Publications by authors named "Raph Goldacre"

Article Synopsis
  • - The systematic review analyzed the link between socioeconomic disadvantage and risks of severe maternal morbidity (SMM) and maternal mortality (MM) in high-income countries by examining studies published from 2000 to 2023.
  • - The review included 52 studies, showing that greater neighborhood deprivation, lower income, and less education significantly increased the odds of SMM (ranging from 1.29 to 1.61) and MM (ranging from 1.61 to 2.10) compared to those with higher socioeconomic status.
  • - Findings highlight that socioeconomic disadvantage is strongly correlated with worse maternal health outcomes, indicating a pressing need for effective interventions at various societal levels to address these disparities.
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Article Synopsis
  • The study examined trends in pneumothorax hospital admissions in England from 2017 to 2023, highlighting a significant peak during COVID-19 in January 2021, where admissions increased by about 65% compared to pre-pandemic levels.
  • When excluding COVID-19 cases, the overall trend showed a decrease in admissions during the pandemic, with post-pandemic rates returning to pre-pandemic levels.
  • The findings revealed that while the incidence of spontaneous pneumothorax was notably higher in males, trends remained consistent across genders, suggesting the need for further investigation into these patterns.
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Objective: The optimal time for neonatal stoma closure is unclear and there have been calls for a trial to compare early and late surgery. The feasibility of such a trial will depend on the population of eligible infants and acceptability to families and health professionals. In this study, we aimed to determine current UK practice and characteristics of those undergoing stoma surgery.

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Background: In the United Kingdom, pregnant women who live in the most deprived areas have two times the risk of dying than those who live in the least deprived areas. There are even greater disparities between women from different ethnic groups. The aim of this study was to investigate the role of area-based deprivation and ethnicity in the increased risk of severe maternal morbidity (SMM), in primiparous women in England.

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Background: Venous thromboembolism (VTE) can occur in amyotrophic lateral sclerosis (ALS) and pulmonary embolism causes death in a minority of cases. The benefits of preventing VTE must be weighed against the risks. An accurate estimate of the incidence of VTE in ALS is crucial to assessing this balance.

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Background: Although morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.

Methods And Results: Analyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016-21. Admissions and procedures during the pandemic (2020-21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016-19).

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Objective: Occasionally, patients with eating disorders have been subsequently diagnosed with esophageal achalasia. We sought to establish whether eating disorders and achalasia coexisted more often than expected by chance alone.

Method: National record-linkage study of hospital inpatients in England, between 2001 and 2017.

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Background: The epidemiology of psychiatric comorbidity in multiple sclerosis (MS) remains poorly understood.

Objective: We aimed to determine the risk of schizophrenia and bipolar disorder in MS patients.

Material And Methods: Retrospective cohort analyses were performed using an all-England national linked Hospital Episode Statistics (HES) dataset (1999-2016) and to determine whether schizophrenia or bipolar disorder are more commonly diagnosed subsequently in people with MS (n=128,194), and whether MS is more commonly diagnosed subsequently in people with schizophrenia (n=384,188) or bipolar disorder (n=203,592), than would be expected when compared with a reference cohort (~15 million people) after adjusting for age and other factors.

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Importance: Spontaneous pneumothorax is a common disease known to have an unusual epidemiological profile, but there are limited contemporary population-based data.

Objective: To estimate the incidence of hospital admissions for spontaneous pneumothorax, its recurrence and trends over time using large, longstanding hospitalization data sets in England.

Design, Setting, And Participants: A population-based epidemiological study was conducted using an English national data set and an English regional data set, each spanning 1968 to 2016, and including 170 929 hospital admission records of patients 15 years and older.

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Objective: To investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD).

Methods: Linked English national Hospital Episode Statistics and mortality data (1999-2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort.

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We aimed to compare long-term mortality trends in end-stage renal disease versus general population controls after accounting for differences in age, sex and comorbidity. Cohorts of 45,000 patients starting maintenance renal replacement therapy (RRT) and 5.3 million hospital controls were identified from two large electronic hospital inpatient data sets: the Oxford Record Linkage Study (1965-1999) and all-England Hospital Episode Statistics (2000-2011).

