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1. Consistency, completeness and external validity of ethnicity recording in NHS primary care records: a cohort study in 25 million patients’ records at source using OpenSAFELY

Author

Andrews, Colm D., Mathur, Rohini, Massey, Jon, Park, Robin, Curtis, Helen J., Hopcroft, Lisa, Mehrkar, Amir, Bacon, Seb, Hickman, George, Smith, Rebecca, Evans, David, Ward, Tom, Davy, Simon, Inglesby, Peter, Dillingham, Iain, Maude, Steven, O’Dwyer, Thomas, Butler-Cole, Ben F. C., Bridges, Lucy, Bates, Chris, Parry, John, Hester, Frank, Harper, Sam, Cockburn, Jonathan, Goldacre, Ben, MacKenna, Brian, Tomlinson, Laurie A., Walker, Alex J., and Hulme, William J.

Published
2024
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2. Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study

Author

Cezard, Genevieve I., Denholm, Rachel E., Knight, Rochelle, Wei, Yinghui, Teece, Lucy, Toms, Renin, Forbes, Harriet J., Walker, Alex J., Fisher, Louis, Massey, Jon, Hopcroft, Lisa E. M., Horne, Elsie M. F., Taylor, Kurt, Palmer, Tom, Arab, Marwa Al, Cuitun Coronado, Jose Ignacio, Ip, Samantha H. Y., Davy, Simon, Dillingham, Iain, Bacon, Sebastian, Mehrkar, Amir, Morton, Caroline E., Greaves, Felix, Hyams, Catherine, Davey Smith, George, Macleod, John, Chaturvedi, Nishi, Goldacre, Ben, Whiteley, William N., Wood, Angela M., Sterne, Jonathan A. C., and Walker, Venexia

Published
2024
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3. Changes in opioid prescribing during the COVID-19 pandemic in England: an interrupted time-series analysis in the OpenSAFELY-TPP cohort

Author

Bridges, Lucy, Butler-Cole, Benjamin FC, Davy, Simon, Dillingham, Iain, Evans, David, Fisher, Louis, Green, Amelia, Hart, Liam, Hickman, George, Maude, Steven, O'Dwyer, Thomas, Smith, Rebecca M, Stokes, Pete, Ward, Tom, Cockburn, Johnathan, Harper, Sam, Hester, Frank, Parry, John, Schaffer, Andrea L, Andrews, Colm D, Brown, Andrew D, Croker, Richard, Hulme, William J, Nab, Linda, Quinlan, Jane, Speed, Victoria, Wood, Christopher, Wiedemann, Milan, Massey, Jon, Inglesby, Peter, Bacon, Seb C J, Mehrkar, Amir, Bates, Chris, Goldacre, Ben, Walker, Alex J, and MacKenna, Brian

Published
2024
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4. Clinical coding of long COVID in primary care 2020–2023 in a cohort of 19 million adults: an OpenSAFELY analysis

Author

Walker, Alex, Green, Amelia, Mehrkar, Amir, Schaffer, Andrea, Brown, Andrew, Goldacre, Ben, Butler-Cole, Ben, MacKenna, Brian, Morton, Caroline, Walters, Caroline, Stables, Catherine, Cunningham, Christine, Wood, Christopher, Andrews, Colm, Evans, David, Hickman, George, Curtis, Helen, Drysdale, Henry, Dillingham, Iain, Morley, Jessica, Massey, Jon, Nab, Linda, Hopcroft, Lisa, Fisher, Louis, Bridges, Lucy, Wiedemann, Milan, DeVito, Nicholas, Macdonald, Orla, Inglesby, Peter, Smith, Rebecca, Croker, Richard, Park, Robin, Higgins, Rose, Bacon, Sebastian, Davy, Simon, Maude, Steven, O'Dwyer, Thomas, Ward, Tom, Speed, Victoria, Hulme, William, Hart, Liam, Stokes, Pete, Bhaskaran, Krishnan, Costello, Ruth, Cowling, Thomas, Douglas, Ian, Eggo, Rosalind, Evans, Stephen, Forbes, Harriet, Grieve, Richard, Grint, Daniel, Herrett, Emily, Langan, Sinead, Mahalingasivam, Viyaasan, Mansfield, Kathryn, Mathur, Rohini, McDonald, Helen, Parker, Edward, Rentsch, Christopher, Schultze, Anna, Smeeth, Liam, Tazare, John, Tomlinson, Laurie, Walker, Jemma, Williamson, Elizabeth, Wing, Kevin, Wong, Angel, Zheng, Bang, Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, O'Hanlon, Shaun, Eavis, Alex, Jarvis, Richard, Avramov, Dima, Griffiths, Paul, Fowles, Aaron, Parkes, Nasreen, Perera, Rafael, Harrison, David, Khunti, Kamlesh, Sterne, Jonathan, Quint, Jennifer, Henderson, Alasdair D., Butler-Cole, Ben FC., Tomlinson, Laurie A., Marks, Michael, Jit, Mark, Briggs, Andrew, Lin, Liang-Yu, Carlile, Oliver, Bates, Chris, Bacon, Sebastian CJ., Dennison, William A., Costello, Ruth E., Wei, Yinghui, Walker, Alex J., and Eggo, Rosalind M.

Published
2024
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5. Impact of long COVID on health-related quality-of-life: an OpenSAFELY population cohort study using patient-reported outcome measures (OpenPROMPT)

Author

Walker, Alex, Green, Amelia, Mehrkar, Amir, Schaffer, Andrea, Brown, Andrew, Goldacre, Ben, Butler-Cole, Ben, MacKenna, Brian, Morton, Caroline, Walters, Caroline, Stables, Catherine, Cunningham, Christine, Wood, Christopher, Andrews, Colm, Evans, David, Hickman, George, Curtis, Helen, Drysdale, Henry, Dillingham, Iain, Morley, Jessica, Massey, Jon, Nab, Linda, Hopcroft, Lisa, Fisher, Louis, Bridges, Lucy, Wiedemann, Milan, DeVito, Nicholas, Macdonald, Orla, Inglesby, Peter, Smith, Rebecca, Croker, Richard, Park, Robin, Higgins, Rose, Bacon, Sebastian, Davy, Simon, Maude, Steven, O'Dwyer, Thomas, Ward, Tom, Speed, Victoria, Hulme, William, Hart, Liam, Stokes, Pete, Bhaskaran, Krishnan, Costello, Ruth, Cowling, Thomas, Douglas, Ian, Eggo, Rosalind, Evans, Stephen, Forbes, Harriet, Grieve, Richard, Grint, Daniel, Herrett, Emily, Langan, Sinead, Mahalingasivam, Viyaasan, Mansfield, Kathryn, Mathur, Rohini, McDonald, Helen, Parker, Edward, Rentsch, Christopher, Schultze, Anna, Smeeth, Liam, Tazare, John, Tomlinson, Laurie, Walker, Jemma, Williamson, Elizabeth, Wing, Kevin, Wong, Angel, Zheng, Bang, Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, O'Hanlon, Shaun, Eavis, Alex, Jarvis, Richard, Avramov, Dima, Griffiths, Paul, Fowles, Aaron, Parkes, Nasreen, Perera, Rafael, Harrison, David, Khunti, Kamlesh, Sterne, Jonathan, Quint, Jennifer, Carlile, Oliver, Briggs, Andrew, Henderson, Alasdair D., Butler-Cole, Ben F.C., Tomlinson, Laurie A., Marks, Michael, Jit, Mark, Lin, Liang-Yu, Bates, Chris, Bacon, Sebastian C.J., Dennison, William A., Costello, Ruth E., Walker, Alex J., and Eggo, Rosalind M.

