Multimorbidity clusters and their associations with health-related quality of life in two UK cohorts.

Background: Identifying clusters of multiple long-term conditions (MLTCs), also known as multimorbidity, and their associated burden may facilitate the development of effective and cost-effective targeted healthcare strategies. This study aimed to identify clusters of MLTCs and their associations with long-term health-related quality of life (HRQoL) in two UK population-based cohorts.

Methods: Age-stratified clusters of MLTCs were identified at baseline in UK Biobank (n = 502,363, 54.

Maternal and pregnancy factors contributing to the association between area deprivation and infant mortality in England: a retrospective cohort study.

Background: Socioeconomic inequality in infant mortality in the UK is rising. This study aims to identify contributory maternal and pregnancy factors that can explain the known association between area deprivation and infant mortality.

Methods: A cohort study was conducted using Clinical Practice Research Datalink (CPRD) primary care data between 2004 and 2019 linked to the Index of Multiple Deprivation (IMD), and infant mortality from the Office for National Statistics death data.

The conceptualisation of cardiometabolic disease policy model in the UK.

Background: Decision models are increasingly used to inform policy-making processes, and there is a need to improve their credibility. The estimation of health and economic outcomes generated from decision models is influenced by the development process itself. This paper aims to present the conceptual model development process of cardiometabolic disease (CMD) policy models in the UK setting.

Estimating the causal effects of income on health: how researchers' definitions of "income" matter.

Background: There is a well-established cross-sectional association between income and health, but estimates of the causal effects of income vary substantially. Different definitions of income may lead to substantially different empirical results, yet research is often framed as investigating "the effect of income" as if it were a single, easily definable construct.

Methods/results: The aim of this paper is to introduce a taxonomy for definitional and conceptual issues in studying individual- or household-level income for health research.

Loop diuretic therapy with or without heart failure: impact on prognosis.

Background And Aims: Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis.

Methods: Glasgow regional health records (2009-16) were obtained for adults with cardiovascular disease or taking loop diuretics.

Evaluating the impact of minimum unit pricing (MUP) on alcohol sales after 3 years of implementation in Scotland: A controlled interrupted time-series study.

Background And Aims: On 1 May 2018, Scotland introduced minimum unit pricing (MUP), a strength-based floor price below which alcohol cannot be sold, throughout all alcoholic beverages. The legislation necessitates an evaluation of its impact across a range of outcomes that will inform whether MUP will continue beyond its sixth year. We measured the impact of MUP on per-adult alcohol sales (as a proxy for consumption) after 3 years of implementation.

Pharmacological treatments for alcohol dependence: Evidence on uptake, inequalities and comparative effectiveness from a UK population-based cohort.

Introduction: We assessed the prevalence of prescribing of certain medications for alcohol dependence and the extent of any inequalities in receiving prescriptions for individuals with such a diagnosis. Further, we compared the effectiveness of two of the most prescribed medications (acamprosate and disulfiram) for alcohol dependence and assessed whether there is inequality in prescribing either of them.

Methods: We used a nationwide dataset on prescriptions and hospitalisations in Scotland, UK (N = 19,748).

Assessing the performance of physician's prescribing preference as an instrumental variable in comparative effectiveness research with moderate and small sample sizes: a simulation study.

This simulation study is to assess the utility of physician's prescribing preference (PPP) as an instrumental variable for moderate and smaller sample sizes. We designed a simulation study to imitate a comparative effectiveness research under different sample sizes. We compare the performance of instrumental variable (IV) and non-IV approaches using two-stage least squares (2SLS) and ordinary least squares (OLS) methods, respectively.

Comparing the performance of two-stage residual inclusion methods when using physician's prescribing preference as an instrumental variable: unmeasured confounding and noncollapsibility.

The first objective is to compare the performance of two-stage residual inclusion (2SRI), two-stage least square (2SLS) with the multivariable generalized linear model (GLM) in terms of the reducing unmeasured confounding bias. The second objective is to demonstrate the ability of 2SRI and 2SPS in alleviating unmeasured confounding when noncollapsibility exists. This study comprises a simulation study and an empirical example from a real-world UK population health dataset (Clinical Practice Research Datalink).

An observational analysis of frailty in combination with loneliness or social isolation and their association with socioeconomic deprivation, hospitalisation and mortality among UK Biobank participants.

Frailty, social isolation, and loneliness have individually been associated with adverse health outcomes. This study examines how frailty in combination with loneliness or social isolation is associated with socioeconomic deprivation and with all-cause mortality and hospitalisation rate in a middle-aged and older population. Baseline data from 461,047 UK Biobank participants (aged 37-73) were used to assess frailty (frailty phenotype), social isolation, and loneliness.

The effect of a minimum price per unit of alcohol in Scotland on alcohol-related ambulance call-outs: A controlled interrupted time-series analysis.

Background And Aims: On 1 May 2018, Scotland introduced a minimum unit price (MUP) of £0.50 for alcohol, with one UK unit of alcohol being 10 ml of pure ethanol. This study measured the association between MUP and changes in the volume of alcohol-related ambulance call-outs in the overall population and in call-outs subsets (night-time call-outs and subpopulations with higher incidence of alcohol-related harm).

