%0 Journal Article %J BMJ Open %D 2024 %T Talking in primary care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost-effectiveness of communication skills e-learning for practitioners on patients’ musculoskeletal pain and enablement %A Felicity L Bishop %A Nadia Cross %A Rachel Dewar-Haggart %A Emma Teasdale %A Amy Herbert %A Michelle E Robinson %A Matthew J Ridd %A Christian Mallen %A Lorna Clarson %A Jennifer Bostock %A Taeko Becque %A Beth Stuart %A Kirsty Garfield %A Leanne Morrison %A Sebastien Pollet %A Jane Vennik %A Helen Atherton %A Jeremy Howick %A Geraldine M Leydon %A Jacqui Nuttall %A Islam, Nazrul %A Lee, Paul H %A Little, Paul %A Hazel A Everitt %X Introduction Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain.Methods and analysis A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews.Ethics approval and dissemination Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country.Trial registration number ISRCTN18010240. %B BMJ Open %I British Medical Journal Publishing Group %V 14 %G eng %U https://bmjopen.bmj.com/content/14/3/e081932 %N 3 %R 10.1136/bmjopen-2023-081932 %0 Journal Article %J BMJ Medicine %D 2024 %T Socioeconomic inequalities in risk of infection with SARS-CoV-2 delta and omicron variants in the UK, 2020-22: analysis of the longitudinal COVID-19 Infection Survey %A Razieh, Cameron %A Shabnam, Sharmin %A Dambha-Miller, Hajira %A Morris, Eva J A %A Yates, Tom %A Chudasama, Yogini %A Zaccardi, Francesco %A Gillies, Clare %A Banerjee, Amitava %A Pareek, Manish %A Lacey, Ben %A White, Martin %A Khunti, Kamlesh %A Islam, Nazrul %X Objective To explore the risk of a positive test result for the delta or omicron variant of the SARS-CoV-2 virus in different occupations and deprivation groups in the UK.Design Analysis of the longitudinal COVID-19 Infection Survey.Setting COVID-19 Infection Survey, conducted by the Office for National Statistics and the University of Oxford, UK, a nationwide longitudinal survey to monitor SARS-CoV-2 infection in the community, 26 April 2020 to 31 January 2022.Participants Survey participants recruited from randomly selected households to reflect the UK population (England, Scotland, Wales, and Northern Ireland) were divided into the delta cohort (2 July 2020 to 19 December 2021) and the omicron variant (on or after 20 December 2021), the dominant variants during our study period.Main outcome measures Incidence rate and incidence rate ratio for the presence of the delta and omicron variants by area level deprivation and occupation sector. Multivariable Poisson regression models were fitted to estimate the adjusted incidence rate ratio after adjusting for age, sex, ethnic group, comorbid conditions, urban or rural residence, household size, patient or client facing job, and time (as quarters of the year).Results 329 356 participants were included in the delta cohort and 246 061 in the omicron cohort. The crude incidence rate for the presence of the delta and omicron variants of the SARS-CoV-2 virus were higher in the most deprived group (based on the index of multiple deprivation divided by deciles; delta cohort 4.33 per 1000 person months, 95% confidence interval 4.09 to 4.58; omicron cohort 76.67 per 1000 person months, 71.60 to 82.11) than in the least deprived group (3.18, 3.05 to 3.31 and 54.52, 51.93 to 57.24, respectively); the corresponding adjusted incidence rate ratios were 1.37 (95% confidence interval 1.29 to 1.47) and 1.34 (1.24 to 1.46) during the delta and omicron variant dominant periods, respectively. The adjusted incidence rate ratios for a positive test result in the most deprived group compared with the least deprived group in the delta cohort were 1.59 (95% confidence interval 1.25 to 2.02) and 1.50 (1.19 to 1.87) in the healthcare and manufacturing or construction sectors, respectively. Corresponding values in the omicron cohort were 1.50 (1.15 to 1.95) and 1.43 (1.09 to 1.86) in the healthcare and teaching and education sectors, respectively. Associations between SARS-CoV-2 infection and other employment sectors were not significant or were not tested because of small numbers.Conclusion In this study, the risk of a positive test result for the SARS-CoV-2 virus in the delta and omicron cohorts was higher in the most deprived than in the least deprived group in the healthcare, manufacturing or construction, and teaching and education sectors.Data are available upon reasonable request. Data from the Office of National Statistics (ONS) COVID-19 Infection Survey can be accessed only by ONS accredited researchers through the secure research service. Researchers can apply for accreditation through the research accreditation service and will need approval to access the COVID-19 Infection Survey data. Further details can be found at https://www.ons.gov.uk/aboutus/whatwedo/statistics/requestingstatistics/secureresearchservice %B BMJ Medicine %I BMJ Specialist Journals %V 3 %G eng %U https://bmjmedicine.bmj.com/content/3/1/e000624 %N 1 %R 10.1136/bmjmed-2023-000624 %0 Journal Article %J BMJ %D 2024 %T Use of generative artificial intelligence in medical research %A Islam, Nazrul %A Mihaela van der Schaar %B BMJ %V 384 %P q119 %G eng %R 10.1136/bmj.q119 %0 Journal Article %J JAMA %D 2023 %T Reporting of Factorial Randomized Trials: Extension of the CONSORT 2010 Statement %A Kahan, Brennan C. %A Hall, Sophie S. %A Beller, Elaine M. %A Birchenall, Megan %A Chan, An-Wen %A Elbourne, Diana %A Little, Paul %A John Fletcher %A Golub, Robert M. %A Goulao, Beatriz %A Hopewell, Sally %A Islam, Nazrul %A Zwarenstein, Merrick %A Juszczak, Edmund %A Montgomery, Alan A. %X Transparent reporting of randomized trials is essential to facilitate critical appraisal and interpretation of results. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, reporting of factorial trials is suboptimal.To develop a consensus-based extension to the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement for factorial trials.Using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework, the CONSORT extension for factorial trials was developed by (1) generating a list of reporting recommendations for factorial trials using a scoping review of methodological articles identified using a MEDLINE search (from inception to May 2019) and supplemented with relevant articles from the personal collections of the authors; (2) a 3-round Delphi survey between January and June 2022 to identify additional items and assess the importance of each item, completed by 104 panelists from 14 countries; and (3) a hybrid consensus meeting attended by 15 panelists to finalize the selection and wording of items for the checklist.This CONSORT extension for factorial trials modifies 16 of the 37 items in the CONSORT 2010 checklist and adds 1 new item. The rationale for the importance of each item is provided. Key recommendations are (1) the reason for using a factorial design should be reported, including whether an interaction is hypothesized, (2) the treatment groups that form the main comparisons should be clearly identified, and (3) for each main comparison, the estimated interaction effect and its precision should be reported.This extension of the CONSORT 2010 Statement provides guidance on the reporting of factorial randomized trials and should facilitate greater understanding of and transparency in their reporting. %B JAMA %V 330 %P 2106-2114 %@ 0098-7484 %G eng %U https://doi.org/10.1001/jama.2023.19793 %N 21 %R 10.1001/jama.2023.19793 %0 Journal Article %J JAMA Network Open %D 2023 %T Consensus Statement for Protocols of Factorial Randomized Trials: Extension of the SPIRIT 2013 Statement %A Kahan, Brennan C. %A Hall, Sophie S. %A Beller, Elaine M. %A Birchenall, Megan %A Elbourne, Diana %A Juszczak, Edmund %A Little, Paul %A John Fletcher %A Golub, Robert M. %A Goulao, Beatriz %A Hopewell, Sally %A Islam, Nazrul %A Zwarenstein, Merrick %A Chan, An-Wen %A Montgomery, Alan A. %X Trial protocols outline a trial’s objectives as well as the methods (design, conduct, and analysis) that will be used to meet those objectives, and transparent reporting of trial protocols ensures objectives are clear and facilitates appraisal regarding the suitability of study methods. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, no extension of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement, which provides guidance on reporting of trial protocols, for factorial trials is available.To develop a consensus-based extension to the SPIRIT 2013 Statement for factorial trials.The SPIRIT extension for factorial trials was developed using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework. First, a list of reporting recommendations was generated using a scoping review of methodological articles identified using a MEDLINE search (inception to May 2019), which was supplemented with relevant articles from the personal collections of the authors. Second, a 3-round Delphi survey (January to June 2022, completed by 104 panelists from 14 countries) was conducted to assess the importance of items and identify additional recommendations. Third, a hybrid consensus meeting was held, attended by 15 panelists to finalize selection and wording of the checklist.This SPIRIT extension for factorial trials modified 9 of the 33 items in the SPIRIT 2013 checklist. Key reporting recommendations were that the rationale for using a factorial design should be provided, including whether an interaction is hypothesized; the treatment groups that will form the main comparisons should be identified; and statistical methods for each main comparison should be provided, including how interactions will be assessed.In this consensus statement, 9 factorial-specific items were provided that should be addressed in all protocols of factorial trials to increase the trial’s utility and transparency. %B JAMA Network Open %V 6 %P e2346121-e2346121 %@ 2574-3805 %G eng %U https://doi.org/10.1001/jamanetworkopen.2023.46121 %N 12 %R 10.1001/jamanetworkopen.2023.46121 %0 Journal Article %J European Journal of Public Health %D 2023 %T A comparison of excess deaths by UK country and region during the first year of the COVID-19 pandemic %A Hopper, Neil A %A Campbell, Annie %A Roberts, Cath %A Ramsay, Julie %A IJpelaar, Jos %A Glickman, Myer %A Nafilyan, Vahé %A Islam, Nazrul %X We compare the impact of the first two waves of the COVID-19 pandemic on risk of age-standardized mortality by sex, UK country, and English region. Each wave is defined as lasting 26 weeks and are consecutive beginning in 2020 week 11. The expected rate is estimated from 2015 to 2019 mean and the projected mortality trend from the same period are used to estimate excess mortality. By both measures, excess mortality was highest and lowest in regions of England, London and the South-West, respectively. Excess mortality was consistently higher for males than females. %B European Journal of Public Health %@ 1101-1262 %G eng %U https://doi.org/10.1093/eurpub/ckad144 %1 ckad144 %R 10.1093/eurpub/ckad144 %0 Journal Article %J BMJ Open %D 2023 %T Development of the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) guideline %A Hansford, Harrison J %A Cashin, Aidan G %A Jones, Matthew D %A Swanson, Sonja A %A Islam, Nazrul %A Dahabreh, Issa J %A Dickerman, Barbra A %A Egger, Matthias %A Xavier Garcia-Albeniz %A Golub, Robert M %A Lodi, Sara %A Moreno-Betancur, Margarita %A Pearson, Sallie-Anne %A Schneeweiss, Sebastian %A Sterne, Jonathan %A Sharp, Melissa K %A Elizabeth A. Stuart %A Hernan, Miguel A %A Hopin Lee %A McAuley, James H %X Background Observational studies are increasingly used to inform health decision-making when randomised trials are not feasible, ethical or timely. The target trial approach provides a framework to help minimise common biases in observational studies that aim to estimate the causal effect of interventions. Incomplete reporting of studies using the target trial framework limits the ability for clinicians, researchers, patients and other decision-makers to appraise, synthesise and interpret findings to inform clinical and public health practice and policy. This paper describes the methods that we will use to develop the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) reporting guideline.Methods/design The TARGET reporting guideline will be developed in five stages following recommended guidance. The first stage will identify target trial reporting practices by systematically reviewing published studies that explicitly emulated a target trial. The second stage will identify and refine items to be considered for inclusion in the TARGET guideline by consulting content experts using sequential online surveys. The third stage will prioritise and consolidate key items to be included in the TARGET guideline at an in-person consensus meeting of TARGET investigators. The fourth stage will produce and pilot-test both the TARGET guideline and explanation and elaboration document with relevant stakeholders. The fifth stage will disseminate the TARGET guideline and resources via journals, conferences and courses.Ethics and dissemination Ethical approval for the survey has been attained (HC220536). The TARGET guideline will be disseminated widely in partnership with stakeholders to maximise adoption and improve reporting of these studies. %B BMJ Open %V 13 %P e074626 %G eng %U https://bmjopen.bmj.com/content/bmjopen/13/9/e074626.full.pdf %N 9 %R 10.1136/bmjopen-2023-074626 %0 Journal Article %J medRxiv %D 2023 %T Combinations of multiple long-term conditions and risk of hospitalisation and death during the winter season: population-based study of 48 million people in England %A Islam, Nazrul %A Shabnam, Sharmin %A Nusrat Khan %A Gillies, Clare %A Zaccardi, Francesco %A Banerjee, Amitava %A Nafilyan, Vahé %A Khunti, Kamlesh %A Dambha-Miller, Hajira %X Background The annual winter season poses substantial challenges to the National Health Service (NHS) in England. Hospitalisation and mortality increase during winter, especially in people with multiple long-term conditions (MLTC or multimorbidity). We aimed to describe which combinations of long-term conditions (LTC) are associated with a higher risk of hospitalisation and death during winter amongst adults in England.Methods In this population-based study, we used linked primary and secondary care data from the General Practice Extraction Service Data for Pandemic Planning (GDPPR) database, Hospital Episode Statistics, and Office for National Statistics death registry. We included individuals aged ≥18 years and alive on 1st December 2021 and used overdispersed Poisson models to estimate the incidence rate ratios of all-cause hospitalisations and deaths associated with the combinations of MLTCs – compared to those with no LTC – during the winter season (1 December 2021 to 31 March 2022).Findings Complete data were available for 48,253,125 adults, of which 15 million (31.2%) had MLTC. Hospitalisation per 1000 person-years was higher in individuals with MLTCs, and varied by combination, e.g.: 96, 1643, and 1552 in individuals with no LTC, cancer+chronic kidney disease (CKD)+cardiovascular disease (CVD)+type 2 diabetes mellitus, and cancer+CKD+CVD+osteoarthritis, respectively. Incidence of death (per 1000 person-years) was 345 in individuals with cancer+CKD+CVD+dementia and 1 with no LTC. CVD+dementia appeared in all the top five MLTC combinations by death and was associated with a substantially higher rate of death than many 3-, 4- and 5-disease combinations.Interpretation Risks of hospitalisation and death vary by combinations of MLTCs and are substantially higher in those with vs. without any LTCs. We have highlighted high-risk combinations for prioritisation and preventive action by policymakers to help manage the challenges imposed by winter pressures on the NHS.Funding National Institute for Health and Care Research (NIHR) through Health Data Research UK rapid funding call for the research activity “Data Science to inform NHS compound winter pressure policy response” (grant number: HDRUK2022.0313)Evidence before this study We searched PubMed, from inception to April 2023, for published population-based studies examining MLTC combinations in cohorts of adults aged 18 years and over. The search terms were “multimorbidity” or ‘’multiple-long-term conditions’’ alongside “groups” or “combinations”. We found no previous studies examining MLTC in relation to death or hospitalisation during the winter season.Added value of this study We have identified distinct combinations of LTCs and estimated the associated risk of hospitalisation and deaths during the winter season using the whole-population primary and secondary care data in England.Implications of all the available evidence Understanding which combinations of MLTCs are associated with the highest risk of hospitalisation and death allows clinicians and policymakers to prioritise resources for preventative measures, such as vaccination to those that will benefit most during winter seasons.