Published
2024
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6. Clinical and health inequality risk factors for non-COVID-related sepsis during the global COVID-19 pandemic: a national case-control and cohort study

Author

Walker, Alex J., MacKenna, Brian, Inglesby, Peter, Goldacre, Ben, Curtis, Helen J., Morley, Jessica, Mehrkar, Amir, Bacon, Sebastian C.J., Hickman, George, Croker, Richard, Evans, David, Ward, Tom, DeVito, Nicholas J., Fisher, Louis, Green, Amelia C.A., Massey, Jon, Smith, Rebecca M., Hulme, William J., Davy, Simon, Andrews, Colm D., Hopcroft, Lisa E.M., Dillingham, Iain, Higgins, Rose, Cunningham, Christine, Wiedemann, Milan, Nab, Linda, Maude, Steven, Macdonald, Orla, Butler-Cole, Ben F.C., O'Dwyer, Thomas, Stables, Catherine L., Wood, Christopher, Brown, Andrew D., Speed, Victoria, Bridges, Lucy, Schaffer, Andrea L., Walters, Caroline E., Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, Zhong, Xiaomin, Ashiru-Oredope, Diane, Pate, Alexander, Martin, Glen P., Sharma, Anita, Dark, Paul, Felton, Tim, Lake, Claire, Hand, Kieran, Bladon, Sian, Cunningham, Neil, Gilham, Ellie, Brown, Colin S., Mirfenderesky, Mariyam, Palin, Victoria, and van Staa, Tjeerd Pieter

Published
2023
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7. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform

Author

Chaturvedi, Nishi, Park, Chloe, Carnemolla, Alisia, Williams, Dylan, Knueppel, Anika, Boyd, Andy, Turner, Emma L., Evans, Katharine M., Thomas, Richard, Berman, Samantha, McLachlan, Stela, Crane, Matthew, Whitehorn, Rebecca, Oakley, Jacqui, Foster, Diane, Woodward, Hannah, Campbell, Kirsteen C., Timpson, Nicholas, Kwong, Alex, Soares, Ana Goncalves, Griffith, Gareth, Toms, Renin, Jones, Louise, Annie, Herbert, Mitchell, Ruth, Palmer, Tom, Sterne, Jonathan, Walker, Venexia, Huntley, Lizzie, Fox, Laura, Denholm, Rachel, Knight, Rochelle, Northstone, Kate, Kanagaratnam, Arun, Horne, Elsie, Forbes, Harriet, North, Teri, Taylor, Kurt, Arab, Marwa A.L., Walker, Scott, Coronado, Jose I.C., Karthikeyan, Arun S., Ploubidis, George, Moltrecht, Bettina, Booth, Charlotte, Parsons, Sam, Wielgoszewska, Bozena, Bridger-Staatz, Charis, Steves, Claire, Thompson, Ellen, Garcia, Paz, Cheetham, Nathan, Bowyer, Ruth, Freydin, Maxim, Roberts, Amy, Goldacre, Ben, Walker, Alex, Morley, Jess, Hulme, William, Nab, Linda, Fisher, Louis, MacKenna, Brian, Andrews, Colm, Curtis, Helen, Hopcroft, Lisa, Green, Amelia, Patalay, Praveetha, Maddock, Jane, Patel, Kishan, Stafford, Jean, Jacques, Wels, Tilling, Kate, Macleod, John, McElroy, Eoin, Shah, Anoop, Silverwood, Richard, Denaxas, Spiros, Flaig, Robin, McCartney, Daniel, Campbell, Archie, Tomlinson, Laurie, Tazare, John, Zheng, Bang, Smeeth, Liam, Herrett, Emily, Cowling, Thomas, Mansfield, Kate, Costello, Ruth E., Wang, Kevin, Mansfield, Kathryn, Mahalingasivam, Viyaasan, Douglas, Ian, Langan, Sinead, Brophy, Sinead, Parker, Michael, Kennedy, Jonathan, McEachan, Rosie, Wright, John, Willan, Kathryn, Badrick, Ellena, Santorelli, Gillian, Yang, Tiffany, Hou, Bo, Steptoe, Andrew, Giorgio, Di Gessa, Zhu, Jingmin, Zaninotto, Paola, Wood, Angela, Cezard, Genevieve, Ip, Samantha, Bolton, Tom, Sampri, Alexia, Rafeti, Elena, Almaghrabi, Fatima, Sheikh, Aziz, Shah, Syed A., Katikireddi, Vittal, Shaw, Richard, Hamilton, Olivia, Green, Michael, Kromydas, Theocharis, Kopasker, Daniel, Greaves, Felix, Willans, Robert, Glen, Fiona, Sharp, Steve, Hughes, Alun, Wong, Andrew, Howes, Lee Hamill, Rapala, Alicja, Nigrelli, Lidia, McArdle, Fintan, Beckford, Chelsea, Raman, Betty, Dobson, Richard, Folarin, Amos, Stewart, Callum, Ranjan, Yatharth, Carpentieri, Jd, Sheard, Laura, Fang, Chao, Baz, Sarah, Gibson, Andy, Kellas, John, Neubauer, Stefan, Piechnik, Stefan, Lukaschuk, Elena, Saunders, Laura C., Wild, James M., Smith, Stephen, Jezzard, Peter, Tunnicliffe, Elizabeth, Sanders, Zeena-Britt, Finnigan, Lucy, Ferreira, Vanessa, Green, Mark, Rhead, Rebecca, Kibble, Milla, Wei, Yinghui, Lemanska, Agnieszka, Perez-Reche, Francisco, Piehlmaier, Dominik, Teece, Lucy, Parker, Edward, Walker, Alex J., Inglesby, Peter, Curtis, Helen J., Morton, Caroline E., Morley, Jessica, Mehrkar, Amir, Bacon, Sebastian C.J., Hickman, George, Croker, Richard, Evans, David, Ward, Tom, DeVito, Nicholas J., Green, Amelia C.A., Massey, Jon, Smith, Rebecca M., Hulme, William J., Davy, Simon, Andrews, Colm D., Hopcroft, Lisa E.M., Drysdale, Henry, Dillingham, Iain, Park, Robin Y., Higgins, Rose, Cunningham, Christine, Wiedemann, Milan, Maude, Steven, Macdonald, Orla, Butler-Cole, Ben F.C., O'Dwyer, Thomas, Stables, Catherine L., Wood, Christopher, Brown, Andrew D., Speed, Victoria, Bridges, Lucy, Schaffer, Andrea L., Walters, Caroline E., Rentsch, Christopher T., Bhaskaran, Krishnan, Schultze, Anna, Williamson, Elizabeth J., McDonald, Helen I., Tomlinson, Laurie A., Mathur, Rohini, Eggo, Rosalind M., Wing, Kevin, Wong, Angel Y.S., Grieve, Richard, Grint, Daniel J., Mansfield, Kathryn E., Douglas, Ian J., Evans, Stephen J.W., Walker, Jemma L., Cowling, Thomas E., Herrett, Emily L., Parker, Edward P.K., Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, O'Hanlon, Shaun, Eavis, Alex, Jarvis, Richard, Avramov, Dima, Griffiths, Paul, Fowles, Aaron, Parkes, Nasreen, Nicholson, Brian, Perera, Rafael, Harrison, David, Khunti, Kamlesh, Sterne, Jonathan AC., Quint, Jennifer, Henderson, Alasdair D., Carreira, Helena, Bidulka, Patrick, Warren-Gash, Charlotte, Hayes, Joseph F., Quint, Jennifer K., Katikireddi, Srinivasa Vittal, and Langan, Sinéad M.

Published
2023
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9. Changes in COVID-19-related mortality across key demographic and clinical subgroups in England from 2020 to 2022: a retrospective cohort study using the OpenSAFELY platform

Author

Nab, Linda, Parker, Edward P K, Andrews, Colm D, Hulme, William J, Fisher, Louis, Morley, Jessica, Mehrkar, Amir, MacKenna, Brian, Inglesby, Peter, Morton, Caroline E, Bacon, Sebastian C J, Hickman, George, Evans, David, Ward, Tom, Smith, Rebecca M, Davy, Simon, Dillingham, Iain, Maude, Steven, Butler-Cole, Ben F C, O’Dwyer, Thomas, Stables, Catherine L, Bridges, Lucy, Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, Zheng, Bang, Williamson, Elizabeth J, Eggo, Rosalind M, Evans, Stephen J W, Goldacre, Ben, Tomlinson, Laurie A, and Walker, Alex J

Published
2023
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11. Risk of severe COVID-19 outcomes associated with immune-mediated inflammatory diseases and immune-modifying therapies: a nationwide cohort study in the OpenSAFELY platform

Author

MacKenna, Brian, Kennedy, Nicholas A, Mehrkar, Amir, Rowan, Anna, Galloway, James, Matthewman, Julian, Mansfield, Kathryn E, Bechman, Katie, Yates, Mark, Brown, Jeremy, Schultze, Anna, Norton, Sam, Walker, Alex J, Morton, Caroline E, Harrison, David, Bhaskaran, Krishnan, Rentsch, Christopher T, Williamson, Elizabeth, Croker, Richard, Bacon, Seb, Hickman, George, Ward, Tom, Davy, Simon, Green, Amelia, Fisher, Louis, Hulme, William, Bates, Chris, Curtis, Helen J, Tazare, John, Eggo, Rosalind M, Evans, David, Inglesby, Peter, Cockburn, Jonathan, McDonald, Helen I, Tomlinson, Laurie A, Mathur, Rohini, Wong, Angel Y S, Forbes, Harriet, Parry, John, Hester, Frank, Harper, Sam, Douglas, Ian J, Smeeth, Liam, Lees, Charlie W, Evans, Stephen J W, Goldacre, Ben, Smith, Catherine H, and Langan, Sinéad M

