Publications by authors named "McCowan C"
The role of biomarkers in risk-based early detection of lung cancer may enable screening to become cost effective and widely accessible. EarlyCDT-Lung is an example of such a blood-based autoantibody biomarker which may improve accessibility to Low dose Computed Tomography (LDCT) screening for those at highest risk. We randomized 12 208 individuals aged 50-75 at high risk of developing lung cancer to either the test or to standard clinical care.
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- The increasing prevalence of multiple long-term conditions (MLTCs) poses significant health challenges, leading to worse life expectancy and quality of life for affected individuals.
- An initiative named SysteMatic aims to create a co-designed action plan focused on equitable prevention and care for MLTCs, involving individuals with lived experiences, healthcare professionals, and industry partners in the UK.
- The Hub will analyze both personal experiences and large-scale health data to set specific innovation goals and foster system transformation over the next 3-7 years.
: : To provide contemporary data on cancer mortality rates within the context of incidence in the population with intellectual disabilities. : : Scotland's 2011 Census was used to identify adults with intellectual disabilities and controls with records linked to the Scottish Cancer Registry and death certificate data (March 2011-December 2019). The control cohort without intellectual disabilities and/or autism were used for indirect standardisation and calculation of crude incident rates/crude mortality rates, and age-sex standardised incident rate ratios/standardised mortality ratios (SIR/SMR), with 95% CIs.
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- * Using national Scottish data, the study finds that individuals with five or more conditions are significantly more likely to test negative for antibodies post-vaccination and have a much higher risk of COVID-19 hospitalization or death.
- * There's a clear link showing that lower antibody levels after vaccination are associated with increased risks of severe outcomes, including hospitalization and death, indicating the importance of monitoring antibody levels in vaccinated individuals.
Background: Subclinical hypothyroidism (SCH) is a biochemical thyroid disorder characterised by elevated levels of Thyroid Stimulating Hormone (TSH) together with normal levels of thyroid hormones. Evidence on the benefits of treatment is limited, resulting in persistent controversies relating to its clinical management.
Aim: This study describes the demographic and clinical characteristics of patients identified as having subclinical hypothyroidism in Wales between 2000 and 2021, the annual cumulative incidence during this period and the testing and treatment patterns associated with this disorder.
Objectives: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.
Design: A population-based retrospective cohort analysis.
Setting: Scotland.
Objective: The QCovid 2 and 3 algorithms are risk prediction tools developed during the second wave of the COVID-19 pandemic that can be used to predict the risk of COVID-19 hospitalisation and mortality, taking vaccination status into account. In this study, we assess their performance in Scotland.
Methods: We used the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 national data platform consisting of individual-level data for the population of Scotland (5.
There is still limited understanding of how chronic conditions co-occur in patients with multimorbidity and what are the consequences for patients and the health care system. Most reported clusters of conditions have not considered the demographic characteristics of these patients during the clustering process. The study used data for all registered patients that were resident in Fife or Tayside, Scotland and aged 25 years or more on 1st January 2000 and who were followed up until 31st December 2018.
View Article and Find Full Text PDFBackground: Primary care electronic health records (EHR) are widely used to study long-term conditions in epidemiological and health services research. Therefore, it is important to understand how well the recorded prevalence of these conditions in EHRs, compares to other reliable sources overall, and varies by socio-demographic characteristics. We aimed to describe the prevalence and socio-demographic variation of cardiovascular, renal, and metabolic (CRM) and mental health (MH) conditions in a large, nationally representative, English primary care database and compare with prevalence estimates from other population-based studies.
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- The study addresses the issue of polypharmacy in pregnant women, highlighting the need for more research on the safety of their complex medication plans, particularly focusing on adverse and protective effects of various medications during pregnancy.
- It employs real-world data from the UK to conduct a pharmacovigilance study assessing medication safety in women during the preconception period and the first trimester.
- A multidisciplinary expert team will analyze and reach consensus on the signals of associations between medication exposure and pregnancy outcomes to filter out misleading data for further evaluation.
Article Synopsis
- Multimorbidity (presence of multiple health conditions) is prevalent among pregnant women, with 16.8% experiencing it and 3.6% having complex multimorbidity (four or more conditions) in a study of over 27,000 pregnancies.
- The prevalence of multimorbidity increases with maternal age, ranging from 10.2% in younger women (15-19) to 21.4% in those aged 40-44.
- Pregnant women with multimorbidity have higher rates of preterm birth (PTB), at 11.6%, compared to 6.7% in those without, and 15.6% in those with complex multimorbidity.*
Article Synopsis
- A national study in Scotland examined how SARS-CoV-2 infection and COVID-19 vaccination during pregnancy affect maternal and neonatal health outcomes in women with singleton pregnancies lasting 20 weeks or longer.