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis work is supported by the National Institute for Health and Care Research (NIHR) through Health Data Research UK rapid funding call for the research activity - Data Science to inform NHS compound winter pressure policy response (grant number: HDRUK2022.0313). Health Data Research UK is funded by the British Heart Foundation, Chief Scientists Office of the Scottish Government, Health and Care Research Wales, Health & Social Care Research and Development N. Ireland, Engineering and Physical Sciences Research, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, Cancer Research UK. The funder had no role in study design, data collection, analysis or interpretation, or manuscript writing.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This project used anonymised electronic health records and administrative data which were collected and curated by NHS Digital in a Trusted Research Environment. Data access is available for research conditional on the approval of a research proposal and protocol, data access agreements with NHS Digital, and other information governance requirements. This project falls within the remit of the CVD-COVID-UK/COVID-IMPACT research programme, supported by the British Heart Foundation (BHF) Data Science Centre and the Health Data Research UK (HDR UK), which obtained overall ethics from the Northeast-Newcastle and North Tyneside 2 research ethics committee (REC No 20/NE/0161). Additional details of the linkage, approval, and scope of the consortium approved to use this data have been described here: Wood A, Denholm R, Hollings S, Cooper J, Ip S, Walker V, et al. Linked electronic health records for research on a nationwide cohort of more than 54 million people in England: data resource. BMJ [Internet]. 2021 Apr 7 [cited 2023 May 26];373. Available from: https://www.bmj.com/content/373/bmj.n826I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesThe analytical codes and phenotypes used within the NHS Digital Trusted Research Environment are available in the following repository (GitHub link https://github.com/BHFDSC/CCU059_01). This project used anonymised electronic health records and administrative data which were collected and curated by NHS Digital in a Trusted Research Environment. Due to policies on information governance restrictions, the authors are unable to share individual patient data directly, but data access is available for research conditional on the approval of a research proposal and protocol, data access agreements with NHS Digital, and other information governance requirements. The authors and colleagues across the CVD-COVID-UK/COVID-IMPACT consortium have invested considerable time and energy in developing this data resource and would like to ensure that it is used widely to maximise its value. For inquiries about data access, please see https://web.www.healthdatagateway.org/dataset/7e5f0247-f033-4f98-aed3-3d7422b9dc6d. Data access approval was granted to the CVD-COVID-UK consortium (under project proposal CCU059) through the NHS Digital online Data Access Request Service (DARS-NIC-391419-J3W9T). NHS Digital data have been made available for research under the Control of Patient Information notice, which mandated the sharing of national electronic health records for COVID-19 research (https://digital.nhs.uk/coronavirus/coronavirus-covid-19-response-information-governance-hub/control-of-patient-informationcopi-notice)BHFBritish Heart FoundationCKDChronic Kidney DiseaseCVDCardiovascular DiseasesDHSCDepartment of Health and Social CareGDPPRGeneral Practice Extraction Service Data for pandemic planningGPESGeneral Practice Extraction ServiceHDRUKHealth Data Research United KingdomHES APCHospital Episode Statistics Admitted Patient CareIMDIndex of Multiple DeprivationLTCLong term conditionsNHSNational Health ServiceNIHRNational Institute for Health and Care ResearchOAOsteoarthritisONSOffice for National StatisticsPPIEPublic and Patient Involvement and EngagementT2DMType 2 Diabetes MellitusTRETrusted Research Environment %B medRxiv %P 2023.09.04.23295015 %G eng %U https://www.medrxiv.org/content/medrxiv/early/2023/09/06/2023.09.04.23295015.full.pdf %R 10.1101/2023.09.04.23295015 %0 Journal Article %J Journal of Epidemiology and Community Health %D 2023 %T Predictive value of metabolic profiling in cardiovascular risk scores: analysis of 75 000 adults in UK Biobank %A Jin, Danyao %A Eirini Trichia %A Islam, Nazrul %A Lewington, Sarah %A Lacey, Ben %X Background Metabolic profiling (the extensive measurement of circulating metabolites across multiple biological pathways) is increasingly employed in clinical care. However, there is little evidence on the benefit of metabolic profiling as compared with established atherosclerotic cardiovascular disease (CVD) risk scores.Methods UK Biobank is a prospective study of 0.5 million participants, aged 40–69 at recruitment. Analyses were restricted to 74 780 participants with metabolic profiling (measured using nuclear magnetic resonance) and without CVD at baseline. Cox regression was used to compare model performance before and after addition of metabolites to QRISK3 (an established CVD risk score used in primary care in England); analyses derived three models, with metabolites selected by association significance or by employing two different machine learning approaches.Results We identified 5097 incident CVD events within the 10-year follow-up. Harrell’s C-index of QRISK3 was 0.750 (95% CI 0.739 to 0.763) for women and 0.706 (95% CI 0.696 to 0.716) for men. Adding selected metabolites did not significantly improve measures of discrimination in women (Harrell’s C-index of three models are 0.759 (0.747 to 0.772), 0.759 (0.746 to 0.770) and 0.759 (0.748 to 0.771), respectively) or men (0.710 (0.701 to 0.720), 0.710 (0.700 to 0.719) and 0.710 (0.701 to 0.719), respectively), and neither did it improve reclassification or calibration.Conclusion This large-scale study applied both conventional and machine learning approaches to assess the potential benefit of metabolic profiling to well-established CVD risk scores. However, there was no evidence that metabolic profiling improved CVD risk prediction in this population.Data are available upon reasonable request. Data from the UK Biobank are available to researchers after registration at the UK Biobank server. The data cleaning and coding used to generate the findings of this study are available from the corresponding author on reasonable request. %B Journal of Epidemiology and Community Health %P jech-2023-220801 %G eng %U https://jech.bmj.com/content/jech/early/2023/09/11/jech-2023-220801.full.pdf %R 10.1136/jech-2023-220801 %0 Journal Article %J Journal of the American Heart Association %D 2023 %T Lipoprotein Characteristics and Incident Coronary Heart Disease: Prospective Cohort of Nearly 90 000 Individuals in UK Biobank %A Jin, Danyao %A Eirini Trichia %A Islam, Nazrul %A Jelena Bešević %A Lewington, Sarah %A Lacey, Ben %B Journal of the American Heart Association %P e029552 %G eng %U https://www.ahajournals.org/doi/abs/10.1161/JAHA.123.029552 %R doi:10.1161/JAHA.123.029552 %0 Journal Article %J JAMA Netw Open %D 2023 %T Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review %A Hansford, Harrison J %A Cashin, Aidan G %A Jones, Matthew D %A Swanson, Sonja A %A Islam, Nazrul %A Douglas, Susan R G %A Rizzo, Rodrigo R N %A Devonshire, Jack J %A Williams, Sam A %A Dahabreh, Issa J %A Dickerman, Barbra A %A Egger, Matthias %A Garcia-Albeniz, Xabier %A Golub, Robert M %A Lodi, Sara %A Moreno-Betancur, Margarita %A Pearson, Sallie-Anne %A Schneeweiss, Sebastian %A Sterne, Jonathan A C %A Sharp, Melissa K %A Elizabeth A. Stuart %A Hernán, Miguel A %A Hopin Lee %A McAuley, James H %X IMPORTANCE: Observational (nonexperimental) studies that aim to emulate a randomized trial (ie, the target trial) are increasingly informing medical and policy decision-making, but it is unclear how these studies are reported in the literature. Consistent reporting is essential for quality appraisal, evidence synthesis, and translation of evidence to policy and practice. OBJECTIVE: To assess the reporting of observational studies that explicitly aimed to emulate a target trial. EVIDENCE REVIEW: We searched Medline, Embase, PsycINFO, and Web of Science for observational studies published between March 2012 and October 2022 that explicitly aimed to emulate a target trial of a health or medical intervention. Two reviewers double-screened and -extracted data on study characteristics, key predefined components of the target trial protocol and its emulation (eligibility criteria, treatment strategies, treatment assignment, outcome[s], follow-up, causal contrast[s], and analysis plan), and other items related to the target trial emulation. FINDINGS: A total of 200 studies that explicitly aimed to emulate a target trial were included. These studies included 26 subfields of medicine, and 168 (84%) were published from January 2020 to October 2022. The aim to emulate a target trial was explicit in 70 study titles (35%). Forty-three studies (22%) reported use of a published reporting guideline (eg, Strengthening the Reporting of Observational Studies in Epidemiology). Eighty-five studies (43%) did not describe all key items of how the target trial was emulated and 113 (57%) did not describe the protocol of the target trial and its emulation. CONCLUSION AND RELEVANCE: In this systematic review of 200 studies that explicitly aimed to emulate a target trial, reporting of how the target trial was emulated was inconsistent. A reporting guideline for studies explicitly aiming to emulate a target trial may improve the reporting of the target trial protocols and other aspects of these emulation attempts. %B JAMA Netw Open %V 6 %P e2336023 %8 2023 Sep 05 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/37755828?dopt=Abstract %R 10.1001/jamanetworkopen.2023.36023 %0 Journal Article %J European Journal of Epidemiology %D 2023 %T A comprehensive analysis of all-cause and cause-specific excess deaths in 30 countries during 2020 %A Alicandro, Gianfranco %A La Vecchia, Carlo %A Islam, Nazrul %A Pizzato, Margherita %X The impact of COVID-19 on mortality from specific causes of death remains poorly understood. This study analysed cause-of-death data provided by the World Health Organization from 2011 to 2019 to estimate excess deaths in 2020 in 30 countries. Over-dispersed Poisson regression models were used to estimate the number of deaths that would have been expected if the pandemic had not occurred, separately for men and women. The models included year and age categories to account for temporal trends and changes in size and age structure of the populations. Excess deaths were calculated by subtracting observed deaths from expected ones. Our analysis revealed significant excess deaths from ischemic heart diseases (IHD) (in 10 countries), cerebrovascular diseases (CVD) (in 10 countries), and diabetes (in 19 countries). The majority of countries experienced excess mortality greater than 10%, including Mexico (+ 38·8% for IHD, + 34·9% for diabetes), Guatemala (+ 30·0% for IHD, + 10·2% for CVD, + 39·7% for diabetes), Cuba (+ 18·8% for diabetes), Brazil (+ 12·9% for diabetes), the USA (+ 15·1% for diabetes), Slovenia (+ 33·8% for diabetes), Poland (+ 30·2% for IHD, + 19·5% for CVD, + 26 1% for diabetes), Estonia (+ 26·9% for CVD, + 34·7% for diabetes), Bulgaria (+ 22·8% for IHD, + 11·4% for diabetes), Spain (+ 19·7% for diabetes), Italy (+ 18·0% for diabetes), Lithuania (+ 17·6% for diabetes), Finland (+ 13·2% for diabetes) and Georgia (+ 10·7% for IHD, + 19·0% for diabetes). In 2020, 22 out of 30 countries had a significant increase in total mortality. Some of this excess was attributed to COVID-19, but a substantial increase was also observed in deaths attributed to cardiovascular diseases and diabetes. %B European Journal of Epidemiology %8 2023/09/08 %@ 1573-7284 %G eng %0 Journal Article %J Canadian Journal of Diabetes %D 2023 %T Defining a childhood type 1 diabetes cohort, clinical practice measures and outcomes within administrative data in British Columbia %A Fox, Danya %A Zhang, Qian %A Islam, Nazrul %A Chen, Leo %A Leung, Joseph %A Bone, Jeffrey %A Amed, Shazhan %K administrative health data %K childhood diabetes %K outcome measures %X ABSTRACT Objectives We used administrative data to (1) establish a cohort of individuals with childhood-onset type 1 diabetes (T1D) in British Columbia (BC) and (2) define T1D-related clinical practice measures. Methods We applied a validated diabetes case finding definition and differentiating algorithm to linked administrative data (1992/93–2019/20). Cases were removed when they did not meet inclusion criteria for childhood-onset T1D. Clinical practice measures were defined based on clinical practice guidelines. Results We developed an administrative cohort that includes 5901 individuals with childhood diagnosed T1D between 04/01/1996 and 03/31/2020. The mean age was 22.31 (8.21). Clinical practice measures that were derived included diabetes outpatient visits (N=4935), hemoglobin A1C tests (N=4935), and screening for thyroid function (N=4457), retinopathy (N=1602), and nephropathy (N=2369). Conclusions We established an administrative cohort of ∼6000 individuals with childhood-onset T1D with 20+ years of follow-up data that can be used to describe the association between clinical practice measures and clinical outcomes. %B Canadian Journal of Diabetes %8 2023/08/29/ %@ 1499-2671 %G eng %0 Journal Article %J Scientific Reports %D 2023 %T Socioeconomic inequities of COVID-19 mortality in vulnerable Comunas of the City of Buenos Aires %A Marconi, Agustina M. %A Castillo Salgado, Carlos %A Sarrouf, Elena Beatriz %A Zamora, Rafael Jose %A Irurzun, Alejandra Maria %A Islam, Nazrul %K Public Health %K Quality of Life %X During the COVID-19 pandemic, the gap in health inequities was exposed and increased, showing how different vulnerable groups were affected. Our aim was to examine the correlation between an area-based health inequity index and mortality due to COVID-19 in people 60 years old or above in the City of Buenos Aires in 2020. We developed a Health Inequity Composite Index (HICI), including six core indicators. Each indicator value per Comuna was first standardized to a Z-score. All six Z-scores were summed into a final composite Z-score to rank the Comunas from lowest to highest social inequities. Comunas from the northern part of the city had lower inequities whereas those in the south had higher levels of inequities. COVID-19 age-standardized mortality rate in people 60 years or above was higher in the Comunas from the south and lower in those from the north. Finally, we found a strong positive correlation (Rho = 0.83, p < 0.0001 CI95% = 0.65–0.99) between HICI and age-standardized mortality rates from COVID-19 in people 60 years or above. Our finding of a strong correlation between the levels of health inequity and mortality calls for a concerted effort in narrowing or eliminating existing inequities. %B Scientific Reports %V 13 %P 13642 %8 2023/08/22/ %@ 2045-2322 %G en %0 Journal Article %J Journal of the American Heart Association %D 2023 %T Body Composition and Risk of Incident Heart Failure in 1 Million Adults: A Systematic Review and Dose–Response Meta‐Analysis of Prospective Cohort Studies %A Ayodipupo S. Oguntade %A Islam, Nazrul %A Malouf, Reem %A Taylor, Hannah %A Jin, Danyao %A Lewington, Sarah %A Lacey, Ben %B Journal of the American Heart Association %P e029062 %G eng %U https://www.ahajournals.org/doi/abs/10.1161/JAHA.122.029062 %R 10.1161/JAHA.122.029062 %0 Journal Article %J BMJ %D 2023 %T Race and gender inequity in awards and recognition %A Loder, Elizabeth %A Islam, Nazrul %B BMJ %I BMJ Publishing Group Ltd %V 381 %G eng %U https://www.bmj.com/content/381/bmj.p1004 %R 10.1136/bmj.p1004 %0 Journal Article %J Journal of the Royal Society of Medicine %D 2023 %T Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom %A Shabnam, Sharmin %A Razieh, Cameron %A Dambha-Miller, Hajira %A Yates, Tom %A Gillies, Clare %A Chudasama, Yogini V %A Pareek, Manish %A Banerjee, Amitava %A Kawachi, Ichiro %A Lacey, Ben %A Morris, Eva J A %A White, Martin %A Zaccardi, Francesco %A Khunti, Kamlesh %A Islam, Nazrul %X

