13,657 research outputs found
Comparison of methods for predicting COVID-19-related death in the general population using the OpenSAFELY platform.
No full textBACKGROUND: Obtaining accurate estimates of the risk of COVID-19-related death in the general population is challenging in the context of changing levels of circulating infection. METHODS: We propose a modelling approach to predict 28-day COVID-19-related death which explicitly accounts for COVID-19 infection prevalence using a series of sub-studies from new landmark times incorporating time-updating proxy measures of COVID-19 infection prevalence. This was compared with an approach ignoring infection prevalence. The target population was adults registered at a general practice in England in March 2020. The outcome was 28-day COVID-19-related death. Predictors included demographic characteristics and comorbidities. Three proxies of local infection prevalence were used: model-based estimates, rate of COVID-19-related attendances in emergency care, and rate of suspected COVID-19 cases in primary care. We used data within the TPP SystmOne electronic health record system linked to Office for National Statistics mortality data, using the OpenSAFELY platform, working on behalf of NHS England. Prediction models were developed in case-cohort samples with a 100-day follow-up. Validation was undertaken in 28-day cohorts from the target population. We considered predictive performance (discrimination and calibration) in geographical and temporal subsets of data not used in developing the risk prediction models. Simple models were contrasted to models including a full range of predictors. RESULTS: Prediction models were developed on 11,972,947 individuals, of whom 7999 experienced COVID-19-related death. All models discriminated well between individuals who did and did not experience the outcome, including simple models adjusting only for basic demographics and number of comorbidities: C-statistics 0.92-0.94. However, absolute risk estimates were substantially miscalibrated when infection prevalence was not explicitly modelled. CONCLUSIONS: Our proposed models allow absolute risk estimation in the context of changing infection prevalence but predictive performance is sensitive to the proxy for infection prevalence. Simple models can provide excellent discrimination and may simplify implementation of risk prediction tools
OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic.
No full textBACKGROUND: The COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. AIM: To describe changes in the volume and variation of coded clinical activity in general practice across six clinical areas: cardiovascular disease, diabetes, mental health, female and reproductive health, screening and related procedures, and processes related to medication. DESIGN AND SETTING: With the approval of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY. METHOD: Common primary care activities were analysed using Clinical Terms Version 3 codes and keyword searches from January 2019 to December 2020, presenting median and deciles of code usage across practices per month. RESULTS: Substantial and widespread changes in clinical activity in primary care were identified since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health (for example, for 'Depression interim review' the median occurrences across practices in December 2020 was down by 41.6% compared with December 2019). CONCLUSION: Granular NHS general practice data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for the key measures identified in this study, as well as further studies using primary care data to monitor and mitigate the indirect health impacts of COVID-19 on the NHS
Changes in opioid prescribing during the COVID-19 pandemic in England: an interrupted time-series analysis in the OpenSAFELY-TTP cohort
No full textBackgroundThe COVID-19 pandemic disrupted health-care delivery, including difficulty accessing in-person care, which could have increased the need for strong pharmacological pain relief. Due to the risks associated with overprescribing of opioids, especially to vulnerable populations, we aimed to quantify changes to measures during the COVID-19 pandemic, overall, and by key subgroups.MethodsFor this interrupted time-series analysis study conducted in England, with National Health Service England approval, we used routine clinical data from more than 20 million general practice adult patients in OpenSAFELY-TPP, which is a a secure software platform for analysis of electronic health records. We included all adults registered with a primary care practice using TPP-SystmOne software. Using interrupted time-series analysis, we quantified prevalent and new opioid prescribing before the COVID-19 pandemic (January, 2018–February, 2020), during the lockdown (March, 2020–March, 2021), and recovery periods (April, 2021–June, 2022), overall and stratified by demographics (age, sex, deprivation, ethnicity, and geographical region) and in people in care homes identified via an address-matching algorithm.FindingsThere was little change in prevalent prescribing during the pandemic, except for a temporary increase in March, 2020. We observed a 9·8% (95% CI –14·5 to –6·5) reduction in new opioid prescribing from March, 2020, with a levelling of the downward trend, and rebounding slightly after April, 2021 (4·1%, 95% CI –0·9 to 9·4). Opioid prescribing