Published
2022
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12. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records

Author

Thompson, Ellen J., Williams, Dylan M., Walker, Alex J., Mitchell, Ruth E., Niedzwiedz, Claire L., Yang, Tiffany C., Huggins, Charlotte F., Kwong, Alex S. F., Silverwood, Richard J., Di Gessa, Giorgio, Bowyer, Ruth C. E., Northstone, Kate, Hou, Bo, Green, Michael J., Dodgeon, Brian, Doores, Katie J., Duncan, Emma L., Williams, Frances M. K., Steptoe, Andrew, Porteous, David J., McEachan, Rosemary R. C., Tomlinson, Laurie, Goldacre, Ben, Patalay, Praveetha, Ploubidis, George B., Katikireddi, Srinivasa Vittal, Tilling, Kate, Rentsch, Christopher T., Timpson, Nicholas J., Chaturvedi, Nishi, and Steves, Claire J.

Published
2022
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13. Comparison of methods for predicting COVID-19-related death in the general population using the OpenSAFELY platform

Author

Williamson, Elizabeth J., Tazare, John, Bhaskaran, Krishnan, McDonald, Helen I., Walker, Alex J., Tomlinson, Laurie, Wing, Kevin, Bacon, Sebastian, Bates, Chris, Curtis, Helen J., Forbes, Harriet J., Minassian, Caroline, Morton, Caroline E., Nightingale, Emily, Mehrkar, Amir, Evans, David, Nicholson, Brian D., Leon, David A., Inglesby, Peter, MacKenna, Brian, Davies, Nicholas G., DeVito, Nicholas J., Drysdale, Henry, Cockburn, Jonathan, Hulme, William J., Morley, Jessica, Douglas, Ian, Rentsch, Christopher T., Mathur, Rohini, Wong, Angel, Schultze, Anna, Croker, Richard, Parry, John, Hester, Frank, Harper, Sam, Grieve, Richard, Harrison, David A., Steyerberg, Ewout W., Eggo, Rosalind M., Diaz-Ordaz, Karla, Keogh, Ruth, Evans, Stephen J. W., Smeeth, Liam, and Goldacre, Ben

Published
2022
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15. The impact of the COVID-19 pandemic on Antidepressant Prescribing with a focus on people with learning disability and autism: An interrupted time-series analysis in England using OpenSAFELY-TPP

Author

Cunningham, Christine, primary, Macdonald, Orla, additional, Schaffer, Andrea L, additional, Brown, Andrew D, additional, Wiedemann, Milan, additional, Fisher, Louis, additional, Curtis, Helen J, additional, Mehrkar, Amir, additional, Higgins, Rose, additional, Hulme, William J, additional, Speed, Victoria, additional, Ward, Thomas, additional, Croker, Richard, additional, Walker, Alex J, additional, Butler-Cole, Benjamin, additional, Andrews, Colm D, additional, Parry, John, additional, Bates, Chris, additional, Evans, David, additional, Inglesby, Peter, additional, Dillingham, Iain, additional, Davy, Simon, additional, Bridges, Lucy, additional, O'Dwyer, Thomas, additional, Maude, Steven, additional, Smith, Rebecca, additional, Hart, Liam, additional, Goldacre, Ben, additional, Bacon, Sebastian, additional, and MacKenna, Brian, additional

Published
2024
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16. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform

Author

Rentsch, Christopher T, DeVito, Nicholas J, MacKenna, Brian, Morton, Caroline E, Bhaskaran, Krishnan, Brown, Jeremy P, Schultze, Anna, Hulme, William J, Croker, Richard, Walker, Alex J, Williamson, Elizabeth J, Bates, Chris, Bacon, Seb, Mehrkar, Amir, Curtis, Helen J, Evans, David, Wing, Kevin, Inglesby, Peter, Mathur, Rohini, Drysdale, Henry, Wong, Angel Y S, McDonald, Helen I, Cockburn, Jonathan, Forbes, Harriet, Parry, John, Hester, Frank, Harper, Sam, Smeeth, Liam, Douglas, Ian J, Dixon, William G, Evans, Stephen J W, Tomlinson, Laurie, and Goldacre, Ben

Published
2021
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17. HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

Author

Bhaskaran, Krishnan, Rentsch, Christopher T, MacKenna, Brian, Schultze, Anna, Mehrkar, Amir, Bates, Chris J, Eggo, Rosalind M, Morton, Caroline E, Bacon, Sebastian C J, Inglesby, Peter, Douglas, Ian J, Walker, Alex J, McDonald, Helen I, Cockburn, Jonathan, Williamson, Elizabeth J, Evans, David, Forbes, Harriet J, Curtis, Helen J, Hulme, William J, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen J W, Smeeth, Liam, and Goldacre, Ben

Published
2021
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18. Effectiveness of mRNA COVID-19 Vaccines as First Booster Doses in England: An Observational Study in OpenSAFELY-TPP.

Author

Horne, Elsie M. F., Hulme, William J., Parker, Edward P. K., Keogh, Ruth H., Williamson, Elizabeth J., Walker, Venexia M., Palmer, Tom M., Denholm, Rachel, Knight, Rochelle, Curtis, Helen J., Walker, Alex J., Andrews, Colm D., Mehrkar, Amir, Morley, Jessica, MacKenna, Brian, Bacon, Sebastian C. J., Goldacre, Ben, Hernán, Miguel A., and Sterne, Jonathan A. C.

Abstract

Background: The UK delivered its first “booster” COVID-19 vaccine doses in September 2021, initially to individuals at high risk of severe disease, then to all adults. The BNT162b2 Pfizer-BioNTech vaccine was used initially, then also Moderna mRNA-1273. Methods: With the approval of the National Health Service England, we used routine clinical data to estimate the effectiveness of boosting with BNT162b2 or mRNA-1273 compared with no boosting in eligible adults who had received two primary course vaccine doses. We matched each booster recipient with an unboosted control on factors relating to booster priority status and prior COVID-19 immunization. We adjusted for additional factors in Cox models, estimating hazard ratios up to 182 days (6 months) following booster dose. We estimated hazard ratios overall and within the following periods: 1–14, 15–42, 43–69, 70–97, 98–126, 127–152, and 155–182 days. Outcomes included a positive SARS-CoV-2 test, COVID-19 hospitalization, COVID-19 death, non-COVID-19 death, and fracture. Results: We matched 8,198,643 booster recipients with unboosted controls. Adjusted hazard ratios over 6-month follow-up were: positive SARS-CoV-2 test 0.75 (0.74, 0.75); COVID-19 hospitalization 0.30 (0.29, 0.31); COVID-19 death 0.11 (0.10, 0.14); non- COVID-19 death 0.22 (0.21, 0.23); and fracture 0.77 (0.75, 0.78). Estimated effectiveness of booster vaccines against severe COVID- 19-related outcomes peaked during the first 3 months following the booster dose. By 6 months, the cumulative incidence of positive SARS-CoV-2 test was higher in boosted than unboosted individuals. Conclusions: We estimate that COVID-19 booster vaccination, compared with no booster vaccination, provided substantial protection against COVID-19 hospitalization and COVID-19 death but only limited protection against positive SARS-CoV-2 test. Lower rates of fracture in boosted than unboosted individuals may suggest unmeasured confounding. Observational studies should report estimated vaccine effectiveness against nontarget and negative control outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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19. The impact of COVID‐19 on medication reviews in English primary care. An OpenSAFELY‐TPP analysis of 20 million adult electronic health records.