Objectives: To estimate the risk of Long COVID by socioeconomic deprivation and to further examine the inequality by sex and occupation.

 

Design: We conducted a retrospective population-based cohort study using data from the ONS COVID-19 Infection Survey between 26 April 2020 and 31 January 2022. This is the largest nationally representative survey of COVID-19 in the UK with longitudinal data on occupation, COVID-19 exposure and Long COVID.

Setting: Community-based survey in the UK.

Participants: A total of 201,799 participants aged 16 to 64 years and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Main outcome measures: The risk of Long COVID at least 4 weeks after SARS-CoV-2 infection by index of multiple deprivation (IMD) and the modifying effects of socioeconomic deprivation by sex and occupation.

Results: Nearly 10% (n = 19,315) of participants reported having Long COVID. Multivariable logistic regression models, adjusted for a range of variables (demographic, co-morbidity and time), showed that participants in the most deprived decile had a higher risk of Long COVID (11.4% vs. 8.2%; adjusted odds ratio (aOR): 1.46; 95% confidence interval (CI): 1.34, 1.59) compared to the least deprived decile. Significantly higher inequalities (most vs. least deprived decile) in Long COVID existed in healthcare and patient-facing roles (aOR: 1.76; 95% CI: 1.27, 2.44), in the education sector (aOR: 1.68; 95% CI: 1.31, 2.16) and in women (aOR: 1.56; 95% CI: 1.40, 1.73) than men (aOR: 1.32; 95% CI: 1.15, 1.51).

Conclusions: This study provides insights into the heterogeneous degree of inequality in Long COVID by deprivation, sex and occupation. These findings will help inform public health policies and interventions in incorporating a social justice and health inequality lens.