rates varied by demographics, but we found a reduction in new prescribing for all subgroups except people aged 80 years or older. Among care home residents, in April, 2020, parenteral opioid prescribing increased by 186·3% (153·1 to 223·9).InterpretationOpioid prescribing increased temporarily among older people and care home residents, likely reflecting use to treat end-of-life COVID-19 symptoms. Despite vulnerable populations being more affected by health-care disruptions, disparities in opioid prescribing by most demographic subgroups did not widen during the pandemic. Further research is needed to understand what is driving the changes in new opioid prescribing and its relation to changes to health-care provision during the pandemic.FundingThe Wellcome Trust, Medical Research Council, The National Institute for Health and Care Research, UK Research and Innovation, and Health Data Research UK
Potentially inappropriate prescribing of DOACs to people with mechanical heart valves: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY
No full textExploratory talk within collaborative small groups in mathematics
No full textThis report describes one aspect of a wider research study on exploratory talk within collaborative small groups in secondary mathematics lessons. It outlines students’ views of using collaborative activity to learn mathematics. The fuller research study explores the extent to which exploratory talk occurs in collaborative peer groups in secondary mathematics classrooms
COMMENT ON WILLIAMSON ET AL. (OpenSAFELY):
No full textUpdated 31 July, 2020. This is a letter to the editor about a publication in Nature by the UK OpenSAFELY Collaborative, available at https://www.nature.com/articles/s41586-020-2521-4. This work has been submitted to Nature in the category "Matters Arising."
Earlier versions of this letter (see versions) were in response to the pre-print of the Nature paper, available at https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1.full.pdf
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Collaborative Educational Systems in the Virtual Environment
No full textThe work leads to an original approach to the construction of collaborative systems metrics. The approach is based both on research already conducted by the author, on the experimental results obtained, and the foundation taken from the specific literature. The collaborative systems in knowledgebased economy are formalized and their characteristics are identified. The virtual campus structure is described and a comparison with the classical university is achieved. The architecture of virtual is designed and the categories of agents in virtual campus are analyzed.
Collaborative gym: A simulation benchmark for multi-robotic tasks
No full textThe design of multi-robot systems has gained increasing attention in recent years. The field of cooperative Multi-Agent Robot Systems (MARS) has shown the potential to provide reliable and cost-effective solutions to a wide range of automated applications. Communication and coordination between autonomous agents require robust and intelligent control systems in order to achieve high-quality performance. This paper presents Collaborative Gym, an open-source, physics-based simulation framework for multi-robot interaction. This simulation environment differs from existing robotic simulation environments in that it is designed to model the interaction between multiple robots. Despite the presence of a large number of single robotic environments, multi-robotic simulation environments for reinforcement learning are rare. Collaborative Gym contains four simulated tasks in which different commercial robots work in collaboration: poking, lifting, balancing, and passing. For each of the four tasks, baseline policies are presented for various combinations of commercial robots which have been trained using reinforcement learning. The study demonstrated that Collaborative Gym is a promising open-source framework for the development of multi-robotic collaborative robotic tasks.https://github.com/gabriansa/collaborative-gymMechanical Engineering | Multi-Machine Engineerin
Bayesian latent variable models for collaborative item rating prediction
No full textCollaborative filtering systems based on ratings make it easier for users to find content of interest on the Web and as such they constitute an area of much research. In this paper we first present a Bayesian latent variable model for rating prediction that models ratings over each user's latent interests and also each item's latent topics. We describe a Gibbs sampling procedure that can be used to estimate its parameters and show by experiment that it is competitive with the gradient descent SVD methods commonly used in state-of-the-art systems. We then proceed to make an important and novel extension to this model, enhancing it with user-dependent and item-dependant biases to significantly improve rating estimation. We show by experiment on a large set of real ratings data that these models are able to outperform 3 common baselines, including a very competitive and modern SVD-based model. Furthermore we illustrate other advantages of our approach beyond simply its ability to provide more accurate ratings and show that it is able to perform better on the common and important case where the user profile is short
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