Author

Wood, Christopher, Speed, Victoria, Fisher, Louis, Curtis, Helen J., Schaffer, Andrea L., Walker, Alex J., Croker, Richard, Brown, Andrew D., Cunningham, Christine, Hulme, William J., Andrews, Colm D., Butler‐Cole, Ben F. C., Evans, David, Inglesby, Peter, Dillingham, Iain, Bacon, Sebastian C. J., Davy, Simon, Ward, Tom, Hickman, George, and Bridges, Lucy

Subjects
MEDICATION reconciliation, ELECTRONIC health records, PRIMARY care, COVID-19 pandemic, COVID-19, CUCUMBER mosaic virus
Abstract

Aims: The COVID‐19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative implications for patient care. Using routinely collected data, our aim was first to describe codes used to record medication review activity and then to report the impact of COVID‐19 on the rates of medication reviews. Methods: With the approval of NHS England, we conducted a cohort study of 20 million adult patient records in general practice, in‐situ using the OpenSAFELY platform. For each month, between April 2019 and March 2022, we report the percentage of patients with a medication review coded monthly and in the previous 12 months with breakdowns by regional, clinical and demographic subgroups and those prescribed high‐risk medications. Results: In April 2019, 32.3% of patients had a medication review coded in the previous 12 months. During the first COVID‐19 lockdown, monthly activity decreased (−21.1% April 2020), but the 12‐month rate was not substantially impacted (−10.5% March 2021). The rate of structured medication review in the last 12 months reached 2.9% by March 2022, with higher percentages in high‐risk groups (care home residents 34.1%, age 90+ years 13.1%, high‐risk medications 10.2%). The most used medication review code was Medication review done 314530002 (59.5%). Conclusions: There was a substantial reduction in the monthly rate of medication reviews during the pandemic but rates recovered by the end of the study period. Structured medication reviews were prioritized for high‐risk patients. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform

Author

Schultze, Anna, Walker, Alex J, MacKenna, Brian, Morton, Caroline E, Bhaskaran, Krishnan, Brown, Jeremy P, Rentsch, Christopher T, Williamson, Elizabeth, Drysdale, Henry, Croker, Richard, Bacon, Seb, Hulme, William, Bates, Chris, Curtis, Helen J, Mehrkar, Amir, Evans, David, Inglesby, Peter, Cockburn, Jonathan, McDonald, Helen I, Tomlinson, Laurie, Mathur, Rohini, Wing, Kevin, Wong, Angel Y S, Forbes, Harriet, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen J W, Quint, Jennifer, Smeeth, Liam, Douglas, Ian J, and Goldacre, Ben

Published
2020
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23. Clinical coding of long COVID in primary care 2020-2023 in a cohort of 19 million adults: an OpenSAFELY analysis

Author

Henderson, Alasdair D, primary, Butler-Cole, Ben FC, additional, Tazare, John, additional, Tomlinson, Laurie A, additional, Marks, Michael, additional, Jit, Mark, additional, Briggs, Andrew, additional, Lin, Liang-Yu, additional, Carlile, Oliver, additional, Bates, Christopher, additional, Parry, John, additional, Bacon, Sebastian CJ, additional, Dillingham, Iain, additional, Dennison, William A, additional, Costello, Ruth E, additional, Wei, Yinghui, additional, Walker, Alex J, additional, Hulme, William, additional, Goldacre, Ben, additional, Mehrkar, Amir, additional, MacKenna, Brian, additional, Collaborative, The OpenSAFELY, additional, Herrett, Emily, additional, and Eggo, Rosalind M, additional

Published
2023
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25. Factors associated with COVID-19-related death using OpenSAFELY

Author

Williamson, Elizabeth J., Walker, Alex J., Bhaskaran, Krishnan, Bacon, Seb, Bates, Chris, Morton, Caroline E., Curtis, Helen J., Mehrkar, Amir, Evans, David, Inglesby, Peter, Cockburn, Jonathan, McDonald, Helen I., MacKenna, Brian, Tomlinson, Laurie, Douglas, Ian J., Rentsch, Christopher T., Mathur, Rohini, Wong, Angel Y. S., Grieve, Richard, Harrison, David, Forbes, Harriet, Schultze, Anna, Croker, Richard, Parry, John, Hester, Frank, Harper, Sam, Perera, Rafael, Evans, Stephen J. W., Smeeth, Liam, and Goldacre, Ben

Published
2020
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28. During the COVID‐19 pandemic 20 000 prostate cancer diagnoses were missed in England.

Author

Lemanska, Agnieszka, Andrews, Colm, Fisher, Louis, Bacon, Seb, Mehrkar, Amir, Inglesby, Peter, Davy, Simon, Goldacre, Ben, MacKenna, Brian, Walker, Alex J., Rentsch, Christopher T., Curtis, Helen J., Morton, Caroline E., Morley, Jessica, Hickman, George, Bates, Chris, Croker, Richard, Evans, David, Ward, Tom, and Cockburn, Jonathan

Subjects
COVID-19 pandemic, CANCER diagnosis, PROSTATE cancer, PROSTATE cancer patients, OLDER men
Abstract

Objectives: To investigate the effect of the COVID‐19 pandemic on prostate cancer incidence, prevalence, and mortality in England. Patients and Methods: With the approval of NHS England and using the OpenSAFELY‐TPP dataset of 24 million patients, we undertook a cohort study of men diagnosed with prostate cancer. We visualised monthly rates in prostate cancer incidence, prevalence, and mortality per 100 000 adult men from January 2015 to July 2023. To assess the effect of the pandemic, we used generalised linear models and the pre‐pandemic data to predict the expected rates from March 2020 as if the pandemic had not occurred. The 95% confidence intervals (CIs) of the predicted values were used to estimate the significance of the difference between the predicted and observed rates. Results: In 2020, there was a drop in recorded incidence by 4772 (31%) cases (15 550 vs 20 322; 95% CI 19 241–21 403). In 2021, the incidence started to recover, and the drop was 3148 cases (18%, 17 950 vs 21 098; 95% CI 19 740–22 456). By 2022, the incidence returned to the levels that would be expected. During the pandemic, the age at diagnosis shifted towards older men. In 2020, the average age was 71.6 (95% CI 71.5–71.8) years, in 2021 it was 71.8 (95% CI 71.7–72.0) years as compared to 71.3 (95% CI 71.1–71.4) years in 2019. Conclusions: Given that our dataset represents 40% of the population, we estimate that proportionally the pandemic led to 20 000 missed prostate cancer diagnoses in England alone. The increase in incidence recorded in 2023 was not enough to account for the missed cases. The prevalence of prostate cancer remained lower throughout the pandemic than expected. As the recovery efforts continue, healthcare should focus on finding the men who were affected. The research should focus on investigating the potential harms to men diagnosed at older age. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Clinical and health inequality risk factors for non-COVID-related sepsis during the global COVID-19 pandemic: a national case-control and cohort study

Author

Zhong, Xiaomin, primary, Ashiru-Oredope, Diane, additional, Pate, Alexander, additional, Martin, Glen P., additional, Sharma, Anita, additional, Dark, Paul, additional, Felton, Tim, additional, Lake, Claire, additional, MacKenna, Brian, additional, Mehrkar, Amir, additional, Bacon, Sebastian C.J., additional, Massey, Jon, additional, Inglesby, Peter, additional, Goldacre, Ben, additional, Hand, Kieran, additional, Bladon, Sian, additional, Cunningham, Neil, additional, Gilham, Ellie, additional, Brown, Colin S., additional, Mirfenderesky, Mariyam, additional, Palin, Victoria, additional, van Staa, Tjeerd Pieter, additional, Walker, Alex J., additional, Curtis, Helen J., additional, Morley, Jessica, additional, Hickman, George, additional, Croker, Richard, additional, Evans, David, additional, Ward, Tom, additional, DeVito, Nicholas J., additional, Fisher, Louis, additional, Green, Amelia C.A., additional, Smith, Rebecca M., additional, Hulme, William J., additional, Davy, Simon, additional, Andrews, Colm D., additional, Hopcroft, Lisa E.M., additional, Dillingham, Iain, additional, Higgins, Rose, additional, Cunningham, Christine, additional, Wiedemann, Milan, additional, Nab, Linda, additional, Maude, Steven, additional, Macdonald, Orla, additional, Butler-Cole, Ben F.C., additional, O'Dwyer, Thomas, additional, Stables, Catherine L., additional, Wood, Christopher, additional, Brown, Andrew D., additional, Speed, Victoria, additional, Bridges, Lucy, additional, Schaffer, Andrea L., additional, Walters, Caroline E., additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, and Harper, Sam, additional

Published
2023
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30. Anti-cancer actions in commonly used drugs : epidemiology led by laboratory science

Author

Walker, Alex J.