%B Journal of the Royal Society of Medicine %P 01410768231168377 %G eng %U https://doi.org/10.1177/01410768231168377 %R 10.1177/01410768231168377 %0 Journal Article %J BMJ %D 2023 %T Age and sex adjustments are critical when comparing death rates %A Islam, Nazrul %A Jdanov, Dmitri A %B BMJ %I BMJ Publishing Group Ltd %V 381 %G eng %U https://www.bmj.com/content/381/bmj.p845 %R 10.1136/bmj.p845 %0 Journal Article %J Nutrition, Metabolism and Cardiovascular Diseases %D 2023 %T Life expectancy following a cardiovascular event in individuals with and without type 2 diabetes: A UK multi-ethnic population-based observational study %A Yogini V. Chudasama %A Khunti, Kamlesh %A Briana Coles %A Clare L. Gillies %A Islam, Nazrul %A Rowlands, Alex V. %A Seidu, Samuel %A Razieh, Cameron %A Davies, Melanie J. %A Nilesh J. Samani %A Yates, Thomas %A Zaccardi, Francesco %K Cardiovascular disease %K Diabetes %K Life Expectancy %K Prognosis %K years of life lost %X Background and Aims We aimed to evaluate the life expectancy following the first cardiovascular disease (CVD) event by type 2 diabetes (T2D) status and ethnicity. Methods and Results We used the Clinical Practice Research Datalink database in England (UK), linked to the Hospital Episode Statistics information, to identify individuals with and without T2D who survived a first CVD event between 1st Jan 2007 and 31st Dec 2017; subsequent death events were extracted from the Office for National Statistics database. Ethnicity was categorised as White, South Asian (SA), Black, or other. Flexible parametric survival models were used to estimate survival and predict life expectancy. 59,939 individuals with first CVD event were included: 7,596 (12.7%) with T2D (60.9% men; mean age at event: 69.7 years [63.2 years in SA, 65.9 in Black, 70.2 in White]) and 52,343 without T2D (56.7% men; 65.9 years [54.7 in Black, 58.2 in SA, 66.3 in White]). Accounting for potential confounders (sex, deprivation, lipid-lowering medication, current smoking, and pre-existing hypertension), comparing individuals with vs without T2D the mortality rate was 53% higher in White (hazard ratio [HR]: 1.53 [95% CI: 1.44, 1.62]), corresponding to a potential loss of 3.87 (3.30, 4.44) life years at the age of 50 years in individuals with T2D. No evidence of a difference in life expectancy was observed in individuals of SA (HR: 0.82 [0.52, 1.29]; -1.36 [-4.58, 1.86] life years), Black (HR: 1.26 [0.59, 2.70]; 1.21 [-2.99, 5.41] life years); and other (HR: 1.64 [0.80, 3.39]; 3.89 [-2.28, 9.99] life years) ethnic group. Conclusion Following a CVD event, T2D is associated with a different prognosis and life years lost among ethnic groups. %B Nutrition, Metabolism and Cardiovascular Diseases %G eng %U https://www.sciencedirect.com/science/article/pii/S0939475323001485 %R https://doi.org/10.1016/j.numecd.2023.04.003 %0 Journal Article %J Journal of Viral Hepatitis %D 2023 %T Correlates of chronic hepatitis B virus infection in the general adult population of China: Systematic review and meta-analysis %A Hamilton, Elizabeth Mova %A Rassam, Wadie %A Yan, Yan %A Singh, Avjit %A Ng, Sarah Yoon Ai %A Zhang, Jiabi %A Lv, Jun %A Islam, Nazrul %A Malouf, Reem %A Yang, Ling %A Millwood, Iona Y. %A Chen, Zhengming %K China %K chronic hepatitis B infection %K hepatitis B surface antigen %K Prevalence %K Risk Factors %X Abstract Chronic infection with hepatitis B virus (HBV) is a significant public health issue in China. Understanding factors associated with chronic HBV is important to enable targeted screening and education and to improve early diagnosis and prevention of disease progression. This systematic review and meta-analysis aimed to identify and describe correlates of chronic HBV among Chinese adults. Searches were conducted in MEDLINE, EMBASE and grey literature up to 25 June 2020. Eligible papers included observational studies in adults of the general population in China that reported factors associated with chronic HBV, measured by Hepatitis B surface antigen (HBsAg). Meta-analysis was performed using fixed-effect models of HBsAg prevalence among factors, and of adjusted odds ratios (ORs) for chronic HBV associated with each factor. Overall 39 articles were included, covering 22 factors, including a range of sociodemographic, behavioural and medical factors. In meta-analysis of eligible studies, a range of factors were significantly associated with higher HBsAg prevalence, including middle age, male sex, being married, rural residence, lower education, smoking, having a HBsAg positive household contact, family history of HBV, history of surgery or blood transfusion. The adjusted ORs varied, from 1.11 (95% CI 1.05–1.18) for smoking to 5.13 (95% CI 4.99–5.26) for having a HBsAg positive household contact. In Chinese adults, a range of factors are associated with chronic HBV infection, which may help inform targeted screening in the general population. %B Journal of Viral Hepatitis %V Epub ahead of print %G eng %U https://onlinelibrary.wiley.com/doi/abs/10.1111/jvh.13816 %R https://doi.org/10.1111/jvh.13816 %0 Journal Article %J BMC Medicine %D 2023 %T Ethnic differences in COVID-19 mortality in the second and third waves of the pandemic in England during the vaccine rollout: a retrospective, population-based cohort study %A Bosworth, Matthew L. %A Ahmed, Tamanna %A Larsen, Tim %A Lorenzi, Luke %A Morgan, Jasper %A Ali, Raghib %A Goldblatt, Peter %A Islam, Nazrul %A Khunti, Kamlesh %A Raleigh, Veena %A Ayoubkhani, Daniel %A Bannister, Neil %A Glickman, Myer %A Nafilyan, Vahé %X Abstract Background Ethnic minority groups in England have been disproportionately affected by the COVID-19 pandemic and have lower vaccination rates than the White British population. We examined whether ethnic differences in COVID-19 mortality in England have continued since the vaccine rollout and to what extent differences in vaccination rates contributed to excess COVID-19 mortality after accounting for other risk factors. Methods We conducted a retrospective, population-based cohort study of 28.8 million adults aged 30–100 years in England. Self-reported ethnicity was obtained from the 2011 Census. The outcome was death involving COVID-19 during the second (8 December 2020 to 12 June 2021) and third wave (13 June 2021 to 1 December 2021). We calculated hazard ratios (HRs) for death involving COVID-19, sequentially adjusting for age, residence type, geographical factors, sociodemographic characteristics, pre-pandemic health, and vaccination status. Results Age-adjusted HRs of death involving COVID-19 were elevated for most ethnic minority groups during both waves, particularly for groups with lowest vaccination rates (Bangladeshi, Pakistani, Black African, and Black Caribbean). HRs were attenuated after adjusting for geographical factors, sociodemographic characteristics, and pre-pandemic health. Further adjusting for vaccination status substantially reduced residual HRs for Black African, Black Caribbean, and Pakistani groups in the third wave. Fully adjusted HRs only remained elevated for the Bangladeshi group (men: 2.19 [95% CI 1.72–2.78]; women: 2.12 [1.58–2.86]) and Pakistani men (1.24 [1.06–1.46]). Conclusions Lower COVID-19 vaccination uptake in several ethnic minority groups may drive some of the differences in COVID-19 mortality compared to White British. Public health strategies to increase vaccination uptake in ethnic minority groups would help reduce inequalities in COVID-19 mortality, which have remained substantial since the start of the vaccination campaign. %B BMC Medicine %V 21 %P 13 %G eng %U https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02704-7 %N 1 %R 10.1186/s12916-022-02704-7 %0 Journal Article %J European Heart Journal - Quality of Care and Clinical Outcomes %D 2022 %T Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries %A Wright, F Lucy %A Cheema, Kate %A Goldacre, Raph %A Hall, Nick %A Herz, Naomi %A Islam, Nazrul %A Karim, Zainab %A Moreno-Martos, David %A Morales, Daniel R %A O'Connell, Daniel %A Spata, Enti %A Akbari, Ashley %A Ashworth, Mark %A Barber, Mark %A Briffa, Norman %A Canoy, Dexter %A Denaxas, Spiros %A Khunti, Kamlesh %A Kurdi, Amanj %A Mamas, Mamas %A Priedon, Rouven %A Sudlow, Cathie %A Morris, Eva J A %A Lacey, Ben %A Banerjee, Amitava %A on behalf of the CVD-COVID-UK Consortium %X 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.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). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.The present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years. %B European Heart Journal - Quality of Care and Clinical Outcomes %@ 2058-5225 %G eng %U https://doi.org/10.1093/ehjqcco/qcac077 %1 qcac077 %R 10.1093/ehjqcco/qcac077 %0 Journal Article %J The Lancet Public Health %D 2022 %T Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial %A Ahern, Amy L %A Breeze, Penny %A Francesco Fusco %A Sharp, Stephen J %A Islam, Nazrul %A Graham M Wheeler %A Hill, Andrew J %A Hughes, Carly A %A Robbie Duschinsky %A Thomas, Chloe %A Bates, Sarah %A Jenny Woolston %A Marie Stubbings %A Fiona Whittle %A Clare Boothby %A Jennifer Bostock %A Jebb, Susan %A Paul Aveyard %A Emma Boyland %A Jason C G Halford %A Stephen Morris %A Brennan, Alan %A Griffin, Simon J %X Summary Background There is evidence that commercially available behavioural weight management programmes can lead to short-term weight loss and reductions in glycaemia. Here, we aimed to provide the 5-year impact and cost-effectiveness of these interventions compared with a brief intervention. Methods WRAP was a non-blinded, parallel-group randomised controlled trial (RCT). We recruited from primary care practices in England and randomly assigned participants to one of three interventions (brief intervention, 12-week open-group behavioural programme [WW, formerly Weight Watchers], or a 52-week open-group WW behavioural programme) in an uneven (2:5:5) allocation. Participants