertake study selection, quality assessment and data extraction every 2 weeks. We will synthesise the findings using quantitative random effects meta-analysis and report OR or proportions with 95% CIs and prediction intervals. Case reports and series will be reported as qualitative narrative synthesis. Heterogeneity will be reported as I2 and τ2 statistics.Ethics and dissemination Ethical approval is not required as this is a synthesis of primary data. Regular updates of the results will be published on a dedicated website (https://www.birmingham.ac.uk/research/who-collaborating-centre/pregcov/index.aspx) and disseminated through publications, social media and webinars.PROSPERO registration number CRD42020178076.

Published
2020
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7. SARS-CoV-2 positivity in offspring and timing of mother-to-child transmission: living systematic review and meta-analysis

Author

John Allotey, Shaunak Chatterjee, Tania Kew, Andrea Gaetano, Elena Stallings, Silvia Fernández-García, Magnus Yap, Jameela Sheikh, Heidi Lawson, Dyuti Coomar, Anushka Dixit, Dengyi Zhou, Rishab Balaji, Megan Littmoden, Yasmin King, Luke Debenham, Anna Clavé Llavall, Kehkashan Ansari, Gurimaan Sandhu, Adeolu Banjoko, Kate Walker, Keelin O’Donoghue, Madelon van Wely, Elizabeth van Leeuwen, Elena Kostova, Heinke Kunst, Asma Khalil, Vanessa Brizuela, Nathalie Broutet, Edna Kara, Caron Rahn Kim, Anna Thorson, Olufemi T Oladapo, Javier Zamora, Mercedes Bonet, Lynne Mofenson, Shakila Thangaratinam, Graduate School, Center for Reproductive Medicine, APH - Methodology, APH - Personalized Medicine, and ARD - Amsterdam Reproduction and Development

Subjects
COVID-19 Testing, Pregnancy, SARS-CoV-2, COVID-19 Nucleic Acid Testing, Infant, Newborn, Pregnancy Outcome, COVID-19, Humans, Female, General Medicine, Pregnancy Complications, Infectious, Infectious Disease Transmission, Vertical
Abstract

ObjectivesTo assess the rates of SARS-CoV-2 positivity in babies born to mothers with SARS-CoV-2 infection, the timing of mother-to-child transmission and perinatal outcomes, and factors associated with SARS-CoV-2 status in offspring.DesignLiving systematic review and meta-analysis.Data sourcesMajor databases between 1 December 2019 and 3 August 2021.Study selectionCohort studies of pregnant and recently pregnant women (including after abortion or miscarriage) who sought hospital care for any reason and had a diagnosis of SARS-CoV-2 infection, and also provided data on offspring SARS-CoV-2 status and risk factors for positivity. Case series and case reports were also included to assess the timing and likelihood of mother-to-child transmission in SARS-CoV-2 positive babies.Data extractionTwo reviewers independently extracted data and assessed study quality. A random effects model was used to synthesise data for rates, with associations reported using odds ratios and 95% confidence intervals. Narrative syntheses were performed when meta-analysis was inappropriate. The World Health Organization classification was used to categorise the timing of mother-to-child transmission (in utero, intrapartum, early postnatal).Results472 studies (206 cohort studies, 266 case series and case reports; 28 952 mothers, 18 237 babies) were included. Overall, 1.8% (95% confidence interval 1.2% to 2.5%; 140 studies) of the 14 271 babies born to mothers with SARS-CoV-2 infection tested positive for the virus with reverse transcriptase polymerase chain reaction (RT-PCR). Of the 592 SARS-CoV-2 positive babies with data on the timing of exposure and type and timing of tests, 14 had confirmed mother-to-child transmission: seven in utero (448 assessed), two intrapartum (18 assessed), and five during the early postnatal period (70 assessed). Of the 800 SARS-CoV-2 positive babies with outcome data, 20 were stillbirths, 23 were neonatal deaths, and eight were early pregnancy losses; 749 babies were alive at the end of follow-up. Severe maternal covid-19 (odds ratio 2.4, 95% confidence interval 1.3 to 4.4), maternal death (14.1, 4.1 to 48.0), maternal admission to an intensive care unit (3.5, 1.7 to 6.9), and maternal postnatal infection (5.0, 1.2 to 20.1) were associated with SARS-CoV-2 positivity in offspring. Positivity rates using RT-PCR varied between regions, ranging from 0.1% (95% confidence interval 0.0% to 0.3%) in studies from North America to 5.7% (3.2% to 8.7%) in studies from Latin America and the Caribbean.ConclusionSARS-CoV-2 positivity rates were found to be low in babies born to mothers with SARS-CoV-2 infection. Evidence suggests confirmed vertical transmission of SARS-CoV-2, although this is likely to be rare. Severity of maternal covid-19 appears to be associated with SARS-CoV-2 positivity in offspring.Systematic review registrationPROSPERO CRD42020178076.Readers’ noteThis article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