Subjects
616.994061, QZ Pathology
Abstract

Despite considerable research on cancer treatments and preventatives, poor outcomes in cancer patients are common. The vital search for effective cancer drugs often begins in the laboratory, where unfortunately the effects of a drug in humans cannot be perfectly modelled. Epidemiology can play a vital role in determining the real world efficacy of a drug currently used for other purposes before clinical trials begin. This thesis therefore used primarily laboratory evidence to identify potential anti-cancer uses for existing common drugs. The drugs and cancers studied were; tricyclic antidepressants and both incidence and survival in a number of cancer types, particularly glioma; aspirin and colorectal cancer survival; and angiotensin converting enzyme (ACE) inhibitors and hepatocellular carcinoma (HCC) incidence. A series of studies using The General Practice Research Database as a data source assessed any potential associations: A case-control study for tricyclic antidepressant use and cancer incidence; cohort studies to examine mortality in colorectal cancer and glioma in relation to tricyclic use, and for colorectal cancer mortality in aspirin users; and a case-control study in relation to ACE inhibitor use and HCC. A strong, cancer type specific, dose and time dependant protective effect was found for the incidence of glioma and colorectal cancer. This led to a further study examining mortality for these cancer types in tricyclic users. While no significant protective effects in all-cause mortality of tricyclic users were found, a larger study could still find such an effect in glioma. For aspirin and colorectal cancer mortality, a small but significant reduction in mortality was observed, though these effects were not entirely consistent throughout the study. There were no significant associations found between ACE inhibitors and HCC. These findings contribute to the knowledge of the anti-cancer effectiveness of these drugs, and may assist in designing future clinical studies.

Published
2011

31. Overall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform

Author

Bhaskaran, Krishnan, Rentsch, Christopher T., Hickman, George, Hulme, William J., Schultze, Anna, Curtis, Helen J., Wing, Kevin, Warren-Gash, Charlotte, Tomlinson, Laurie, Bates, Chris J., Mathur, Rohini, MacKenna, Brian, Mahalingasivam, Viyaasan, Wong, Angel, Walker, Alex J., Morton, Caroline E., Grint, Daniel, Mehrkar, Amir, Eggo, Rosalind M., Inglesby, Peter, Douglas, Ian J., McDonald, Helen I., Cockburn, Jonathan, Williamson, Elizabeth J., Evans, David, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen JW, Bacon, Sebastian, Smeeth, Liam, and Goldacre, Ben

Subjects
Hospital care -- Patient outcomes -- Risk factors, Biological sciences
Abstract

Background There is concern about medium to long-term adverse outcomes following acute Coronavirus Disease 2019 (COVID-19), but little relevant evidence exists. We aimed to investigate whether risks of hospital admission and death, overall and by specific cause, are raised following discharge from a COVID-19 hospitalisation. Methods and findings With the approval of NHS-England, we conducted a cohort study, using linked primary care and hospital data in OpenSAFELY to compare risks of hospital admission and death, overall and by specific cause, between people discharged from COVID-19 hospitalisation (February to December 2020) and surviving at least 1 week, and (i) demographically matched controls from the 2019 general population; and (ii) people discharged from influenza hospitalisation in 2017 to 2019. We used Cox regression adjusted for age, sex, ethnicity, obesity, smoking status, deprivation, and comorbidities considered potential risk factors for severe COVID-19 outcomes. We included 24,673 postdischarge COVID-19 patients, 123,362 general population controls, and 16,058 influenza controls, followed for [less than or equal to]315 days. COVID-19 patients had median age of 66 years, 13,733 (56%) were male, and 19,061 (77%) were of white ethnicity. Overall risk of hospitalisation or death (30,968 events) was higher in the COVID-19 group than general population controls (fully adjusted hazard ratio [aHR] 2.22, 2.14 to 2.30, p < 0.001) but slightly lower than the influenza group (aHR 0.95, 0.91 to 0.98, p = 0.004). All-cause mortality (7,439 events) was highest in the COVID-19 group (aHR 4.82, 4.48 to 5.19 versus general population controls [p < 0.001] and 1.74, 1.61 to 1.88 versus influenza controls [p < 0.001]). Risks for cause-specific outcomes were higher in COVID-19 survivors than in general population controls and largely similar or lower in COVID-19 compared with influenza patients. However, COVID-19 patients were more likely than influenza patients to be readmitted or die due to their initial infection or other lower respiratory tract infection (aHR 1.37, 1.22 to 1.54, p < 0.001) and to experience mental health or cognitive-related admission or death (aHR 1.37, 1.02 to 1.84, p = 0.039); in particular, COVID-19 survivors with preexisting dementia had higher risk of dementia hospitalisation or death (age- and sex-adjusted HR 2.47, 1.37 to 4.44, p = 0.002). Limitations of our study were that reasons for hospitalisation or death may have been misclassified in some cases due to inconsistent use of codes, and we did not have data to distinguish COVID-19 variants. Conclusions In this study, we observed that people discharged from a COVID-19 hospital admission had markedly higher risks for rehospitalisation and death than the general population, suggesting a substantial extra burden on healthcare. Most risks were similar to those observed after influenza hospitalisations, but COVID-19 patients had higher risks of all-cause mortality, readmission or death due to the initial infection, and dementia death, highlighting the importance of postdischarge monitoring., Author(s): Krishnan Bhaskaran 1,*, Christopher T. Rentsch 1, George Hickman 2, William J. Hulme 2, Anna Schultze 1, Helen J. Curtis 2, Kevin Wing 1, Charlotte Warren-Gash 1, Laurie Tomlinson [...]

Published
2022
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32. Impact of Electronic Health Record Interface Design on Unsafe Prescribing of Ciclosporin, Tacrolimus, and Diltiazem: Cohort Study in English National Health Service Primary Care

Author

MacKenna, Brian, Bacon, Sebastian, Walker, Alex J, Curtis, Helen J, Croker, Richard, and Goldacre, Ben

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundIn England, national safety guidance recommends that ciclosporin, tacrolimus, and diltiazem are prescribed by brand name due to their narrow therapeutic windows and, in the case of tacrolimus, to reduce the chance of organ transplantation rejection. Various small studies have shown that changes to electronic health record (EHR) system interfaces can affect prescribing choices. ObjectiveOur objectives were to assess variation by EHR systems in breach of safety guidance around prescribing of ciclosporin, tacrolimus, and diltiazem, and to conduct user-interface research into the causes of such breaches. MethodsWe carried out a retrospective cohort study using prescribing data in English primary care. Participants were English general practices and their respective EHR systems. The main outcome measures were (1) the variation in ratio of safety breaches to adherent prescribing in all practices and (2) the description of observations of EHR system usage. ResultsA total of 2,575,411 prescriptions were issued in 2018 for ciclosporin, tacrolimus, and diltiazem (over 60 mg); of these, 316,119 prescriptions breached NHS guidance (12.27%). Breaches were most common among users of the EMIS EHR system (breaches in 18.81% of ciclosporin and tacrolimus prescriptions and in 17.99% of diltiazem prescriptions), but breaches were observed in all EHR systems. ConclusionsDesign choices in EHR systems strongly influence safe prescribing of ciclosporin, tacrolimus, and diltiazem, and breaches are prevalent in general practices in England. We recommend that all EHR vendors review their systems to increase safe prescribing of these medicines in line with national guidance. Almost all clinical practice is now mediated through an EHR system; further quantitative research into the effect of EHR system design on clinical practice is long overdue.

Published
2020
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33. Data-Driven Identification of Potentially Successful Intervention Implementations Using 5 Years of Opioid Prescribing Data: Retrospective Database Study (Preprint)

Author

Hopcroft, Lisa EM, primary, Curtis, Helen J, additional, Croker, Richard, additional, Pretis, Felix, additional, Inglesby, Peter, additional, Evans, David, additional, Bacon, Sebastian, additional, Goldacre, Ben, additional, Walker, Alex J, additional, and MacKenna, Brian, additional

Published
2023
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34. Eleven key measures for monitoring general practice clinical activity during COVID-19: A retrospective cohort study using 48 million adults’ primary care records in England through OpenSAFELY