were followed up 5 years after randomisation using data from measurement visits at primary care practices or a research centre, review of primary care electronic medical notes, and self-report questionnaires. The primary outcome was change in weight at 5 years follow-up, assessed using analysis of covariance. We also estimated cost-effectiveness of the intervention. This study is registered at Current Controlled Trials, ISRCTN64986150. Findings Between Oct 18, 2012, and Feb 10, 2014, we recruited 1269 eligible participants (two participants were randomly assigned but not eligible and therefore excluded) and 1040 (82%) consented to be approached about additional follow-up and to have their medical notes reviewed at 5 years. The primary outcome (weight) was ascertained for 871 (69%) of 1267 eligible participants. Mean duration of follow-up was 5·1 (SD 0·3) years. Mean weight change from baseline to 5 years was −0·46 (SD 8·31) kg in the brief intervention group, −1·95 (9·55) kg in the 12-week programme group, and −2·67 (9·81) kg in the 52-week programme. The adjusted difference in weight change was –1·76 (95% CI –3·68 to 0·17) kg between the 52-week programme and the brief intervention; –0·80 (–2·13 to 0·54) kg between the 52-week and the 12-week programme; and –0·96 (–2·90 to 0·97) kg between the 12-week programme and the brief intervention. During the trial, the 12-week programme incurred the lowest cost and produced the highest quality-adjusted life-years (QALY). Simulations beyond 5 years suggested that the 52-week programme would deliver the highest QALYs at the lowest cost and would be the most cost-effective. No participants reported adverse events related to the intervention. Interpretation Although the difference in weight change between groups was not statistically significant, some weight loss was maintained at 5 years after an open-group behavioural weight management programme. Health economic modelling suggests that this could have important implications to reduce the incidence of weight-related disease and these interventions might be cost-saving. Funding The UK National Institute for Health and Care Research Programme Grants for Applied Research and the Medical Research Council. %B The Lancet Public Health %V 7 %P e866-e875 %G eng %U https://www.sciencedirect.com/science/article/pii/S2468266722002262 %N 10 %R https://doi.org/10.1016/S2468-2667(22)00226-2 %0 Journal Article %J BMJ %D 2022 %T Post-submission changes to prespecified statistical analysis plans %A Islam, Nazrul %A Cole, Tim J %A Ross, Joseph S %A Feeney, Timothy %A Loder, Elizabeth %B BMJ %V 378 %P o2244 %8 2022 Sep 21 %G eng %U https://www.bmj.com/content/378/bmj.o2244 %1 http://www.ncbi.nlm.nih.gov/pubmed/36130792?dopt=Abstract %R 10.1136/bmj.o2244 %0 Journal Article %J The Lancet Digital Health %D 2022 %T COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records %A Thygesen, Johan H %A Tomlinson, Christopher %A Hollings, Sam %A Mizani, Mehrdad A %A Handy, Alex %A Akbari, Ashley %A Banerjee, Amitava %A Cooper, Jennifer %A Lai, Alvina G %A Li, Kezhi %A Mateen, Bilal A %A Sattar, Naveed %A Sofat, Reecha %A Torralbo, Ana %A Wu, Honghan %A Wood, Angela %A Sterne, Jonathan A C %A Pagel, Christina %A Whiteley, William N %A Sudlow, Cathie %A Hemingway, Harry %A Denaxas, Spiros %A Abbasizanjani, Hoda %A Ahmed, Nida %A Ahmed, Badar %A Akbari, Ashley %A Akinoso-Imran, Abdul Qadr %A Allara, Elias %A Allery, Freya %A Di Angelantonio, Emanuele %A Ashworth, Mark %A Ayyar-Gupta, Vandana %A Babu-Narayan, Sonya %A Bacon, Seb %A Ball, Steve %A Banerjee, Ami %A Barber, Mark %A Barrett, Jessica %A Bennie, Marion %A Berry, Colin %A Beveridge, Jennifer %A Birney, Ewan %A Bojanić, Lana %A Bolton, Thomas %A Bone, Anna %A Boyle, Jon %A Braithwaite, Tasanee %A Bray, Ben %A Briffa, Norman %A Brind, David %A Brown, Katherine %A Buch, Maya %A Canoy, Dexter %A Caputo, Massimo %A Carragher, Raymond %A Carson, Alan %A Cezard, Genevieve %A Chang, Jen-Yu Amy %A Cheema, Kate %A Chin, Richard %A Chudasama, Yogini %A Cooper, Jennifer %A Copland, Emma %A Crallan, Rebecca %A Cripps, Rachel %A Cromwell, David %A Curcin, Vasa %A Curry, Gwenetta %A Dale, Caroline %A Danesh, John %A Das-Munshi, Jayati %A Dashtban, Ashkan %A Davies, Alun %A Davies, Joanna %A Davies, Gareth %A Davies, Neil %A Day, Joshua %A Delmestri, Antonella %A Denaxas, Spiros %A Denholm, Rachel %A Dennis, John %A Denniston, Alastair %A Deo, Salil %A Dhillon, Baljean %A Docherty, Annemarie %A Dong, Tim %A Douiri, Abdel %A Downs, Johnny %A Dregan, Alexandru %A Ellins, Elizabeth A %A Elwenspoek, Martha %A Falck, Fabian %A Falter, Florian %A Fan, Yat Yi %A Firth, Joseph %A Fraser, Lorna %A Friebel, Rocco %A Amir Gavrieli %A Gerstung, Moritz %A Gilbert, Ruth %A Gillies, Clare %A Glickman, Myer %A Goldacre, Ben %A Goldacre, Raph %A Greaves, Felix %A Green, Mark %A Grieco, Luca %A Griffiths, Rowena %A Gurdasani, Deepti %A Halcox, Julian %A Hall, Nick %A Hama, Tuankasfee %A Handy, Alex %A Hansell, Anna %A Hardelid, Pia %A Hardy, Flavien %A Harris, Daniel %A Harrison, Camille %A Harron, Katie %A Hassaine, Abdelaali %A Hassan, Lamiece %A Healey, Russell %A Hemingway, Harry %A Henderson, Angela %A Herz, Naomi %A Heyl, Johannes %A Hidajat, Mira %A Higginson, Irene %A Hinchliffe, Rosie %A Hippisley-Cox, Julia %A Frederick Ho %A Hocaoglu, Mevhibe %A Hollings, Sam %A Horne, Elsie %A Hughes, David %A Humberstone, Ben %A Inouye, Mike %A Ip, Samantha %A Islam, Nazrul %A Jackson, Caroline %A Jenkins, David %A Jiang, Xiyun %A Johnson, Shane %A Kadam, Umesh %A Kallis, Costas %A Karim, Zainab %A Kasan, Jake %A Katsoulis, Michalis %A Kavanagh, Kim %A Kee, Frank %A Keene, Spencer %A Kent, Seamus %A Khalid, Sara %A Khawaja, Anthony %A Khunti, Kamlesh %A Killick, Richard %A Kinnear, Deborah %A Knight, Rochelle %A Kolamunnage-Dona, Ruwanthi %A Kontopantelis, Evan %A Kurdi, Amanj %A Lacey, Ben %A Lai, Alvina %A Lambarth, Andrew %A Larzjan, Milad Nazarzadeh %A Lawler, Deborah %A Lawrence, Thomas %A Lawson, Claire %A Li, Qiuju %A Li, Ken %A Llinares, Miguel Bernabeu %A Lorgelly, Paula %A Lowe, Deborah %A Lyons, Jane %A Lyons, Ronan %A Machado, Pedro %A Macleod, Mary Joan %A Macleod, John %A Malgapo, Evaleen %A Mamas, Mamas %A Mamouei, Mohammad %A Manohar, Sinduja %A Mapeta, Rutendo %A Martelli, Javiera Leniz %A Martos, David Moreno %A Mateen, Bilal %A McCarthy, Aoife %A Melville, Craig %A Milton, Rebecca %A Mizani, Mehrdad %A Moncusi, Marta Pineda %A Morales, Daniel %A Mordi, Ify %A Morrice, Lynn %A Morris, Carole %A Morris, Eva %A Mu, Yi %A Mueller, Tanja %A Murdock, Lars %A Nafilyan, Vahé %A Nicholson, George %A Nikiphorou, Elena %A Nolan, John %A Norris, Tom %A Norris, Ruth %A North, Laura %A North, Teri-Louise %A O'Connell, Dan %A Oliver, Dominic %A Oluyase, Adejoke %A Olvera-Barrios, Abraham %A Omigie, Efosa %A Onida, Sarah %A Padmanabhan, Sandosh %A Palmer, Tom %A Pasea, Laura %A Patel, Riyaz %A Payne, Rupert %A Pell, Jill %A Petitjean, Carmen %A Pherwani, Arun %A Pickrell, Owen %A Pierotti, Livia %A Pirmohamed, Munir %A Priedon, Rouven %A Prieto-Alhambra, Dani %A Proudfoot, Alastair %A Quinn, Terry %A Quint, Jennifer %A Raffetti, Elena %A Kazem Rahimi %A Rao, Shishir %A Razieh, Cameron %A Roberts, Brian %A Rogers, Caroline %A Rossdale, Jennifer %A Salim, Safa %A Samani, Nilesh %A Sattar, Naveed %A Schnier, Christian %A Schwartz, Roy %A Selby, David %A Seminog, Olena %A Shabnam, Sharmin %A Shah, Ajay %A Shelton, Jon %A Sheppard, James %A Sinha, Shubhra %A Skrypak, Mirek %A Slapkova, Martina %A Sleeman, Katherine %A Smith, Craig %A Sofat, Reecha %A Sosenko, Filip %A Sperrin, Matthew %A Steeg, Sarah %A Sterne, Jonathan %A Stoica, Serban %A Sudell, Maria %A Sudlow, Cathie %A Sun, Luanluan %A Suseeladevi, Arun Karthikeyan %A Sweeting, Michael %A Sydes, Matt %A Takhar, Rohan %A Tang, Howard %A Thygesen, Johan %A Tilston, George %A Tochel, Claire %A Toit, Clea du %A Tomlinson, Christopher %A Toms, Renin %A Torabi, Fatemeh %A Torralbo, Ana %A Townson, Julia %A Tufail, Adnan %A Tungamirai, Tapiwa %A Varma, Susheel %A Sebastian Vollmer %A Walker, Venexia %A Wang, Tianxiao %A Wang, Huan %A Warwick, Alasdair %A Watkinson, Ruth %A Watson, Harry %A Whiteley, William %A Whittaker, Hannah %A Wilde, Harry %A Wilkinson, Tim %A Williams, Gareth %A Williams, Michelle %A Williams, Richard %A Withnell, Eloise %A Wolfe, Charles %A Wood, Angela %A Wright, Lucy %A Wu, Honghan %A Wu, Jinge %A Wu, Jianhua %A Yates, Tom %A Zaccardi, Francesco %A Zhang, Haoting %A Zhang, Huayu %A Zuccolo, Luisa %B The Lancet Digital Health %V 4 %P e542–e557 %G eng %U https://linkinghub.elsevier.com/retrieve/pii/S2589750022000917 %N 7 %R 10.1016/S2589-7500(22)00091-7 %0 Journal Article %J BMJ %D 2022 %T Target trial emulation: applying principles of randomised trials to observational studies %A Matthews, Anthony A. %A Danaei, Goodarz %A Islam, Nazrul %A Kurth, Tobias %K Comparative Effectiveness Research %K Covid-19 %K Extracorporeal Membrane Oxygenation %K Humans %K Respiratory Distress Syndrome %K Respiratory Insufficiency %B BMJ %V 378 %P e071108 %G eng %U https://www.bmj.com/content/378/bmj-2022-071108 %R 10.1136/bmj-2022-071108 %0 Journal Article %J BMC Public Health %D 2022 %T Using health economic modelling to inform the design and development of an intervention: estimating the justifiable cost of weight loss maintenance in the UK %A Bates, Sarah E. %A Thomas, Chloe %A Islam, Nazrul %A Ahern, Amy L. %A Breeze, Penny %A Griffin, Simon %A Brennan, Alan %X Abstract Background There is a need to develop cost-effective weight loss maintenance interventions to prolong the positive impact of weight loss on health outcomes. Conducting pre-trial health economic modelling is recommended to inform the design and development of behavioural interventions. We aimed to use health economic modelling to estimate the maximum cost per-person (justifiable cost) of a cost-effective behavioural weight loss maintenance intervention, given an estimated intervention