- Results showed that SARS-CoV-2 infection is linked to higher risks of preterm births, severe maternal complications, and venous thromboembolism.
- Conversely, the study found no increased risks associated with COVID-19 vaccination, indicating it is a safe choice for pregnant women to help protect themselves and their babies.
Article Synopsis
- This study developed a core outcome set for future research on pregnant women with multimorbidity to tackle issues of inconsistent outcome reporting across studies.
- The development process involved a systematic literature search, focus groups, and Delphi surveys engaging diverse stakeholders, including affected women and healthcare professionals.
- The final core outcome set identified 11 key outcomes, including maternal death, severe morbidity, and baby survival rates, which should be consistently measured in related research.
Background: Vaccination continues to be the key public health measure for preventing severe COVID-19 outcomes. Certain groups may be at higher risk of incomplete vaccine schedule, which may leave them vulnerable to COVID-19 hospitalisation and death.
Aim: To identify the sociodemographic and clinical predictors for not receiving a scheduled COVID-19 vaccine after previously receiving one.
Article Synopsis
- A qualitative study was conducted to identify important outcomes for pregnant women with multiple long-term health conditions by involving women, their partners, and healthcare professionals in focus groups.
- The study found 63 outcomes related to maternal health, child health, and healthcare utilization, with new outcomes discovered that haven't been previously emphasized in the literature.
- Participants highlighted the importance of care processes, particularly the need for effective information sharing during transitions in healthcare, showing a consensus on the significance of various outcomes across different stakeholders.
Background: This study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland.
Methods: We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals ≥ 16 years living in Scotland on 1 March 2020.
Background: Understanding and quantifying the differences in disease development in different socioeconomic groups of people across the lifespan is important for planning healthcare and preventive services. The study aimed to measure chronic disease accrual, and examine the differences in time to individual morbidities, multimorbidity, and mortality between socioeconomic groups in Wales, UK.
Methods: Population-wide electronic linked cohort study, following Welsh residents for up to 20 years (2000-2019).
Background: Systemic corticosteroids have been widely used for treating patients with severe acute respiratory distress syndrome. Inhaled corticosteroids may have a protective effect for treating acute coronavirus disease 2019 (COVID-19); however, little is known about the potential effect of intranasal corticosteroids (INCS) on COVID-19 outcomes and severity.
Objective: To assess the impact of prior long-term INCS exposure on COVID-19 mortality among patients with chronic respiratory disease and in the general population.
Article Synopsis
- - The study investigates how diseases like psychosis, diabetes, and congestive heart failure coexist and develop over time, focusing on their impact on life expectancy in Wales from 2000 to 2019.
- - Researchers used a large set of health data from the Wales Multimorbidity e-Cohort, modeling disease trajectories and their effects on overall mortality while adjusting for factors like sex, age, and socio-economic status.
- - Findings reveal that the order in which these diseases are acquired significantly affects life expectancy, indicating a complex interplay of multimorbidity that warrants targeted public health strategies.
Introduction: Screening can reduce deaths from colorectal cancer (CRC). Despite high levels of public enthusiasm, participation rates in population CRC screening programmes internationally remain persistently below target levels. Simple behavioural interventions such as completion goals and planning tools may support participation among those inclined to be screened but who fail to act on their intentions.
View Article and Find Full Text PDFObesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.
View Article and Find Full Text PDFObjective: To develop international consensus on the definition and measurement of multimorbidity in research.
Design: Delphi consensus study.
Setting: International consensus; data collected in three online rounds from participants between 30 November 2020 and 18 May 2021.
Article Synopsis
- * Researchers will analyze data from UK health records spanning from 2000 to 2019, examining various health outcomes during different stages: antenatal, peripartum, postnatal, and long-term mental health.
- * Ethical approval has been secured, and findings are set to be published in peer-reviewed journals and presented at major conferences for wider dissemination.
Article Synopsis
- This study focuses on using radiomic analysis of contrast-enhanced mammographic images to distinguish between benign and malignant lesions through classification models based on a diverse data set.
- It utilized CEM images from different equipment, extracting textural features with software and comparing segmentation techniques (freehand vs. ellipsoid).
- The findings showed high diagnostic accuracy (>0.9), with ellipsoid segmentation being more effective, and suggested that using both mammographic views might not be necessary for improved accuracy.
Article Synopsis
- The study looks at how many pregnant women are taking multiple medications, which has become more common over the last 20 years.
- It gathered data from a big medical records database to see how often women used 2 or more medicines during pregnancy.
- The findings show that about 25% of women used multiple medications in their first trimester, and some risk factors for this include being overweight, from certain ethnic groups, or being a smoker.