Author

Fisher, Louis, primary, Curtis, Helen J, additional, Croker, Richard, additional, Wiedemann, Milan, additional, Speed, Victoria, additional, Wood, Christopher, additional, Brown, Andrew, additional, Hopcroft, Lisa EM, additional, Higgins, Rose, additional, Massey, Jon, additional, Inglesby, Peter, additional, Morton, Caroline E, additional, Walker, Alex J, additional, Morley, Jessica, additional, Mehrkar, Amir, additional, Bacon, Seb, additional, Hickman, George, additional, Macdonald, Orla, additional, Lewis, Tom, additional, Wood, Marion, additional, Myers, Martin, additional, Samuel, Miriam, additional, Conibere, Robin, additional, Baqir, Wasim, additional, Sood, Harpreet, additional, Drury, Charles, additional, Collison, Kiren, additional, Bates, Chris, additional, Evans, David, additional, Dillingham, Iain, additional, Ward, Tom, additional, Davy, Simon, additional, Smith, Rebecca M, additional, Hulme, William, additional, Green, Amelia, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, Cockburn, Jonathan, additional, O'Hanlon, Shaun, additional, Eavis, Alex, additional, Jarvis, Richard, additional, Avramov, Dima, additional, Griffiths, Paul, additional, Fowles, Aaron, additional, Parkes, Nasreen, additional, MacKenna, Brian, additional, and Goldacre, Ben, additional

Published
2023
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35. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform

Author

Costello, Ruth E., primary, Tazare, John, additional, Piehlmaier, Dominik, additional, Herrett, Emily, additional, Parker, Edward P.K., additional, Zheng, Bang, additional, Mansfield, Kathryn E., additional, Henderson, Alasdair D., additional, Carreira, Helena, additional, Bidulka, Patrick, additional, Wong, Angel Y.S., additional, Warren-Gash, Charlotte, additional, Hayes, Joseph F., additional, Quint, Jennifer K., additional, MacKenna, Brian, additional, Mehrkar, Amir, additional, Eggo, Rosalind M., additional, Katikireddi, Srinivasa Vittal, additional, Tomlinson, Laurie, additional, Langan, Sinéad M., additional, Mathur, Rohini, additional, Chaturvedi, Nishi, additional, Park, Chloe, additional, Carnemolla, Alisia, additional, Williams, Dylan, additional, Knueppel, Anika, additional, Boyd, Andy, additional, Turner, Emma L., additional, Evans, Katharine M., additional, Thomas, Richard, additional, Berman, Samantha, additional, McLachlan, Stela, additional, Crane, Matthew, additional, Whitehorn, Rebecca, additional, Oakley, Jacqui, additional, Foster, Diane, additional, Woodward, Hannah, additional, Campbell, Kirsteen C., additional, Timpson, Nicholas, additional, Kwong, Alex, additional, Soares, Ana Goncalves, additional, Griffith, Gareth, additional, Toms, Renin, additional, Jones, Louise, additional, Annie, Herbert, additional, Mitchell, Ruth, additional, Palmer, Tom, additional, Sterne, Jonathan, additional, Walker, Venexia, additional, Huntley, Lizzie, additional, Fox, Laura, additional, Denholm, Rachel, additional, Knight, Rochelle, additional, Northstone, Kate, additional, Kanagaratnam, Arun, additional, Horne, Elsie, additional, Forbes, Harriet, additional, North, Teri, additional, Taylor, Kurt, additional, Arab, Marwa A.L., additional, Walker, Scott, additional, Coronado, Jose I.C., additional, Karthikeyan, Arun S., additional, Ploubidis, George, additional, Moltrecht, Bettina, additional, Booth, Charlotte, additional, Parsons, Sam, additional, Wielgoszewska, Bozena, additional, Bridger-Staatz, Charis, additional, Steves, Claire, additional, Thompson, Ellen, additional, Garcia, Paz, additional, Cheetham, Nathan, additional, Bowyer, Ruth, additional, Freydin, Maxim, additional, Roberts, Amy, additional, Goldacre, Ben, additional, Walker, Alex, additional, Morley, Jess, additional, Hulme, William, additional, Nab, Linda, additional, Fisher, Louis, additional, Andrews, Colm, additional, Curtis, Helen, additional, Hopcroft, Lisa, additional, Green, Amelia, additional, Patalay, Praveetha, additional, Maddock, Jane, additional, Patel, Kishan, additional, Stafford, Jean, additional, Jacques, Wels, additional, Tilling, Kate, additional, Macleod, John, additional, McElroy, Eoin, additional, Shah, Anoop, additional, Silverwood, Richard, additional, Denaxas, Spiros, additional, Flaig, Robin, additional, McCartney, Daniel, additional, Campbell, Archie, additional, Smeeth, Liam, additional, Cowling, Thomas, additional, Mansfield, Kate, additional, Costello, Ruth E., additional, Wang, Kevin, additional, Mansfield, Kathryn, additional, Mahalingasivam, Viyaasan, additional, Douglas, Ian, additional, Langan, Sinead, additional, Brophy, Sinead, additional, Parker, Michael, additional, Kennedy, Jonathan, additional, McEachan, Rosie, additional, Wright, John, additional, Willan, Kathryn, additional, Badrick, Ellena, additional, Santorelli, Gillian, additional, Yang, Tiffany, additional, Hou, Bo, additional, Steptoe, Andrew, additional, Giorgio, Di Gessa, additional, Zhu, Jingmin, additional, Zaninotto, Paola, additional, Wood, Angela, additional, Cezard, Genevieve, additional, Ip, Samantha, additional, Bolton, Tom, additional, Sampri, Alexia, additional, Rafeti, Elena, additional, Almaghrabi, Fatima, additional, Sheikh, Aziz, additional, Shah, Syed A., additional, Katikireddi, Vittal, additional, Shaw, Richard, additional, Hamilton, Olivia, additional, Green, Michael, additional, Kromydas, Theocharis, additional, Kopasker, Daniel, additional, Greaves, Felix, additional, Willans, Robert, additional, Glen, Fiona, additional, Sharp, Steve, additional, Hughes, Alun, additional, Wong, Andrew, additional, Howes, Lee Hamill, additional, Rapala, Alicja, additional, Nigrelli, Lidia, additional, McArdle, Fintan, additional, Beckford, Chelsea, additional, Raman, Betty, additional, Dobson, Richard, additional, Folarin, Amos, additional, Stewart, Callum, additional, Ranjan, Yatharth, additional, Carpentieri, Jd, additional, Sheard, Laura, additional, Fang, Chao, additional, Baz, Sarah, additional, Gibson, Andy, additional, Kellas, John, additional, Neubauer, Stefan, additional, Piechnik, Stefan, additional, Lukaschuk, Elena, additional, Saunders, Laura C., additional, Wild, James M., additional, Smith, Stephen, additional, Jezzard, Peter, additional, Tunnicliffe, Elizabeth, additional, Sanders, Zeena-Britt, additional, Finnigan, Lucy, additional, Ferreira, Vanessa, additional, Green, Mark, additional, Rhead, Rebecca, additional, Kibble, Milla, additional, Wei, Yinghui, additional, Lemanska, Agnieszka, additional, Perez-Reche, Francisco, additional, Teece, Lucy, additional, Parker, Edward, additional, Walker, Alex J., additional, Inglesby, Peter, additional, Curtis, Helen J., additional, Morton, Caroline E., additional, Morley, Jessica, additional, Bacon, Sebastian C.J., additional, Hickman, George, additional, Croker, Richard, additional, Evans, David, additional, Ward, Tom, additional, DeVito, Nicholas J., additional, Green, Amelia C.A., additional, Massey, Jon, additional, Smith, Rebecca M., additional, Hulme, William J., additional, Davy, Simon, additional, Andrews, Colm D., additional, Hopcroft, Lisa E.M., additional, Drysdale, Henry, additional, Dillingham, Iain, additional, Park, Robin Y., additional, Higgins, Rose, additional, Cunningham, Christine, additional, Wiedemann, Milan, additional, Maude, Steven, additional, Macdonald, Orla, additional, Butler-Cole, Ben F.C., additional, O'Dwyer, Thomas, additional, Stables, Catherine L., additional, Wood, Christopher, additional, Brown, Andrew D., additional, Speed, Victoria, additional, Bridges, Lucy, additional, Schaffer, Andrea L., additional, Walters, Caroline E., additional, Rentsch, Christopher T., additional, Bhaskaran, Krishnan, additional, Schultze, Anna, additional, Williamson, Elizabeth J., additional, McDonald, Helen I., additional, Tomlinson, Laurie A., additional, Wing, Kevin, additional, Grieve, Richard, additional, Grint, Daniel J., additional, Douglas, Ian J., additional, Evans, Stephen J.W., additional, Walker, Jemma L., additional, Cowling, Thomas E., additional, Herrett, Emily L., additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, O'Hanlon, Shaun, additional, Eavis, Alex, additional, Jarvis, Richard, additional, Avramov, Dima, additional, Griffiths, Paul, additional, Fowles, Aaron, additional, Parkes, Nasreen, additional, Nicholson, Brian, additional, Perera, Rafael, additional, Harrison, David, additional, Khunti, Kamlesh, additional, Sterne, Jonathan AC., additional, and Quint, Jennifer, additional

Published
2023
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36. Implementing Germ Defence digital behaviour change intervention via all primary care practices in England to reduce respiratory infections during the COVID-19 pandemic: an efficient cluster randomised controlled trial using the OpenSAFELY platform.