Published
2022

8. Treatment of COVID-19 in pregnant women: a systematic review and meta-analysis

Author

Steven Giesbers, Edwina Goh, Tania Kew, John Allotey, Vanessa Brizuela, Edna Kara, Heinke Kunst, Mercedes Bonet, Shakila Thangaratinam, Shaunak Chatterjee, Andrea Gae, Elena Stallings, Magnus Yap, Jameela Sheikh, Heidi Lawson, Dyuti Coomar, Anushka Dixit, Dengyi Zhou, Rishab Balaji, Megan Littmoden, Yasmin King, Luke Debenham, Anna Clavé Llavall, Kehkashan Ansari, Gurimaan Sandhu, Adeolu Banjoko, Helen Fraser, Tanisha Rajah, Anoushka Ramkumar, Alya Khashaba, Shruit Attarde, Kate Walker, Jim Thornton, Madelon van Wely, Elizabeth van Leeuwen, Elena Kostova, Asma Khalil, Simon Tiberi, Nathalie Broutet, Caron Rahn Kim, Anna Thorson, Olufemi T. Oladapo, Javier Zamora, and Lynne Mofenson

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, Review Article, neonatal, systematic review, medicine, Humans, Caesarean section, Prospective Studies, Prospective cohort study, education, Retrospective Studies, education.field_of_study, Pregnancy, treatment, business.industry, Obstetrics, Cesarean Section, SARS-CoV-2, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, COVID-19, Retrospective cohort study, medicine.disease, meta-analysis, Systematic review, Reproductive Medicine, Meta-analysis, Premature Birth, Maternal death, Female, Pregnant Women, pregnancy, business
Abstract

OBJECTIVE: Clinical trials evaluating pharmacological and non-pharmacological treatment of COVID-19, either excluded pregnant women or included very few women. Unlike the numerous systematic reviews on prevalence, symptoms and adverse outcomes of COVID-19 in pregnancy, there are very few on the effects of treatment on maternal and neonatal outcomes in pregnancy. We undertook a systematic review of all published and unpublished studies on the effects of pharmacological and non-pharmacological interventions for COVID-19 on maternal and neonatal pregnancy outcomes. DATA SOURCES: We performed a systematic literature search of the following databases: Medline, Embase, Cochrane database, WHO (World Health Organization) COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 1 December 2020. STUDY ELIGIBILITY CRITERIA: Studies were only included if they involved pregnant or postnatal women who were exposed to pregnancy specific interventions like the mode of delivery and type of anaesthesia, pharmacological or non-pharmacological interventions. STUDY APPRAISAL AND SYNTHESIS METHODS: We first screened the titles and abstracts of studies and then assessed the full text of the selected studies in detail for eligibility. Data on study design, population, type of screening for COVID-19, country, hospital, country status (high or low and middle income), treatment given (mode of delivery, type of anaesthesia, type of pharmacological and non-pharmacological treatment was extracted. The pre-defined maternal outcomes we collected were mode of delivery (vaginal or by caesarean section), severe or critical COVID-19 (as defined by the authors), symptomatic COVID-19, maternal death, maternal hospital admission, ICU admission, mechanical ventilation, ECMO and maternal pneumonia. The pre-defined neonatal outcomes we extracted were preterm birth (

Published
2021

9. Visible lipaemia in a man with early onset metabolic syndrome

Author

Luke Debenham and Jayashekara Acharya

Subjects
0301 basic medicine, Adult, Male, Pediatrics, medicine.medical_specialty, Time Factors, endocrine system diseases, Images In…, Hyperlipidemias, Type 2 diabetes, 030105 genetics & heredity, 03 medical and health sciences, 0302 clinical medicine, Polyuria, Diabetes mellitus, medicine, Humans, Family history, Metabolic Syndrome, business.industry, nutritional and metabolic diseases, General Medicine, medicine.disease, Ketonuria, medicine.symptom, Metabolic syndrome, business, Polydipsia, Body mass index, 030217 neurology & neurosurgery
Abstract

A 27-year-old man of Indian descent who is 174 cm tall, weighed 85 kg, with a body mass index of 29 kg/m2 presented with polyuria, polydipsia, dyslipidaemia, hyperglycaemia and ketonuria. He has a family history of type 2 diabetes and drinks around one unit of alcohol a week. On clinical

