181 research outputs found
Could NICE guidance on the choice of blood pressure lowering drugs be simplified?
No full textReecha Sofat and colleagues argue that prescribing advice needs updating in the light of recent evidence that all classes of blood pressure lowering drugs are broadly equivalen
Appendices_-_rev1_-_clean.rjf_online_supp – Supplemental material for Directly Acting Oral Anticoagulants for the Prevention of Stroke in Atrial Fibrillation in England and Wales: Cost-Effectiveness Model and Value of Information Analysis
No full textSupplemental material, Appendices_-_rev1_-_clean.rjf_online_supp for Directly Acting Oral Anticoagulants for the Prevention of Stroke in Atrial Fibrillation in England and Wales: Cost-
Effectiveness Model and Value of Information Analysis by Howard H. Z. Thom, Will Hollingworth, Reecha Sofat, Zhenru Wang, Wei Fang, Pritesh N. Bodalia, Peter A. Bryden, Philippa A. Davies, Deborah M. Caldwell, Sofia Dias, Diane Eaton, Julian P. T. Higgins, Aroon D. Hingorani, Jose A. Lopez-Lopez, George N. Okoli, Alison Richards, Chris Salisbury, Jelena Savović, Annya Stephens-Boal, Jonathan A. C. Sterne and Nicky J. Welton in MDM Policy & Practice</p
Childhood maltreatment and chronic ‘all over’ body pain in adulthood : a counterfactual analysis using UK Biobank
No full textThe investigators on the CAPE consortium are: Tim Hales, Lesley Colvin, Douglas Steele, 11 Andrew Brown (University of Dundee), Gary Macfarlane (University of Aberdeen), Bhuvaneish Selvaraj, Colin Smith (University of Edinburgh), Line Caes (Stirling University), Reecha Sofat, Suellen Walker, Debajit Sen, Madeleine Verriotis (University College London) while the Chronic Pain Advisory Group includes Carolyn Graham, Maureen O’Reilly and Debs Smith, among others. We thank Jisha Babu (University of Aberdeen) for her work involved in administration in relation to access to data as part of this programme of work. Thanks also to Marcus Beasley and John McBeth for advice on analyses. The authors do not report any conflicts of interest. For the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission.Peer reviewe
Distribution and determinants of circulating complement factor H concentration determined by a high-throughput immunonephelometric assay
No full textBACKGROUND:
Research on complement factor H (fH) in human disease is hampered by lack of an assay suitable for use in large-scale epidemiological studies. We describe the development and validation of a high throughput nephelometric assay for fH.
METHODS:
Reagents from a commercial radial immunodiffusion (RID) assay (The Binding Site) were adapted for use on the Siemens BNII high throughput nephelometric instrument. The assay was calibrated with a highly purified human fH preparation with rigorously determined concentration, and assay performance was comprehensively evaluated using samples from healthy human volunteers, with the commercial RID assay as a comparator. The distribution and determinants of circulating fH concentration in humans were then investigated in a large representative population sample.
RESULTS:
The nephelometric assay had recovery close to 100%, was reproducible with intra- and inter-assay CV's of 11% and 5-15% respectively, and had a wider operating range than the RID assay. fH values were unaffected after multiple freeze-thaw cycles demonstrating that it is evidently a stable analyte for immunoassay. fH concentration was unaltered by an acute inflammatory stimulus. The population study showed that plasma fH concentration is associated with circulating lipids and indices of body fat.
CONCLUSION:
We present the first high throughput assay for circulating fH; the assay is accurate and reliable with reproducible measures from stored samples. It has established the distribution of fH values at a population level and demonstrated important associations with circulating lipids and indices of body fat, thus providing an important reference for future clinical and epidemiological investigations
Overprescribing and rational therapeutics: Barriers to change and opportunities to improve
No full textThere is increasing national and international interest in overprescribing and polypharmacy, and the burden that the inappropriate use of multiple medicines can place on individual patients and on society as a whole. This paper explores the challenges faced by prescribers and pharmacists wishing to reduce polypharmacy, including the uncertainties about the risks and benefits of continuing or stopping individual drugs. We discuss the factors influencing us to prescribe-which may lead to overprescribing-including the increasing number of guidelines, perceived patient pressure and advertising. We offer a critical appraisal of the tools currently available to clinicians and pharmacists aiming to rationalise medicines, and finally a systems-wide approach to improving overprescribing and problematic polypharmacy.</p
Prescribing of high-cost targeted therapies in England is diverging by region.
No full textOBJECTIVES: To examine regional variation in the prescribing of targeted therapies for chronic inflammatory disorders in England between 2019 and 2025. STUDY DESIGN: Retrospective observational study. METHODS: This study analysed Secondary Care Medicines Data from all NHS hospitals in England to evaluate time-trends in prescribing rates of targeted therapies by Integrated Care Board (ICB). RESULTS: Substantial and increasing regional variation in prescribing rates for targeted therapies was observed between 2019 and 2025. The disparity between the highest and lowest prescribing ICBs increased over time, with rates ranging from 2.0 to 6.5 per 1000 people in 2019 and 3.4 to 14.2 per 1000 people in 2025. CONCLUSIONS: There is marked and growing regional variation in the prescribing of targeted therapies across England. Further research should explore the reasons for this divergence to ensure equitable access to these highly effective treatments for patients with chronic inflammatory disorders, irrespective of geography
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