Author

Ainsworth, Ben, Horwood, Jeremy, Walter, Scott R., Miller, Sascha, Chalder, Melanie, De Vocht, Frank, Denison-Day, James, Elwenspoek, Martha M. C., Curtis, Helen J., Bates, Chris, Mehrkar, Amir, Bacon, Seb, Goldacre, Ben, Walker, Alex J., MacKenna, Brian, Inglesby, Peter, Morton, Caroline E., Morley, Jessica, Hickman, George, and Croker, Richard

Subjects
COVID-19 pandemic, COVID-19, RESPIRATORY infections, PATIENT participation, PRIMARY care
Abstract

Background: Germ Defence (www.germdefence.org) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19, the intervention needed to be implemented at scale rapidly. Methods: With NHS England approval, we conducted an efficient two-arm (1:1 ratio) cluster randomised controlled trial (RCT) to examine the effectiveness of randomising implementation of Germ Defence via general practitioner (GP) practices across England, UK, compared with usual care to disseminate Germ Defence to patients. GP practices randomised to the intervention arm (n = 3292) were emailed and asked to disseminate Germ Defence to all adult patients via mobile phone text, email or social media. Usual care arm GP practices (n = 3287) maintained standard management for the 4-month trial period and then asked to share Germ Defence with their adult patients. The primary outcome was the rate of GP presentations for respiratory tract infections (RTI) per patient. Secondary outcomes comprised rates of acute RTIs, confirmed COVID-19 diagnoses and suspected COVID-19 diagnoses, COVID-19 symptoms, gastrointestinal infection diagnoses, antibiotic usage and hospital admissions. The impact of the intervention on outcome rates was assessed using negative binomial regression modelling within the OpenSAFELY platform. The uptake of the intervention by GP practice and by patients was measured via website analytics. Results: Germ Defence was used 310,731 times. The average website satisfaction score was 7.52 (0–10 not at all to very satisfied, N = 9933). There was no evidence of a difference in the rate of RTIs between intervention and control practices (rate ratio (RR) 1.01, 95% CI 0.96, 1.06, p = 0.70). This was similar to all other eight health outcomes. Patient engagement within intervention arm practices ranged from 0 to 48% of a practice list. Conclusions: While the RCT did not demonstrate a difference in health outcomes, we demonstrated that rapid large-scale implementation of a digital behavioural intervention is possible and can be evaluated with a novel efficient prospective RCT methodology analysing routinely collected patient data entirely within a trusted research environment. Trial registration: This trial was registered in the ISRCTN registry (14602359) on 12 August 2020. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Challenges in Estimating the Effectiveness of COVID-19 Vaccination Using Observational Data

Author

Hulme, William J., primary, Williamson, Elizabeth, additional, Horne, Elsie M.F., additional, Green, Amelia, additional, McDonald, Helen I., additional, Walker, Alex J., additional, Curtis, Helen J., additional, Morton, Caroline E., additional, MacKenna, Brian, additional, Croker, Richard, additional, Mehrkar, Amir, additional, Bacon, Seb, additional, Evans, David, additional, Inglesby, Peter, additional, Davy, Simon, additional, Bhaskaran, Krishnan, additional, Schultze, Anna, additional, Rentsch, Christopher T., additional, Tomlinson, Laurie, additional, Douglas, Ian J., additional, Evans, Stephen J.W., additional, Smeeth, Liam, additional, Palmer, Tom, additional, Goldacre, Ben, additional, Hernán, Miguel A., additional, and Sterne, Jonathan A.C., additional

Published
2023
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39. Changes in medication safety indicators in England throughout the covid-19 pandemic using OpenSAFELY: population based, retrospective cohort study of 57 million patients using federated analytics

Author

Fisher, Louis, primary, Hopcroft, Lisa EM, additional, Rodgers, Sarah, additional, Barrett, James, additional, Oliver, Kerry, additional, Avery, Anthony J, additional, Evans, Dai, additional, Curtis, Helen, additional, Croker, Richard, additional, Macdonald, Orla, additional, Morley, Jessica, additional, Mehrkar, Amir, additional, Bacon, Sebastian, additional, Davy, Simon, additional, Dillingham, Iain, additional, Evans, David, additional, Hickman, George, additional, Inglesby, Peter, additional, Morton, Caroline E, additional, Smith, Becky, additional, Ward, Tom, additional, Hulme, William, additional, Green, Amelia, additional, Massey, Jon, additional, Walker, Alex J, additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, O’Hanlon, Shaun, additional, Eavis, Alex, additional, Jarvis, Richard, additional, Avramov, Dima, additional, Griffiths, Paul, additional, Fowles, Aaron, additional, Parkes, Nasreen, additional, Goldacre, Ben, additional, and MacKenna, Brian, additional

Published
2023
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40. Data-Driven Identification of Unusual Prescribing Behavior: Analysis and Use of an Interactive Data Tool Using 6 Months of Primary Care Data From 6500 Practices in England

Author

Hopcroft, Lisa EM, primary, Massey, Jon, additional, Curtis, Helen J, additional, Mackenna, Brian, additional, Croker, Richard, additional, Brown, Andrew D, additional, O'Dwyer, Thomas, additional, Macdonald, Orla, additional, Evans, David, additional, Inglesby, Peter, additional, Bacon, Sebastian CJ, additional, Goldacre, Ben, additional, and Walker, Alex J, additional

Published
2023
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41. Comparative effectiveness of BNT162b2 versus mRNA-1273 covid-19 vaccine boosting in England: matched cohort study in OpenSAFELY-TPP

Author

Hulme, William J, primary, Horne, Elsie M F, additional, Parker, Edward P K, additional, Keogh, Ruth H, additional, Williamson, Elizabeth J, additional, Walker, Venexia, additional, Palmer, Tom M, additional, Curtis, Helen J, additional, Walker, Alex J, additional, Andrews, Colm D, additional, Mehrkar, Amir, additional, Morley, Jessica, additional, MacKenna, Brian, additional, Bacon, Sebastian C J, additional, Goldacre, Ben, additional, Hernán, Miguel A, additional, and Sterne, Jonathan A C, additional

Published
2023
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43. First dose COVID-19 vaccine coverage amongst adolescents and children in England: an analysis of 3.21 million patients' primary care records in situ using OpenSAFELY

Author

Hopcroft, Lisa E., primary, Curtis, Helen J., additional, Brown, Andrew D., additional, Hulme, William J., additional, Andrews, Colm D., additional, Morton, Caroline E., additional, Inglesby, Peter, additional, Morley, Jessica, additional, Mehrkar, Amir, additional, Bacon, Sebastian C., additional, Eggo, Rosalind M., additional, Mahalingasivam, Viyaasan, additional, Parker, Edward P. K., additional, Tomlinson, Laurie A., additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, Goldacre, Ben, additional, Walker, Alex J., additional, and MacKenna, Brian, additional

Published
2023
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44. OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care activity across six clinical areas during the COVID-19 pandemic

Author

Curtis, Helen J, primary, MacKenna, Brian, additional, Wiedemann, Milan, additional, Fisher, Louis, additional, Croker, Richard, additional, Morton, Caroline E, additional, Inglesby, Peter, additional, Walker, Alex J, additional, Morley, Jessica, additional, Mehrkar, Amir, additional, Bacon, Sebastian CJ, additional, Hickman, George, additional, Evans, David, additional, Ward, Tom, additional, Davy, Simon, additional, Hulme, William J, additional, Macdonald, Orla, additional, Conibere, Robin, additional, Lewis, Tom, additional, Myers, Martin, additional, Wanninayake, Shamila, additional, Collison, Kiren, additional, Drury, Charles, additional, Samuel, Miriam, additional, Sood, Harpreet, additional, Cipriani, Andrea, additional, Fazel, Seena, additional, Sharma, Manuj, additional, Baqir, Wasim, additional, Bates, Chris, additional, Parry, John, additional, and Goldacre, Ben, additional

Published
2023
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45. Trends, variation, and clinical characteristics of recipients of antiviral drugs and neutralising monoclonal antibodies for covid-19 in community settings: retrospective, descriptive cohort study of 23.4 million people in OpenSAFELY