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Systemic lupus erythematosus (SLE) has a high female predominance with a 9:1 female-to-male sex ratio, but males have poorer clinical outcomes than females. Gonadal hormones may mediate gender differences in SLE, but their role in SLE remains largely uncharacterised. We aimed to investigate a potential association between testicular hypofunction (TH), as a proxy for low testosterone levels, and SLE in males.

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Introduction: The profile of psychiatric disorders associated with multiple sclerosis (MS) may differ in children. We aimed to assess the risk of psychiatric disorders in children with MS and other demyelinating diseases, and vice versa.

Patients And Methods: We analyzed linked English Hospital Episode Statistics, and mortality data, 1999-2011.

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Polycystic liver disease is a well described manifestation of autosomal dominant polycystic kidney disease (ADPKD). Biliary tract complications are less well recognized. We report a 50-year single-center experience of 1007 patients, which raised a hypothesis that ADPKD is associated with biliary tract disease.

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Objective: To study associations between viral hepatitis and Parkinson disease (PD).

Methods: A retrospective cohort study was done by analyzing linked English National Hospital Episode Statistics and mortality data (1999-2011). Cohorts of individuals with hepatitis B, hepatitis C, autoimmune hepatitis, chronic active hepatitis, and HIV were constructed, and compared to a reference cohort for subsequent rates of PD.

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It is recognized that neuropsychiatric conditions are overrepresented in amyotrophic lateral sclerosis (ALS) patient kindreds and psychiatric symptoms may precede the onset of motor symptoms. Using a hospital record linkage database, hospitalization with a diagnosis of schizophrenia, bipolar disorder, depression, or anxiety was significantly associated with a first diagnosis of ALS within the following year. This is likely to specifically reflect the clinicopathological overlap of ALS with frontotemporal dementia.

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Aims: To study trends over time in the incidence of congenital anophthalmia, microphthalmia and orbital malformations in England, along with changes in hospital admission rates for these conditions.

Methods: Using English National Hospital Episode Statistics (1999-2011), the annual rate of hospital admissions related to anophthalmia, microphthalmia and congenital malformations of orbit/lacrimal apparatus was calculated per 100 000 infants. The records were person-linked, which enabled patients' 'first record' rates to be calculated as proxies for incidence.

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Background: Primary open angle glaucoma (POAG) is thought to be associated with obstructive sleep apnoea (OSA) but previous studies are conflicting and have methodological limitations. This potential relationship has implications for investigation and treatment strategies, and may provide insights into disease pathogenesis. The relationship between OSA and age-related macular degeneration (AMD) is unknown.

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Objective: To use an unbiased method to test a previously reported association between cerebral arteriovenous malformation (AVM) embolisation and the subsequent development of amyotrophic lateral sclerosis (ALS).

Methods: A hospital record linkage database was used to create cohorts of individuals coded as having cerebral and peripheral vessel AVMs, stroke (separately for haemorrhagic and ischaemic), transient ischaemic attack (TIA) and subarachnoid haemorrhage (SAH). The rate ratio for subsequent ALS was compared to a reference cohort.

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Purpose: The epidemiologic relationship between age-related macular degeneration (AMD) and arthritis is unknown and has implications for understanding disease pathogenesis and treatment strategies.

Methods: An AMD cohort of 245,912 people was constructed from English linked hospital episode statistics (1999-2011), principally comprising neovascular AMD patients undergoing anti-vascular endothelial growth factor therapy. We compared the AMD cohort with a reference cohort (2,134,771 people) for rates of subsequent osteoarthritis (OA) and rheumatoid arthritis.

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Aims: To investigate English national trends in ophthalmia neonatorum and dacryocystitis (ON) of the newborn and the completeness of statutory notification of this serious infection.

Design: Analysis of hospital episode statistics (HES) from 2000 to 2011.

Materials And Methods: Using linked HES, numbers of neonates hospitalised with ON were identified from 2000 to 2011.

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Aims: The potential association between primary open angle glaucoma (POAG) and Alzheimer's disease (AD) is uncertain and has implications for understanding disease pathogenesis, referral and treatments. The aim was to determine whether individuals diagnosed with POAG are at higher risk of subsequently developing AD or vascular dementia.

Methods: A POAG cohort of 87 658 people was constructed from English National Health Service linked hospital episode statistics from 1999 to 2011.

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