Published
2020

10. Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

Author

Richard Nzewi, Luke Debenham, Calum MacMillan, Kiran Nadeem, Zoe Carrington, Omar Risk, Rebecca Razey, James Parkin, Sam Myers, Asanish Kalyanasundaram, Mark Awad, Zein Gowie, Julian Purdy, Simon E. V. Phillips, Zoe Wellbelove, Mike Jones, Priscilla Kirkland, Nadine Abbas, Oluseyi Adesalu, Roxanne Tajbakhsh, Oliver Shotton, Adele Heaney, Joseph Brandreth, Benjamin Human, Jamie Mac Donald Burrell, Benjamin Thompson, Wassim Merzougui, Chris Harlow, Matthew South, Angelos Mantelakis, Nora Sangvik Grandal, Samuel C. Barnes, Daniel Sims, Fady Sameh Anis, Hannah Lawrence-Smith, Thomas P. W. Cope, Farris Ziyada, Saad Majeed, Carmel Razzaghi, Jack Eldridge, Rachel Maguire, Amy Harrington, Simon Lubbock, Abdul Muiz Azri Yahaya, Roshan Ullah, Oliver P. Devine, Zoe Cashin, Usman Rasul, Daniel Tadross, Pranoy Sangal, Ngan Hong Ta, Ammar Ahmed, Mehar Chawla, Sarah Freeston, Hugo Layard Horsfall, Sohini Pawar, Eve Lancaster, Harriet Hunter, Richard Clough, Alex Eyre, Sonam Aojula, Prabhjot Singh Malhotra, Elliot Raymond-Taggert, Ciaran Grafton-Clarke, Abdelrahman Said, Katherine Aiken, Ryan Janjuha, Adam Sage, Wing Hang Serene Ho, Shree Vadera, Joyce Omatseye, Aninditya Salma Sopian, Daisy Bassey-Duke, Samuel Penrice, Tom Newman, Sarah Douglas, Helen Gilbert, Jia Jun Ang, Aisha Sooltangos, Leher Gumber, Raisa Ramjan, Nasreen Desai, Shaunak Chatterjee, Oloruntobi Rotimi, Shreya Badhrinarayanan, Chris Clements, Harriet Van Den Tooren, Bronwen Jacob-Ramsdale, Savraj Kalsi, Mrudula Utukuri, Soham Bandyopadhyay, Eleanor Houghton, Meron Esere, Sadhana Kalidindi, Chung Shen Chean, James Coultas, Emma Sanders, Jessica Coulthurst, Ahmed Ashraf, Nick Smith, Whitney General, Katherine Garnett, Emma L Howard, Joanna Rigbye, Rebecca Braine, Saba Houshangi, Christina Hood, Aadam Shah, Praveen Mahendran, Ifrah Hussain, Ben Phillips, Keshni Gudka, Alimatu Sadia Akeredolu, Reza Nasseri, Tobin Joseph, Vinay Mandagere, Charlotte Leeson, Jess Trevett, Anjola Mosuro, Othman Khaled Al-Othman, Thomas Hughes-Gooding, Eimear Reel, Vinnie Christine Daniels, Liora Wittner, Sophie Paddock, Verity Ford, Daniel Smith, Sara Venturini, Rahul Atul Shah, Martha Amy Smith, Matthew Tyler, Charlotte Boreham, Ratan Randhawa, Katie Smart, Richard Thomas Jackson-Taylor, Agnieszka Jakubowska, Andrew Christopher Harborne, Jessica Speller, Sophie Mustoe, Ibrahim Alam, Richard B. Anderson, Mohit Patel, Tess Marshall-Andon, Liam Curry, Elliot John Revell, Sami Hussain, Hassan Baig, Geoffrey Hong Kiat Yong, Emma Aspinall, Robert Spencer, Sajan Khullar, Ryan Samuels, Saleh Jawad, Oliver Jones, Ivan Aganin, Rebecca Davis, Hanelie De Waal, I. C. McManus, Ryan Clark, Adam Moxley, Charlie Caird, Ibrahim T. Fazmin, Natasha Benons, Rosalie Ogborne, Rishi K Gupta, Sahaj Kaur, Melanie Vine, Muzzamil Jelani, James Druce, Julius Elisabeth Richard Lenaerts, Anna Kane, Lucy Holloway, Lady Namera Ejamike, Tom Joseph Syer, Alena Ashby, Sophie McGovern, Simon Davies, Sophia Fitzgerald-Smith, Aradhya Vijayakumar, Stuart Pearce, Kerry Long, Joseph Beecham, Catherine Arthur, Qaisar Khan, Joshua William Kearsley, David Johnston, Ross McAllister, Hannah Douglas, Aamna Ali, McManus, I. C. [0000-0003-3510-4814], Harborne, Andrew Christopher [0000-0003-0937-1492], Horsfall, Hugo Layard [0000-0001-7848-5325], Joseph, Tobin [0000-0002-9283-9895], Smith, Daniel T. [0000-0003-1215-5811], Marshall-Andon, Tess [0000-0001-8909-1639], Samuels, Ryan [0000-0002-0886-7990], Abbas, Nadine [0000-0002-9116-2915], Baig, Hassan [0000-0001-8999-0474], Beecham, Joseph [0000-0002-4390-9164], Benons, Natasha [0000-0002-0750-6560], Caird, Charlie [0000-0001-7553-5585], Clark, Ryan [0000-0002-6143-9098], Cope, Thomas [0000-0003-0247-7411], Coultas, James [0000-0003-3381-8936], Debenham, Luke [0000-0002-3300-7802], Douglas, Sarah [0000-0003-3272-8154], Eldridge, Jack [0000-0001-6792-7714], Hughes-Gooding, Thomas [0000-0001-8483-5686], Jakubowska, Agnieszka [0000-0003-3153-8666], Jones, Oliver [0000-0003-4334-3567], Lancaster, Eve [0000-0001-5703-252X], MacMillan, Calum [0000-0002-8167-0051], McAllister, Ross [0000-0003-1686-1174], Merzougui, Wassim [0000-0001-7398-0095], Phillips, Ben [0000-0002-0489-6700], Risk, Omar [0000-0002-9226-9263], Sage, Adam [0000-0002-7763-404X], Sooltangos, Aisha [0000-0001-5675-1709], Spencer, Robert [0000-0001-9045-6260], Tajbakhsh, Roxanne [0000-0002-3753-6306], Adesalu, Oluseyi [0000-0001-8796-2701], Aganin, Ivan [0000-0002-3711-9430], Aiken, Katherine [0000-0002-3245-7772], Alam, Ibrahim [0000-0003-2853-623X], Ali, Aamna [0000-0003-1255-6113], Anderson, Richard [0000-0003-4734-0208], Anis, Fady Sameh [0000-0002-0950-3777], Arthur, Catherine [0000-0001-9551-6250], Ashraf, Ahmed [0000-0002-3921-8395], Aspinall, Emma [0000-0001-8307-1661], Awad, Mark [0000-0002-6570-010X], Yahaya, Abdul-Muiz Azri [0000-0002-7846-9322], Badhrinarayanan, Shreya [0000-0002-7159-098X], Bandyopadhyay, Soham [0000-0001-6553-3842], Barnes, Sam [0000-0001-6009-406X], Bassey-Duke, Daisy [0000-0002-0408-1042], Boreham, Charlotte [0000-0003-4828-0542], Braine, Rebecca [0000-0003-2751-3378], Brandreth, Joseph [0000-0002-6137-5928], Carrington, Zoe [0000-0002-0006-8334], Chawla, Mehar [0000-0003-0697-815X], Chean, Chung Shen [0000-0002-1625-4078], Clements, Chris [0000-0002-2567-5536], Clough, Richard [0000-0001-6941-7881], Coulthurst, Jessica [0000-0003-0714-9572], Curry, Liam [0000-0002-6906-5502], Daniels, Vinnie Christine [0000-0001-9461-8431], Davies, Simon [0000-0001-5556-7512], Davis, Rebecca [0000-0002-6960-5580], De Waal, Hanelie [0000-0002-9131-9521], Desai, Nasreen [0000-0003-4601-9084], Douglas, Hannah [0000-0001-8113-5465], Druce, James [0000-0001-6849-8560], Ejamike, Lady-Namera [0000-0001-6196-5584], Esere, Meron [0000-0002-1838-0756], Eyre, Alex [0000-0002-0474-5662], Fazmin, Ibrahim Talal [0000-0002-3300-6279], Ford, Verity [0000-0002-1364-8522], Freeston, Sarah [0000-0001-8768-5513], Garnett, Katherine [0000-0003-1135-6478], General, Whitney [0000-0002-9222-4233], Gilbert, Helen [0000-0002-5588-411X], Gowie, Zein [0000-0002-7597-7508], Grafton-Clarke, Ciaran [0000-0002-8537-0806], Gudka, Keshni [0000-0003-0880-6992], Gumber, Leher [0000-0003-0154-1207], Gupta, Rishi [0000-0003-3839-7982], Harlow, Chris [0000-0003-2912-0594], Heaney, Adele [0000-0002-0905-4342], Ho, Wing Hang Serene [0000-0002-2687-3198], Hood, Christina [0000-0001-6821-6324], Howard, Emma [0000-0001-8411-5734], Human, Benjamin [0000-0003-4445-0639], Hunter, Harriet [0000-0002-5204-2371], Hussain, Sami [0000-0002-8654-3617], Jackson-Taylor, Richard Thomas [0000-0002-6949-2977], Jacob-Ramsdale, Bronwen [0000-0001-6215-808X], Jawad, Saleh [0000-0001-8221-9871], Jelani, Muzzamil [0000-0003-3785-415X], Johnston, David [0000-0002-7078-7510], Kalidindi, Sadhana [0000-0002-4274-2913], Kalsi, Savraj [0000-0001-9103-5089], Kalyanasundaram, Asanish [0000-0003-4175-5998], Kane, Anna [0000-0002-6197-2511], Kaur, Sahaj [0000-0002-3446-6082], Al-Othman, Othman Khaled [0000-0001-5930-8593], Khan, Qaisar [0000-0002-5486-4205], Khullar, Sajan [0000-0001-6426-2892], Kirkland, Priscilla [0000-0003-2452-4207], Leeson, Charlotte [0000-0003-4735-2452], Lenaerts, Julius Elisabeth Richard [0000-0002-1626-7792], Long, Kerry [0000-0003-4546-5509], Burrell, Jamie Mac Donald [0000-0002-8175-3973], Maguire, Rachel [0000-0003-4855-5550], Mahendran, Praveen [0000-0002-4084-5222], Majeed, Saad [0000-0003-4289-5597], Malhotra, Prabhjot Singh [0000-0001-7463-3941], Mandagere, Vinay [0000-0002-2969-6457], Mantelakis, Angelos [0000-0001-7109-943X], McGovern, Sophie [0000-0002-6198-7553], Mosuro, Anjola [0000-0002-9013-9289], Moxley, Adam [0000-0001-9794-091X], Mustoe, Sophie [0000-0002-7870-1320], Myers, Sam [0000-0001-6050-4663], Nadeem, Kiran [0000-0001-5988-6780], Newman, Tom [0000-0002-7987-9948], Nzewi, Richard [0000-0002-8159-1302], Ogborne, Rosalie [0000-0003-3327-6030], Omatseye, Joyce [0000-0001-7472-4712], Parkin, James [0000-0002-1861-0822], Patel, Mohit [0000-0003-1168-2759], Pawar, Sohini [0000-0003-0224-5258], Pearce, Stuart [0000-0002-7482-0752], Penrice, Samuel [0000-0002-1142-6686], Ramjan, Raisa [0000-0002-2020-2123], Randhawa, Ratan [0000-0002-4749-4410], Rasul, Usman [0000-0001-5820-1313], Raymond-Taggert, Elliot [0000-0003-1514-6662], Razey, Rebecca [0000-0003-1971-3580], Razzaghi, Carmel [0000-0002-3264-8528], Revell, Elliot John [0000-0001-6025-094X], Rigbye, Joanna [0000-0003-4860-4084], Rotimi, Oloruntobi [0000-0002-1385-1993], Said, Abdelrahman [0000-0002-9801-4202], Sangal, Pranoy [0000-0001-5775-5859], Grandal, Nora Sangvik [0000-0002-2461-7852], Shah, Aadam [0000-0003-1841-5530], Shah, Rahul Atul [0000-0002-6981-7305], Shotton, Oliver [0000-0001-6684-3308], Sims, Daniel [0000-0002-6916-3719], Smith, Martha Amy [0000-0002-4652-3507], Smith, Nick [0000-0003-4478-2772], South, Matthew [0000-0003-2297-1089], Speller, Jessica [0000-0001-5503-4791], Ta, Ngan Hong [0000-0002-8747-5329], Tadross, Daniel [0000-0002-3593-0182], Thompson, Benjamin [0000-0002-2491-5235], Trevett, Jess [0000-0001-5008-1724], Ullah, Roshan [0000-0002-5140-6655], Utukuri, Mrudula [0000-0003-1510-469X], Vadera, Shree [0000-0001-9492-7541], Van Den Tooren, Harriet [0000-0001-9902-7147], Venturini, Sara [0000-0002-9541-0090], Vijayakumar, Aradhya [0000-0002-8702-1087], Vine, Melanie [0000-0002-7978-4375], Wittner, Liora [0000-0003-1271-4839], Yong, Geoffrey Hong Kiat [0000-0003-0103-5793], Ziyada, Farris [0000-0003-2117-7262], Devine, Oliver Patrick [0000-0001-7621-9699], Apollo - University of Cambridge Repository, McManus, IC [0000-0003-3510-4814], and Smith, Daniel T [0000-0003-1215-5811]