effect for individuals with: i) a Body Mass Index (BMI) of 28 kg/m 2 or above without diabetes and ii) a diagnosis of type 2 diabetes prescribed a single non-insulin diabetes medication. Methods The School for Public Health Research Diabetes prevention model was used to estimate the lifetime Quality-adjusted life year (QALY) gains, healthcare costs, and maximum justifiable cost associated with a weight loss maintenance intervention. Based on a meta-analysis, the estimated effect of a weight loss maintenance intervention following a 9 kg weight loss, was a regain of 1.33 kg and 4.38 kg in years one and two respectively compared to greater regain of 2.84 kg and 5.6 kg in the control group. Sensitivity analysis was conducted around the rate of regain, duration of effect and initial weight loss. Results The justifiable cost for a weight loss maintenance intervention at an ICER of £20,000 per QALY was £104.64 for an individual with a BMI of 28 or over and £88.14 for an individual with type 2 diabetes. Within sensitivity analysis, this varied from £36.42 to £203.77 for the former, and between £29.98 and £173.05 for the latter. Conclusions Researchers developing a weight loss maintenance intervention should consider these maximum justifiable cost estimates and the potential impact of the duration of effect and initial weight loss when designing intervention content and deciding target populations. Future research should consider using the methods demonstrated in this study to use health economic modelling to inform the design and budgetary decisions in the development of a behavioural interventions. %B BMC Public Health %V 22 %P 290 %G eng %U https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12737-5 %N 1 %R 10.1186/s12889-022-12737-5 %0 Journal Article %J Journal of the Royal Society of Medicine %D 2022 %T Association between household size and COVID-19: A UK Biobank observational study %A Gillies, Clare L %A Rowlands, Alex V %A Razieh, Cameron %A Nafilyan, Vahé %A Chudasama, Yogini %A Islam, Nazrul %A Zaccardi, Francesco %A Ayoubkhani, Daniel %A Lawson, Claire %A Davies, Melanie J %A others %B Journal of the Royal Society of Medicine %I SAGE Publications Sage UK: London, England %V 115 %P 138-44 %G eng %U https://journals.sagepub.com/doi/10.1177/01410768211073923 %N 4 %0 Journal Article %J American Journal of Epidemiology %D 2022 %T Estimating the effectiveness of first dose of COVID-19 vaccine against mortality in England: a quasi-experimental study %A Bermingham, Charlotte %A Morgan, Jasper %A Ayoubkhani, Daniel %A Glickman, Myer %A Islam, Nazrul %A Sheikh, Aziz %A Sterne, Jonathan %A Sarah A Walker %A Nafilyan, Vahé %B American Journal of Epidemiology %I Cold Spring Harbor Laboratory Press %P kwac157 %G eng %U https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwac157/6692446 %0 Journal Article %J BMJ %D 2022 %T “Excess deaths” is the best metric for tracking the pandemic %A Islam, N %B BMJ %I BMJ Publishing Group %V 376 %P o285 %G eng %U https://www.bmj.com/content/376/bmj.o285 %0 Journal Article %J Heart %D 2022 %T Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19 %A Norris, Tom %A Razieh, Cameron %A Zaccardi, Francesco %A Yates, Thomas %A Islam, Nazrul %A Gillies, Clare L %A Chudasama, Yogini V %A Rowlands, Alex V %A Davies, Melanie J %A McCann, Gerry P %A others %B Heart %I BMJ Publishing Group Ltd and British Cardiovascular Society %V 108 %P 1200-1208 %G eng %U https://heart.bmj.com/content/108/15/1200 %N 15 %0 Journal Article %J Nature Communications %D 2022 %T A population-based cohort study of obesity, ethnicity and COVID-19 mortality in 12.6 million adults in England %A Yates, Thomas %A Summerfield, Annabel %A Razieh, Cameron %A Banerjee, Amitava %A Chudasama, Yogini %A Davies, Melanie J %A Gillies, Clare %A Islam, Nazrul %A Lawson, Claire %A Mirkes, Evgeny %A others %B Nature Communications %I Nature Publishing Group %V 13 %P 624 %G eng %U https://www.nature.com/articles/s41467-022-28248-1 %0 Journal Article %J EClinicalMedicine %D 2021 %T Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults %A Rojas, Nurys B Armas %A Lacey, Ben %A Simadibrata, Daniel Martin %A Ross, Stephanie %A Varona-Pérez, Patricia %A Burrett, Julie Ann %A Mart{\'ınez, Marcy Calderón %A Lorenzo-Vázquez, Elba %A Constantén, Sonia Bess %A Thomson, Blake %A others %B EClinicalMedicine %I Elsevier %V 33 %P 100692 %G eng %U https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30436-3/fulltext %0 Journal Article %J Mayo Clinic Proceedings: Innovations, Quality & Outcomes %D 2021 %T Association between accelerometer-assessed physical activity and severity of COVID-19 in UK Biobank %A Rowlands, Alex V %A Dempsey, Paddy C %A Gillies, Clare %A Kloecker, David E %A Razieh, Cameron %A Chudasama, Yogini %A Islam, Nazrul %A Zaccardi, Francesco %A Lawson, Claire %A Norris, Tom %A others %B Mayo Clinic Proceedings: Innovations, Quality & Outcomes %I Elsevier %G eng %U https://www.sciencedirect.com/science/article/pii/S2542454821001302 %0 Journal Article %J BMJ Open Respiratory Research %D 2021 %T Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study %A Wilcox, Christopher R %A Islam, Nazrul %A Dambha-Miller, Hajira %B BMJ Open Respiratory Research %I Archives of Disease in childhood %V 8 %P e000857 %G eng %U https://bmjopenrespres.bmj.com/content/8/1/e000857 %N 1 %0 Conference Paper %B Mayo Clinic Proceedings %D 2021 %T Association of timing and balance of physical activity and rest/sleep with risk of COVID-19: a UK Biobank Study %A Rowlands, Alex V %A Kloecker, David E %A Chudasama, Yogini %A Davies, Melanie J %A Dawkins, Nathan P %A Edwardson, Charlotte L %A Gillies, Clare %A Khunti, Kamlesh %A Razieh, Cameron %A Islam, Nazrul %A others %B Mayo Clinic Proceedings %I Elsevier %V 96 %P 156–164 %G eng %U https://www.sciencedirect.com/science/article/pii/S0025619620312647 %N 1 %0 Journal Article %J BMC public health %D 2021 %T Association of working shifts, inside and outside of healthcare, with severe COVID- 19: an observational study %A Rowlands, AV %A Gillies, Clare %A Chudasama, Yogini %A Davies, MJ %A Islam, Nazrul %A Kloecker, DE %A Lawson, Claire %A Pareek, Manish %A Razieh, Cameron %A Zaccardi, Francesco %A others %B BMC public health %I BioMed Central %V 21 %P 773 %G eng %U https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10839-0 %0 Journal Article %J Open Heart %D 2021 %T Body composition and risk of heart failure: protocol for a systematic review and meta-analysis %A Oguntade, Ayodipupo S %A Jin, Danyao %A Islam, Nazrul %A Malouf, Reem %A Taylor, Hannah %A Caleyachetty, Rishi %A Lewington, Sarah %A Lacey, Ben %B Open Heart %I Archives of Disease in childhood %V 8 %P e001632 %G eng %N 1 %0 Journal Article %J BMJ %D 2021 %T Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries %A Islam, Nazrul %A Jdanov, Dmitri A %A Shkolnikov, Vladimir M %A Khunti, Kamlesh %A Kawachi, Ichiro %A White, Martin %A Lewington, Sarah %A Lacey, Ben %B BMJ %I British Medical Journal Publishing Group %V 375 %P e066768 %G eng %U https://www.bmj.com/content/375/bmj-2021-066768 %0 Journal Article %J European Journal of Epidemiology %D 2021 %T Ethnic differences in COVID-19 mortality during the first two waves of the Coronavirus Pandemic: a nationwide cohort study of 29 million adults in England %A Vahe Nafilyan* %A Islam, Nazrul* %A Mathur, Rohini %A Ayoubkhani, Daniel %A Banerjee, Amitava %A Glickman, Myer %A Humberstone, Ben %A DIamond, Ian %A Khunti, Kamlesh %B European Journal of Epidemiology %V 36 %P 605–617 %G eng %U https://link.springer.com/article/10.1007/s10654-021-00765-1 %0 Journal Article %J European Journal of Public Health %D 2021 %T Ethnic minorities and COVID-19: Examining whether excess risk is mediated through deprivation %A Razieh, Cameron %A Zaccardi, Francesco %A Islam, Nazrul %A Gillies, Clare L %A Chudasama, Yogini %A Rowlands, Alex %A Kloecker, David E %A Davies, Melanie J %A Khunti, Kamlesh %A Yates, Thomas %B European Journal of Public Health %V 31 %P 630–4 %G eng %U https://academic.oup.com/eurpub/article/31/3/630/6179315 %N 3 %0 Journal Article %J BMJ %D 2021 %T Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries %A Islam, Nazrul %A Shkolnikov, Vladimir M %A Acosta, Rolando J %A Klimkin, Ilya %A Kawachi, Ichiro %A Irizarry, Rafael A %A Alicandro, Gianfranco %A Khunti, Kamlesh %A Yates, Tom %A Jdanov, Dmitri A %A others %B BMJ %I British Medical Journal Publishing Group %V 373 %P n1137 %G eng %U https://www.bmj.com/content/373/bmj.n1137 %0 Journal Article %J BMC infectious diseases %D 2021 %T Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort %A Yates, Thomas %A Zaccardi, Francesco %A Islam, Nazrul %A Razieh, Cameron %A Gillies, Clare L %A Lawson, Claire A %A Chudasama, Yogini %A Rowlands, Alex %A Davies, Melanie J %A Docherty, Annemarie B %A others %B BMC infectious diseases %I BioMed Central %V 21 %P 717 %G eng %U https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06466-0 %0 Journal Article %J Obesity %D 2021 %T Obesity, Ethnicity, and Risk of Critical Care, Mechanical Ventilation, and Mortality in Patients Admitted to Hospital with COVID-19: Analysis of the ISARIC CCP-UK Cohort %A Yates, Thomas %A Zaccardi, Francesco %A Islam, Nazrul %A Razieh, Cameron %A Gillies, Clare L %A Lawson, Claire A %A Chudasama, Yogini %A Rowlands, Alex %A Davies, Melanie J %A Docherty, Annemarie B %A others %B Obesity %I John Wiley & Sons, Ltd %V 29 %P 1223–1230 %G eng %U https://onlinelibrary.wiley.com/doi/10.1002/oby.23178 %0 Journal Article %J BMC infectious diseases %D 2021 %T Patterns of Multimorbidity and Risk of Severe SARS-CoV-2 Infection: an observational study in the UK %A Chudasama, Yogini V %A Zaccardi, Francesco %A Gillies, Clare L %A Razieh, Cameron %A Yates, Thomas %A Kloecker, David E %A Rowlands, Alex V %A Davies, Melanie J %A Islam, Nazrul %A Seidu, Samuel %A others %B BMC infectious diseases %I BioMed Central %V 21 %P 908 %G eng %U https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06600-y %0 Journal Article %J Canadian Journal of Diabetes %D 2021 %T Risk Factors for Developing Posttransplant Diabetes After Pediatric Kidney Transplant in a Canadian Tertiary Care Children’s Hospital Between 1995 and 2016 %A Acosta-Gualandri, Alejandra %A Blydt-Hansen, Tom %A Islam, Nazrul %A Amed, Shazhan %B Canadian Journal of Diabetes %I Elsevier %V 45 %P 481–489 %G eng %U https://www.canadianjournalofdiabetes.com/article/S1499-2671(21)00149-0/fulltext %N 5 %0 Journal Article %J European Journal of Public Health %D 2021 %T Sixty-day consequences of COVID-19 in patients discharged from hospital: an electronic health records study %A Islam, Nazrul %A Lewington, Sarah %A Kharbanda, Rajesh K %A Davies, Jim %A Várnai, Kinga A %A Lacey, Ben %B European Journal of Public Health %V 31 %P 280–282 %G eng %U https://academic.oup.com/eurpub/article/31/2/280/6135059 %N 2 %0 Journal Article %J J Epidemiol Community Health %D 2021 %T Social inequality and the syndemic of chronic disease and COVID-19: county-level analysis in the USA %A Islam, Nazrul %A Lacey, Ben %A Shabnam, Sharmin %A Erzurumluoglu, A Mesut %A Dambha-Miller, Hajira %A Chowell, Gerardo %A Kawachi, Ichiro %A Marmot, Michael %B J Epidemiol Community Health %I BMJ Publishing Group Ltd %V 75 %P 496–500 %G eng %U https://jech.bmj.com/content/75/6/496 %N 6 %0 Journal Article %J Journal of the Royal Society of Medicine %D 2021 %T Uses and abuses of real-world data in generating evidence during a pandemic %A Khunti, Kamlesh %A Zaccardi, Francesco %A Islam, Nazrul %A Yates, Tom %B Journal of the Royal Society of Medicine %I SAGE Publications %V 114 %P 109–10 %G eng %U https://journals.sagepub.com/doi/pdf/10.1177/0141076820985282 %N 3 %0 Journal Article %J The Canadian Journal of Psychiatry %D 2021 %T Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders %A Henderson, Amanda M. %A Islam, Nazrul %A Sandor, George G. S. %A Constadina Panagiotopoulos %A Devlin, Angela M. %X Objective: Second-generation antipsychotics (SGAs) are used for a variety of mental disorders and are associated with cardiometabolic side effects in children. The objective of this study was to assess the cardiovascular health of children with mental disorders that are SGA-treated or SGA-naive. Methods: SGA-treated ( n = 47) or SGA-naive ( n = 37) children (aged 6 to 18 years) with mental disorders and control children ( n = 83, no mental disorder) underwent assessment for cardiac function and morphology by echocardiography, aortic pulse wave velocity (PWV), and carotid intima-media thickness (cIMT). Body mass index (BMI) z-scores, waist circumference z-scores, systolic and diastolic blood pressure (BP) percentiles for height and sex, and fasting plasma glucose, insulin, triglycerides, and cholesterol were also assessed. Differences between SGA-treated, SGA-naive, and control children were assessed by linear and log-linear regression models. Results: SGA-treated children had greater BMI z-scores and overweight/obesity (BMI ≥ 85th percentile for age and sex) and hypertension than SGA-naive and control children. The PWV geometric mean was 11.1% higher in SGA-treated (95%CI, 3.95 to 18.77) and 12.9% higher in SGA-naive children (95% CI, 5.60 to 20.59) compared to controls in models adjusted for age, sex, BMI, and systolic BP percentile. Left ventricular (LV) end-diastolic dimension/body surface area (BSA), LV end-systolic dimension/BSA, and LV ejection fraction were lower in SGA-treated and SGA-naive children compared to controls in models adjusted for sex and age. Conclusions: Children with mental disorders have greater arterial stiffness and altered cardiac structure/function than children with no mental health diagnosis. SGA treatment in children is not associated with alterations in cardiovascular structure/function. %B The Canadian Journal of Psychiatry %V 66 %P 667-76 %8 2020-12-02 %@ 0706-7437, 1497-0015 %G en %U http://journals.sagepub.com/doi/10.1177/0706743720974838 %N 7 %! Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders %0 Journal Article %J Environmental research %D 2020 %T COVID-19 and climatic factors: A global analysis %A Islam, Nazrul %A Bukhari, Qasim %A Jameel, Yusuf %A Shabnam, Sharmin %A Erzurumluoglu, A Mesut %A Siddique, Muhammad A %A Massaro, Joseph M %A D'Agostino Sr, Ralph B %B Environmental research %I Academic Press %V 193 %P 110355 %G eng %U https://www.sciencedirect.com/science/article/pii/S0013935120312524 %0 Journal Article %J European Journal of Public Health %D 2020 %T COVID-19 mortality: a complex interplay of sex, gender and ethnicity %A Islam, Nazrul %A Khunti, Kamlesh %A Dambha-Miller, Hajira %A Kawachi, Ichiro %A Marmot, Michael %B European Journal of Public Health %I Oxford University Press %V 30 %P 847–848 %G eng %U https://academic.oup.com/eurpub/article/30/5/847/5879989 %N 5 %0 Journal Article %J Journal of the Royal Society of Medicine %D 2020 %T COVID-19, seasonal influenza and measles: potential triple burden and the role of flu and MMR vaccines %A Islam, Nazrul %A Khunti, Kamlesh %A Majeed, Azeem %B Journal of the Royal Society of Medicine %I SAGE Publications %V 113 %P 485–486 %G eng %U https://journals.sagepub.com/doi/10.1177/0141076820972668 %N 12 %0 Journal Article %J BMJ open %D 2020 %T Currently prescribed drugs in the UK that could upregulate or downregulate ACE2 in COVID-19 disease: a systematic review %A Dambha-Miller, Hajira %A Albasri, Ali %A Hodgson, Sam %A Wilcox, Christopher R %A Khan, Shareen %A Islam, Nazrul %A Little, Paul %A Griffin, Simon J %B BMJ open %I British Medical Journal Publishing Group %V 10 %P e040644 %G eng %U https://bmjopen.bmj.com/content/10/9/e040644 %N 9 %0 Journal Article %J Journal of the Royal Society of Medicine %D 2020 %T Ethnicity, household composition and COVID-19 mortality: a national linked data study %A Nafilyan, Vahé %A Islam, Nazrul %A Ayoubkhani, Daniel %A Gilles, Clare %A Katikireddi, Srinivasa Vittal %A Mathur, Rohini %A Summerfield, Annabel %A Tingay, Karen %A Asaria, Miqdad %A John, Ann %A others %B Journal of the Royal Society of Medicine %I SAGE Publications %V 114 %P 182–211 %G eng %U https://journals.sagepub.com/doi/full/10.1177/0141076821999973 %N 4 %0 Journal Article %J MedRxiv %D 2020 %T Temperature, humidity, and wind speed are associated with lower Covid-19 incidence %A Islam, Nazrul %A Shabnam, Sharmin %A Erzurumluoglu, A Mesut %B MedRxiv %I Cold Spring Harbor Laboratory Press %G eng %U https://www.medrxiv.org/content/10.1101/2020.03.27.20045658v2 %0 Journal Article %J Mayo Clinic Proceedings %D 2020 %T Association of Timing and Balance of Physical Activity and Rest/Sleep With Risk of COVID-19: A UK Biobank Study %A Rowlands, Alex V. %A Kloecker, David E. %A Chudasama, Yogini %A Davies, Melanie J. %A Dawkins, Nathan P. %A Edwardson, Charlotte L. %A Gillies, Clare %A Khunti, Kamlesh %A Razieh, Cameron %A Islam, Nazrul %A Zaccardi, Francesco %A Yates, Tom %B Mayo Clinic Proceedings %P S0025619620312647 %8 10/2020 %@ 00256196 %G en %U https://linkinghub.elsevier.com/retrieve/pii/S0025619620312647 %! Association of Timing and Balance of Physical Activity and Rest/Sleep With Risk of COVID-19 %0 Journal Article %J New England Journal of Medicine %D 2020 %T RAAS Inhibitors and Risk of Covid-19 %A Islam, Nazrul %A Khunti, Kamlesh %A Chowell, Gerardo %B New England Journal of Medicine %V 383 %P 1992 %G eng %U https://www.nejm.org/doi/pdf/10.1056/NEJMc2030446 %N 20 %0 Journal Article %J The Journal of Pediatrics %D 2020 %T Incidence Trends of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes in British Columbia, Canada %A Kao, Kung-Ting* %A Islam, Nazrul* %A Fox, Danya A. %A Amed, Shazhan %K adolescents %K children %K Diabetic Ketoacidosis %K Incidence %K Pediatric %K type 1 diabetes %X ObjectivesTo estimate the 11-year incidence trend of diabetic ketoacidosis (DKA) at and after the diagnosis of type 1 diabetes.Study designA retrospective cohort study using a population-based administrative cohort diagnosed with type 1 diabetes at 14 days, respectively, from diagnosis, identified using International Classification of Diseases, 9th and 10th editions codes. Incidence rate ratios were estimated using Poisson regression and DKA trends using Joinpoint regression analyses.ResultsThere were 1519 individuals (mean age at first-DKA, 12.6 ± 5.9 years; 50% male) with ≥1 DKA episode identified. Of 2615 incident cases of type 1 diabetes, there were 847 (32.4%; mean age, 9.9 ± 4.8 years; 52% male) episodes of DKA at the diagnosis of diabetes. Among prevalent cases of type 1 diabetes (1790 cases in 2002 increasing to 2264 in 2012), there were 1886 episodes of DKA after the diagnosis of diabetes (mean age at first DKA, 15.7 ± 5.2 years). The rates per 100 person-years of DKA at diabetes diagnosis (ranging from 24.1 in 2008 to 37.3 in 2006) and DKA after diabetes diagnosis (ranging from 4.9 in 2002 to 7.7 in 2008) remained stable. Females showed a 67% higher rate of incidence of DKA after the diagnosis of diabetes compared with their male counterparts (incidence rate ratio, 1.67; 95% CI, 1.50-1.86; P < .001), adjusted for the temporal trend by fiscal year. Younger age at diagnosis (<5 years) was associated with a greater risk of DKA at the time of diabetes diagnosis and older children (≥10 years) had a greater risk of DKA after the diagnosis of diabetes.ConclusionsThe risk of DKA at the time of diagnosis of diabetes was greater with younger age and the risk of DKA after the diagnosis of diabetes was higher in females and older children and youth. %B The Journal of Pediatrics %V 221 %P 165-173.e2 %8 June 1, 2020 %@ 0022-3476 %G eng %U http://www.sciencedirect.com/science/article/pii/S0022347620302833 %0 Journal Article %J BMJ %D 2020 %T Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries %A Islam, Nazrul %A Sharp, Stephen J %A Chowell, Gerardo %A Shabnam, Sharmin %A Kawachi, Ichiro %A Lacey, Ben %A Massaro, Joseph M %A D’Agostino, Ralph B %A White, Martin %X