Author

Green, Amelia C A, primary, Curtis, Helen J, additional, Higgins, Rose, additional, Nab, Linda, additional, Mahalingasivam, Viyaasan, additional, Smith, Rebecca M, additional, Mehrkar, Amir, additional, Inglesby, Peter, additional, Drysdale, Henry, additional, DeVito, Nicholas J, additional, Croker, Richard, additional, Rentsch, Christopher T, additional, Bhaskaran, Krishnan, additional, Tazare, John, additional, Zheng, Bang, additional, Andrews, Colm D, additional, Bacon, Sebastian C J, additional, Davy, Simon, additional, Dillingham, Iain, additional, Evans, David, additional, Fisher, Louis, additional, Hickman, George, additional, Hopcroft, Lisa E M, additional, Hulme, William J, additional, Massey, Jon, additional, MacDonald, Orla, additional, Morley, Jessica, additional, Morton, Caroline E, additional, Park, Robin Y, additional, Walker, Alex J, additional, Ward, Tom, additional, Wiedemann, Milan, additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, Douglas, Ian J, additional, Evans, Stephen J W, additional, Goldacre, Ben, additional, Tomlinson, Laurie A, additional, and MacKenna, Brian, additional

Published
2023
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46. Identifying Patterns of Clinical Interest in Clinicians’ Treatment Preferences: Hypothesis-free Data Science Approach to Prioritizing Prescribing Outliers for Clinical Review

Author

MacKenna, Brian, primary, Curtis, Helen J, additional, Hopcroft, Lisa E M, additional, Walker, Alex J, additional, Croker, Richard, additional, Macdonald, Orla, additional, Evans, Stephen J W, additional, Inglesby, Peter, additional, Evans, David, additional, Morley, Jessica, additional, Bacon, Sebastian C J, additional, and Goldacre, Ben, additional

Published
2022
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47. Factors associated with COVID-19 vaccine uptake in people with kidney disease: an OpenSAFELY cohort study

Author

Collaborative, The OpenSAFELY, Parker, Edward PK, Tazare, John, Hulme, William J, Bates, Christopher, Carr, Edward J, Cockburn, Jonathan, Curtis, Helen J, Fisher, Louis, Green, Amelia CA, Harper, Sam, Hester, Frank, Horne, Elsie MF, Loud, Fiona, Lyon, Susan, Mahalingasivam, Viyaasan, Mehrkar, Amir, Nab, Linda, Parry, John, Santhakumaran, Shalini, Steenkamp, Retha, Sterne, Jonathan AC, Walker, Alex J, Williamson, Elizabeth J, Willicombe, Michelle, Zheng, Bang, Goldacre, Ben, Nitsch, Dorothea, and Tomlinson, Laurie A

Subjects
FOS: Clinical medicine, Immunology, Infectious Disease, Cell Biology
Abstract

Objective To characterise factors associated with COVID-19 vaccine uptake among people with kidney disease in England. Design Retrospective cohort study using the OpenSAFELY-TPP platform, performed with the approval of NHS England. Setting Individual-level routine clinical data from 24 million people across GPs in England using TPP software. Primary care data were linked directly with COVID-19 vaccine records up to 31 August 2022 and with renal replacement therapy (RRT) status via the UK Renal Registry (UKRR). Participants A cohort of adults with stage 3–5 chronic kidney disease (CKD) or receiving RRT at the start of the COVID-19 vaccine roll-out was identified based on evidence of reduced estimated glomerular filtration rate (eGFR) or inclusion in the UKRR. Main outcome measures Dose-specific vaccine coverage over time was determined from 1 December 2020 to 31 August 2022. Individual-level factors associated with receipt of a 3-dose or 4-dose vaccine series were explored via Cox proportional hazards models. Results 992 205 people with stage 3–5 CKD or receiving RRT were included. Cumulative vaccine coverage as of 31 August 2022 was 97.5%, 97.0% and 93.9% for doses 1, 2 and 3, respectively, and 81.9% for dose 4 among individuals with one or more indications for eligibility. Delayed 3-dose vaccine uptake was associated with younger age, minority ethnicity, social deprivation and severe mental illness—associations that were consistent across CKD severity subgroups, dialysis patients and kidney transplant recipients. Similar associations were observed for 4-dose uptake. Conclusion Although high primary vaccine and booster dose coverage has been achieved among people with kidney disease in England, key disparities in vaccine uptake remain across clinical and demographic groups and 4-dose coverage is suboptimal. Targeted interventions are needed to identify barriers to vaccine uptake among under-vaccinated subgroups identified in the present study.

Published
2023
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48. The impact of the COVID-19 pandemic on prescribing of pancreatic enzyme replacement therapy for people with unresectable pancreatic cancer in England. A cohort study using OpenSafely-TPP

Author

Lemanska, Agnieszka, Andrews, Colm, Fisher, Louis, Butler-Cole, Ben, Mehrkar, Amir, Roberts, Keith J, Goldacre, Ben, Walker, Alex J, and MacKenna, Brian

Subjects
Article
Abstract

BACKGROUND: Cancer treatments were variably disrupted during the COVID-19 pandemic. Despite UK national guidelines recommending pancreatic enzyme replacement therapy to all people with unresectable pancreatic cancer, observational studies demonstrate under-prescribing. AIM: To investigate the impact of the COVID-19 pandemic on the prescribing of pancreatic enzyme replacement to people with unresectable pancreatic cancer. METHODS: With the approval of NHS England, we conducted a cohort study using 24 million health records through the OpenSAFELY-TPP research platform. We modelled the effect of COVID-19 with multivariable linear regression. RESULTS: We found no reduction in pancreatic enzyme replacement therapy during the COVID-19 pandemic. Overall, since 2015, the rates of prescribing increased steadily over time by 1% every year. The national rates ranged from 41% in 2015 to 48% in 2022. There was substantial regional variation. The highest rates of 50% to 60% were in the West Midlands and the lowest (20% to 30%) were in London. CONCLUSIONS: In contrast to many other treatments, prescribing of pancreatic enzyme replacement therapy was not affected during the COVID-19 pandemic. Although overall rates increased over time, substantial under-prescribing existed at the end of this study (March 2022). At just under 50% in 2022, the rates were still below the recommended 100% standard. Prior work evaluating quality of care in this area relied on manual audits which come at increased cost and reduced frequency of updates. With the methodological advantage of OpenSAFELY, we established an automated audit which allows for regular updates.

Published
2022

49. Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform

Author

Zheng, Bang, primary, Green, Amelia C A, additional, Tazare, John, additional, Curtis, Helen J, additional, Fisher, Louis, additional, Nab, Linda, additional, Schultze, Anna, additional, Mahalingasivam, Viyaasan, additional, Parker, Edward P K, additional, Hulme, William J, additional, Bacon, Sebastian C J, additional, DeVito, Nicholas J, additional, Bates, Christopher, additional, Evans, David, additional, Inglesby, Peter, additional, Drysdale, Henry, additional, Davy, Simon, additional, Cockburn, Jonathan, additional, Morton, Caroline E, additional, Hickman, George, additional, Ward, Tom, additional, Smith, Rebecca M, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, Mehrkar, Amir, additional, Eggo, Rosalind M, additional, Walker, Alex J, additional, Evans, Stephen J W, additional, Douglas, Ian J, additional, MacKenna, Brian, additional, Goldacre, Ben, additional, and Tomlinson, Laurie A, additional

Published
2022
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50. Studying the Long-term Impact of COVID-19 in Kids (SLICK). Healthcare use and costs in children and young people following community-acquired SARS-CoV-2 infection: protocol for an observational study using linked primary and secondary routinely collected healthcare data from England, Scotland and Wales

Author

Swann, Olivia V, primary, Lone, Nazir I, additional, Harrison, Ewen M, additional, Tomlinson, Laurie A, additional, Walker, Alex J, additional, Seaborne, Michael J, additional, Pollock, Louisa, additional, Farrell, James, additional, Hall, Peter S, additional, Seth, Sohan, additional, Williams, Thomas C, additional, Preston, Jennifer, additional, Ainsworth, J. Samantha, additional, Semple, Freya F, additional, Baillie, J Kenneth, additional, Katikireddi, Srinivasa V, additional, Akbari, Ashley, additional, Lyons, Ronan, additional, Simpson, Colin R, additional, Semple, Malcolm G, additional, Goldacre, Ben, additional, Brophy, Sinead, additional, Sheikh, Aziz, additional, and Docherty, Annemarie B, additional

Published
2022
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