Subjects
Male, Students, Medical, 020205 medical informatics, Preparedness, Problem-based learning, media_common.quotation_subject, education, Specialty, lcsh:Medicine, 02 engineering and technology, National Training Study, National Student Survey, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Obstetrics and gynaecology, Perception, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Sanctions, Humans, Quality (business), 030212 general & internal medicine, Fitness to practise, Schools, Medical, GMC sanctions, media_common, Medical education, Postgraduate qualifications, business.industry, lcsh:R, Institutional histories, General Medicine, United Kingdom, Female, Medical school differences, business, Teaching styles, Research Article
Abstract

BackgroundMedical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors.MethodAggregated data were collected for 50 measures across 29 UK medical schools. Data includeinstitutional history(e.g. rate of production of hospital and GP specialists in the past),curricular influences(e.g. PBL schools, spend per student, staff-student ratio), selection measures(e.g. entry grades),teaching and assessment(e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores,Foundation satisfaction,postgraduate examination performance andfitness to practise(postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail.ResultsMedical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant withp p Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reportedgreaterstudent satisfaction with feedback also showedlowerperformance at postgraduate examinations.More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs.Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools.A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning.Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs.ConclusionsMedical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.

Published
2020

11. Climbing Gyms as Possible High-Risk Transmission Locations in Microbial Outbreaks

Author

Luke Debenham and Jacob Reynolds

Subjects
2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Public Health, Environmental and Occupational Health, Outbreak, COVID-19, Biology, Virology, law.invention, Disease Outbreaks, Mountaineering, Transmission (mechanics), law, Climbing, Emergency Medicine, Disease Transmission, Infectious, Humans, Exercise
Published
2020