Evaluating the impact of minimum unit pricing for alcohol on road traffic accidents in Scotland after 20 months: An interrupted time series study.

Background And Aims: On 1 May 2018, Scotland implemented Minimum Unit Pricing (MUP) of £0.50 per unit of alcohol with the aim to lower alcohol consumption and related harms, and reduce health inequalities. We measured the impact of MUP on the most likely categories of road traffic accidents (RTAs) to be affected by drink-driving episodes (fatal and nighttime) up to 20 months after the policy implementation.

Previous psychiatric hospitalizations as risk factors for single and multiple future alcohol-related hospitalizations in patients with alcohol use disorders.

Background And Aims: People with alcohol use disorder (AUD) often have co-occurring psychiatric conditions. The association between psychiatric conditions and AUD relapse has not yet been fully explored. This study aimed to quantify different psychiatric comorbidities as risk factors for first and multiple AUD rehospitalizations in patients already hospitalized once for AUD.

Frailty in people with rheumatoid arthritis: a systematic review of observational studies.

Frailty, an age-related decline in physiological reserve, is an increasingly important concept in the management of chronic diseases. The implications of frailty in people with rheumatoid arthritis are not well understood. We undertook a systematic review to assess prevalence of frailty in people with rheumatoid arthritis, and the relationship between frailty and disease activity or clinical outcomes.

Transportability of two heart failure trials to a disease registry using individual patient data.

Objectives: Randomized controlled trials are the gold-standard for determining therapeutic efficacy, but are often unrepresentative of real-world settings. Statistical transportation methods (hereafter transportation) can partially account for these differences, improving trial applicability without breaking randomization. We transported treatment effects from two heart failure (HF) trials to a HF registry.

Cancer risk in information technology workers: a UK Biobank study.

Background: The information technology (IT) workforce has been growing more rapidly than others, with occupational health (OH) risks of sedentary behaviour, physical inactivity and poor diet, yet studies of their non-communicable disease risk, notably cancer, are lacking.

Aims: To investigate cancer risk in IT workers compared to others in employment and the nine major Standard Occupational Classification (SOC) groups.

Methods: We evaluated incident diagnosed cancers in the UK Biobank cohort through national cancer registry linkage.

The Effect of Minimum Unit Pricing for Alcohol on Prescriptions for Treatment of Alcohol Dependence: A Controlled Interrupted Time Series Analysis.

Unlabelled: In 2018, Scotland introduced a minimum unit price (MUP) for alcohol to reduce alcohol-related harms. We aimed to study the association between MUP introduction and the volume of prescriptions to treat alcohol dependence, and volume of new patients receiving such prescriptions. We also examined whether effects varied across different socio-economic groups.

Frailty in randomised controlled trials for dementia or mild cognitive impairment measured via the frailty index: prevalence and prediction of serious adverse events and attrition.

Background: Frailty and dementia have a bidirectional relationship. However, frailty is rarely reported in clinical trials for dementia and mild cognitive impairment (MCI) which limits assessment of trial applicability. This study aimed to use a frailty index (FI)-a cumulative deficit model of frailty-to measure frailty using individual participant data (IPD) from clinical trials for MCI and dementia.

Treatment effect modification due to comorbidity: Individual participant data meta-analyses of 120 randomised controlled trials.

Background: People with comorbidities are underrepresented in clinical trials. Empirical estimates of treatment effect modification by comorbidity are lacking, leading to uncertainty in treatment recommendations. We aimed to produce estimates of treatment effect modification by comorbidity using individual participant data (IPD).

Joint modelling of longitudinal processes and time-to-event outcomes in heart failure: systematic review and exemplar examining the relationship between serum digoxin levels and mortality.

Background: Joint modelling combines two or more statistical models to reduce bias and increase efficiency. As the use of joint modelling increases it is important to understand how and why it is being applied to heart failure research.

Methods: A systematic review of major medical databases of studies which used joint modelling within heart failure alongside an exemplar; joint modelling repeat measurements of serum digoxin with all-cause mortality using data from the Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure (DIG) trial.

Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland: a controlled interrupted time series study.

Background: Since May 1, 2018, every alcoholic drink sold in Scotland has had minimum unit pricing (MUP) of £0·50 per unit. Previous studies have indicated that the introduction of this policy reduced alcohol sales by 3%. We aimed to assess whether this has led to reductions in alcohol-attributable deaths and hospitalisations.

Evaluating the effect of minimum unit pricing for unit of alcohol on road traffic accidents in Scotland: a controlled interrupted time-series study.

Background: Scotland was the first country to implement on May 1, 2018, a minimum unit pricing (MUP) for alcohol volume in beverages to tackle alcohol-related harms. In this study, we assessed the effect of MUP on road traffic accidents (RTAs) after 20 months of its implementation. We hypothesise that MUP would be associated with decreases in RTAs-ie, rises in alcohol prices and consequent decreases in consumption could lead to reductions in drink driving episodes, leading to reductions in RTAs.