12. The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

Author

Anjola Mosuro, Liora Wittner, Reza Nasseri, Zoe Carrington, Emma L Howard, Ifrah Hussain, Ben Phillips, Asanish Kalyanasundaram, Nadine Abbas, Robert Spencer, Keshni Gudka, Zoe Wellbelove, Harriet Hunter, Richard Clough, Alex Eyre, Ahmed Ashraf, Nick Smith, Tobin Joseph, Benjamin Human, Sajan Khullar, Oloruntobi Rotimi, Abdul-Muiz Azri Yahaya, Shreya Badhrinarayanan, Whitney General, Martha Amy Smith, Adele Heaney, Ratan Randhawa, Tom Joseph Syer, Aninditya Salma Sopian, Christina Hood, Katie Smart, Richard Thomas Jackson-Taylor, Jia Jun Ang, Angelos Mantelakis, Shaunak Chatterjee, Bronwen Jacob-Ramsdale, Matthew Tyler, Saba Houshangi, Charlotte Boreham, Wassim Merzougui, Oliver P. Devine, Soham Bandyopadhyay, Tess Marshall-Andon, Liam Curry, Elliot John Revell, Andrew Christopher Harborne, Oliver Shotton, Natasha Benons, Samuel C. Barnes, Sophie McGovern, Daniel Sims, Stuart Pearce, Sami Hussain, Hassan Baig, Catherine Arthur, Tom Newman, Kerry Long, Farris Ziyada, Savraj Kalsi, Agnieszka Jakubowska, Julian Purdy, Rebecca Braine, Julius Elisabeth Richard Lenaerts, Eimear Reel, Joshua William Kearsley, Ross McAllister, Jess Trevett, Jessica Speller, Joseph Beecham, Roshan Ullah, Geoffrey Hong Kiat Yong, Mrudula Utukuri, Sophie Mustoe, Aradhya Vijayakumar, Mohit Patel, Sadhana Kalidindi, Mark Awad, Hugo Layard Horsfall, Ryan Samuels, Eve Lancaster, Carmel Razzaghi, Sonam Aojula, Priscilla Kirkland, Sophie Paddock, Elliot Raymond-Taggert, Omar Risk, Vinay Mandagere, Saleh Jawad, Rebecca Davis, Ngan Hong Ta, Abdelrahman Said, Aadam Shah, Othman Khaled Al-Othman, Usman Rasul, Mehar Chawla, Ryan Janjuha, Wing Hang Serene Ho, I. C. McManus, Sara Venturini, Thomas Hughes-Gooding, Alimatu-Sadia Akeredolu, Verity Ford, Charlie Caird, Aamna Ali, Saad Majeed, Jack Eldridge, Rachel Maguire, Prabhjot Singh Malhotra, Lady-Namera Ejamike, Sarah Freeston, Katherine Aiken, Mike Jones, Oluseyi Adesalu, Shree Vadera, Roxanne Tajbakhsh, Nasreen Desai, Daniel Tadross, Jessica Coulthurst, Vinnie Christine Daniels, Sam Myers, Joseph Brandreth, Chris Clements, Chung Shen Chean, Chris Harlow, Praveen Mahendran, Benjamin Thompson, Adam Moxley, Thomas P. W. Cope, James Druce, Matthew South, Emma Aspinall, Pranoy Sangal, Ammar Ahmed, Ciaran Grafton-Clarke, Daisy Bassey-Duke, Samuel Penrice, Nora Sangvik Grandal, Eleanor Houghton, Amy Harrington, Simon Lubbock, Leher Gumber, Sohini Pawar, Raisa Ramjan, Qaisar Khan, David Johnston, Aisha Sooltangos, Hannah Douglas, Meron Esere, Lucy Holloway, Alena Ashby, Simon Davies, Sophia Fitzgerald-Smith, Hanelie De Waal, Ibrahim T. Fazmin, Rosalie Ogborne, Sahaj Kaur, Melanie Vine, Muzzamil Jelani, Anna Kane, James Coultas, Ibrahim Alam, Jamie Mac Donald Burrell, Hannah Lawrence-Smith, Zoe Cashin, Joyce Omatseye, Sarah Douglas, Helen Gilbert, Harriet Van Den Tooren, Katherine Garnett, Joanna Rigbye, Rebecca Razey, James Parkin, Simon Phillips, Charlotte Leeson, Rahul Atul Shah, Richard Nzewi, Luke Debenham, Zein Gowie, Calum MacMillan, Kiran Nadeem, Fady Sameh Anis, Adam Sage, Emma Sanders, Oliver Jones, Ivan Aganin, Richard B. Anderson, Rishi K Gupta, Ryan Clark, Devine, Oliver Patrick [0000-0001-7621-9699], Harborne, Andrew Christopher [0000-0003-0937-1492], Horsfall, Hugo Layard [0000-0001-7848-5325], Joseph, Tobin [0000-0002-9283-9895], Marshall-Andon, Tess [0000-0001-8909-1639], Samuels, Ryan [0000-0002-0886-7990], Abbas, Nadine [0000-0002-9116-2915], Baig, Hassan [0000-0001-8999-0474], Beecham, Joseph [0000-0002-4390-9164], Benons, Natasha [0000-0002-0750-6560], Caird, Charlie [0000-0001-7553-5585], Clark, Ryan [0000-0002-6143-9098], Cope, Thomas [0000-0003-0247-7411], Coultas, James [0000-0003-3381-8936], Debenham, Luke [0000-0002-3300-7802], Douglas, Sarah [0000-0003-3272-8154], Eldridge, Jack [0000-0001-6792-7714], Hughes-Gooding, Thomas [0000-0001-8483-5686], Jakubowska, Agnieszka [0000-0003-3153-8666], Jones, Oliver [0000-0003-4334-3567], Lancaster, Eve [0000-0001-5703-252X], MacMillan, Calum [0000-0002-8167-0051], McAllister, Ross [0000-0003-1686-1174], Merzougui, Wassim [0000-0001-7398-0095], Phillips, Ben [0000-0002-0489-6700], Risk, Omar [0000-0002-9226-9263], Sage, Adam [0000-0002-7763-404X], Sooltangos, Aisha [0000-0001-5675-1709], Spencer, Robert [0000-0001-9045-6260], Tajbakhsh, Roxanne [0000-0002-3753-6306], Adesalu, Oluseyi [0000-0001-8796-2701], Aganin, Ivan [0000-0002-3711-9430], Aiken, Katherine [0000-0002-3245-7772], Alam, Ibrahim [0000-0003-2853-623X], Ali, Aamna [0000-0003-1255-6113], Anderson, Richard [0000-0003-4734-0208], Anis, Fady Sameh [0000-0002-0950-3777], Arthur, Catherine [0000-0001-9551-6250], Ashraf, Ahmed [0000-0002-3921-8395], Aspinall, Emma [0000-0001-8307-1661], Awad, Mark [0000-0002-6570-010X], Yahaya, Abdul-Muiz Azri [0000-0002-7846-9322], Badhrinarayanan, Shreya [0000-0002-7159-098X], Bandyopadhyay, Soham [0000-0001-6553-3842], Barnes, Sam [0000-0001-6009-406X], Bassey-Duke, Daisy [0000-0002-0408-1042], Boreham, Charlotte [0000-0003-4828-0542], Braine, Rebecca [0000-0003-2751-3378], Brandreth, Joseph [0000-0002-6137-5928], Carrington, Zoe [0000-0002-0006-8334], Chawla, Mehar [0000-0003-0697-815X], Chean, Chung Shen [0000-0002-1625-4078], Clements, Chris [0000-0002-2567-5536], Clough, Richard [0000-0001-6941-7881], Coulthurst, Jessica [0000-0003-0714-9572], Curry, Liam [0000-0002-6906-5502], Daniels, Vinnie Christine [0000-0001-9461-8431], Davies, Simon [0000-0001-5556-7512], Davis, Rebecca [0000-0002-6960-5580], De Waal, Hanelie [0000-0002-9131-9521], Desai, Nasreen [0000-0003-4601-9084], Douglas, Hannah [0000-0001-8113-5465], Druce, James [0000-0001-6849-8560], Ejamike, Lady-Namera [0000-0001-6196-5584], Esere, Meron [0000-0002-1838-0756], Eyre, Alex [0000-0002-0474-5662], Fazmin, Ibrahim Talal [0000-0002-3300-6279], Ford, Verity [0000-0002-1364-8522], Freeston, Sarah [0000-0001-8768-5513], Garnett, Katherine [0000-0003-1135-6478], General, Whitney [0000-0002-9222-4233], Gilbert, Helen [0000-0002-5588-411X], Gowie, Zein [0000-0002-7597-7508], Grafton-Clarke, Ciaran [0000-0002-8537-0806], Gudka, Keshni [0000-0003-0880-6992], Gumber, Leher [0000-0003-0154-1207], Gupta, Rishi [0000-0003-3839-7982], Harlow, Chris [0000-0003-2912-0594], Heaney, Adele [0000-0002-0905-4342], Ho, Wing Hang Serene [0000-0002-2687-3198], Hood, Christina [0000-0001-6821-6324], Howard, Emma [0000-0001-8411-5734], Human, Benjamin [0000-0003-4445-0639], Hunter, Harriet [0000-0002-5204-2371], Hussain, Sami [0000-0002-8654-3617], Jackson-Taylor, Richard Thomas [0000-0002-6949-2977], Jacob-Ramsdale, Bronwen [0000-0001-6215-808X], Jawad, Saleh [0000-0001-8221-9871], Jelani, Muzzamil [0000-0003-3785-415X], Johnston, David [0000-0002-7078-7510], Kalidindi, Sadhana [0000-0002-4274-2913], Kalsi, Savraj [0000-0001-9103-5089], Kalyanasundaram, Asanish [0000-0003-4175-5998], Kane, Anna [0000-0002-6197-2511], Kaur, Sahaj [0000-0002-3446-6082], Al-Othman, Othman Khaled [0000-0001-5930-8593], Khan, Qaisar [0000-0002-5486-4205], Khullar, Sajan [0000-0001-6426-2892], Kirkland, Priscilla [0000-0003-2452-4207], Leeson, Charlotte [0000-0003-4735-2452], Lenaerts, Julius Elisabeth Richard [0000-0002-1626-7792], Long, Kerry [0000-0003-4546-5509], Burrell, Jamie Mac Donald [0000-0002-8175-3973], Maguire, Rachel [0000-0003-4855-5550], Mahendran, Praveen [0000-0002-4084-5222], Majeed, Saad [0000-0003-4289-5597], Malhotra, Prabhjot Singh [0000-0001-7463-3941], Mandagere, Vinay [0000-0002-2969-6457], Mantelakis, Angelos [0000-0001-7109-943X], McGovern, Sophie [0000-0002-6198-7553], Mosuro, Anjola [0000-0002-9013-9289], Moxley, Adam [0000-0001-9794-091X], Mustoe, Sophie [0000-0002-7870-1320], Myers, Sam [0000-0001-6050-4663], Nadeem, Kiran [0000-0001-5988-6780], Newman, Tom [0000-0002-7987-9948], Nzewi, Richard [0000-0002-8159-1302], Ogborne, Rosalie [0000-0003-3327-6030], Omatseye, Joyce [0000-0001-7472-4712], Parkin, James [0000-0002-1861-0822], Patel, Mohit [0000-0003-1168-2759], Pawar, Sohini [0000-0003-0224-5258], Pearce, Stuart [0000-0002-7482-0752], Penrice, Samuel [0000-0002-1142-6686], Ramjan, Raisa [0000-0002-2020-2123], Randhawa, Ratan [0000-0002-4749-4410], Rasul, Usman [0000-0001-5820-1313], Raymond-Taggert, Elliot [0000-0003-1514-6662], Razey, Rebecca [0000-0003-1971-3580], Razzaghi, Carmel [0000-0002-3264-8528], Revell, Elliot John [0000-0001-6025-094X], Rigbye, Joanna [0000-0003-4860-4084], Rotimi, Oloruntobi [0000-0002-1385-1993], Said, Abdelrahman [0000-0002-9801-4202], Sangal, Pranoy [0000-0001-5775-5859], Grandal, Nora Sangvik [0000-0002-2461-7852], Shah, Aadam [0000-0003-1841-5530], Shah, Rahul Atul [0000-0002-6981-7305], Shotton, Oliver [0000-0001-6684-3308], Sims, Daniel [0000-0002-6916-3719], Smith, Martha Amy [0000-0002-4652-3507], Smith, Nick [0000-0003-4478-2772], South, Matthew [0000-0003-2297-1089], Speller, Jessica [0000-0001-5503-4791], Ta, Ngan Hong [0000-0002-8747-5329], Tadross, Daniel [0000-0002-3593-0182], Thompson, Benjamin [0000-0002-2491-5235], Trevett, Jess [0000-0001-5008-1724], Ullah, Roshan [0000-0002-5140-6655], Utukuri, Mrudula [0000-0003-1510-469X], Vadera, Shree [0000-0001-9492-7541], Van Den Tooren, Harriet [0000-0001-9902-7147], Venturini, Sara [0000-0002-9541-0090], Vijayakumar, Aradhya [0000-0002-8702-1087], Vine, Melanie [0000-0002-7978-4375], Wittner, Liora [0000-0003-1271-4839], Yong, Geoffrey Hong Kiat [0000-0003-0103-5793], Ziyada, Farris [0000-0003-2117-7262], McManus, IC [0000-0003-3510-4814], Apollo - University of Cambridge Repository, and McManus, I. C. [0000-0003-3510-4814]

Subjects
Male, 020205 medical informatics, Problem-based learning, lcsh:Medicine, Timetables, Tutorials, 02 engineering and technology, 03 medical and health sciences, Self-regulated learning, 0302 clinical medicine, Clinical teaching, Surveys and Questionnaires, Curriculum mapping, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Humans, 030212 general & internal medicine, Duration (project management), Student perceptions, Medical education, Academic year, business.industry, lcsh:R, General Medicine, United Kingdom, Lectures, Female, Curriculum, Medical school differences, business, Postgraduate training, Teaching styles, Education, Medical, Undergraduate, Research Article
Abstract

Background: \ud What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL).\ud \ud Method: \ud The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times.\ud \ud Results: \ud A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content.\ud \ud Discussion: \ud UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.

Published
2019

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