Objective: To evaluate the association between physical distancing interventions and incidence of coronavirus disease 2019 (covid-19) globally.

Design: Natural experiment using interrupted time series analysis, with results synthesised using meta-analysis.

Setting: 149 countries or regions, with data on daily reported cases of covid-19 from the European Centre for Disease Prevention and Control and data on the physical distancing policies from the Oxford covid-19 Government Response Tracker.

Participants: Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020.

Main outcome measure: Incidence rate ratios (IRRs) of covid-19 before and after implementation of physical distancing interventions, estimated using data to 30 May 2020 or 30 days post-intervention, whichever occurred first. IRRs were synthesised across countries using random effects meta-analysis.

Results: On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41).

Conclusions: Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.

%B BMJ %V 370 %P m2743 %8 July 15, 2020 %G eng %U https://www.bmj.com/content/370/bmj.m2743.full.pdf %0 Journal Article %J Obesity Reviews %D 2020 %T Third-wave cognitive behaviour therapies for weight management: A systematic review and network meta-analysis %A Lawlor, Emma R.* %A Islam, Nazrul* %A Bates, Sarah %A Griffin, Simon J. %A Hill, Andrew J. %A Hughes, Carly A. %A Sharp, Stephen J. %A Ahern, Amy L. %K network meta-analysis %K Obesity %K third-wave behavioural therapy %K Weight Loss %X

Summary

This systematic review and network meta-analysis synthesized evidence on the effects of third-wave cognitive behaviour therapies (3wCBT) on body weight, and psychological and physical health outcomes in adults with overweight or obesity. Studies that included a 3wCBT for the purposes of weight management and measured weight or body mass index (BMI) pre-intervention and ≥ 3 months post-baseline were identified through database searches (MEDLINE, CINAHL, Embase, Cochrane database [CENTRAL], PsycINFO, AMED, ASSIA, and Web of Science). Thirty-seven studies were eligible; 21 were randomized controlled trials (RCT) and included in the network meta-analyses. Risk of bias was assessed using RoB2, and evidence quality was assessed using GRADE. Random-effects pairwise meta-analysis found moderate- to high-quality evidence suggesting that 3wCBT had greater weight loss than standard behavioural treatment (SBT) at post-intervention (standardized mean difference [SMD]: −0.09, 95% confidence interval [CI]: −0.22, 0.04; N = 19; I2 = 32%), 12 months (SMD: −0.17, 95% CI: −0.36, 0.02; N = 5; I2 = 33%), and 24 months (SMD: −0.21, 95% CI: −0.42, 0.00; N = 2; I2 = 0%). Network meta-analysis compared the relative effectiveness of different types of 3wCBT that were not tested in head-to-head trials up to 18 months. Acceptance and commitment therapy (ACT)-based interventions had the most consistent evidence of effectiveness. Only ACT had RCT evidence of effectiveness beyond 18 months. Meta-regression did not identify any specific intervention characteristics (dose, duration, delivery) that were associated with greater weight loss. Evidence supports the use of 3wCBT for weight management, specifically ACT. Larger trials with long-term follow-up are needed to identify who these interventions work for, their most effective components, and the most cost-effective method of delivery.

%B Obesity Reviews %V 21 %P e13013 %8 2020 %G eng %U https://doi.org/10.1111/obr.13013 %N 7 %R 10.1111/obr.13013 %0 Journal Article %J Pediatric Diabetes %D 2019 %T Ambulatory Blood Pressure and Carotid Intima Media Thickness in Children with Type 1 Diabetes %A Glackin, Sinead %A Islam, Nazrul %A Henderson, Amanda M %A Dionne, Janis M %A Harris, Kevin C %A Constadina Panagiotopoulos %A Devlin, Angela M %B Pediatric Diabetes %I John Wiley & Sons, Ltd (10.1111) %V 21 %P 358–65 %G eng %U https://onlinelibrary.wiley.com/doi/10.1111/pedi.12960 %N 2 %0 Journal Article %J Pediatric Diabetes %D 2019 %T Insulin pump therapy, pre-pump HbA1c and metabolic improvement in children with type 1 diabetes at a tertiary Canadian children’s hospital %A Botros, S %A Islam, N %A Hursh, B %B Pediatric Diabetes %V 20 %P 427–33 %G eng %U https://onlinelibrary.wiley.com/doi/full/10.1111/pedi.12834 %N 4 %0 Journal Article %J Harvard Public Health Review %D 2019 %T War on drugs: the case of Bangladesh %A Islam, Nazrul %B Harvard Public Health Review %V 25 %P 1-4 %G eng %U https://www.jstor.org/stable/48546764 %0 Journal Article %J Nature %D 2019 %T Mapping 123 million neonatal, infant and child deaths between 2000 and 2017 %A Burstein, Roy %A Nathaniel J Henry %A Collison, Michael L %A Marczak, Laurie B %A Sligar, Amber %A Watson, Stefanie %A Marquez, Neal %A Abbasalizad-Farhangi, Mahdieh %A Abbasi, Masoumeh %A Abd-Allah, Foad %A others %B Nature %I Nature Publishing Group %V 574 %P 353–358 %G eng %U https://www.nature.com/articles/s41586-019-1545-0 %N 7778 %0 Journal Article %J The Lancet %D 2018 %T Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 %A Roth, Gregory A %A Degu Abate %A Abate, Kalkidan Hassen %A Solomon M Abay %A Abbafati, Cristiana %A Nooshin Abbasi %A Hedayat Abbastabar %A Abd-Allah, Foad %A Jemal Abdela %A Ahmed Abdelalim %A others %B The Lancet %I Elsevier %V 392 %P 1736–1788 %G eng %U https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32203-7/fulltext %N 10159 %0 Journal Article %J International Journal of Drug Policy %D 2018 %T Identifying injection drug use and estimating population size of people who inject drugs using healthcare administrative datasets %A Janjua, Naveed Zafar %A Islam, Nazrul %A Kuo, Margot %A Yu, Amanda %A Wong, Stanley %A Butt, Zahid A %A Gilbert, Mark %A Buxton, Jane %A Chapinal, Nuria %A Samji, Hasina %A others %B International Journal of Drug Policy %I Elsevier %V 55 %P 31–39 %G eng %U https://www.sciencedirect.com/science/article/pii/S0955395918300306 %0 Journal Article %J Pediatric diabetes %D 2018 %T Incidence and prevalence trends of youth-onset type 2 diabetes in a cohort of Canadian youth: 2002-2013 %A Amed, Shazhan %A Islam, Nazrul %A Sutherland, Jenny %A Reimer, Kim %B Pediatric diabetes %I John Wiley & Sons A/S Former Munksgaard %V 19 %P 630–636 %G eng %U https://onlinelibrary.wiley.com/doi/full/10.1111/pedi.12631 %N 4 %0 Journal Article %J Journal of Hepatology %D 2018 %T Hepatitis C Virus Reinfection after Successful Treatment with Direct-Acting Antiviral Therapy in a Large Population-Based Cohort %A Rossi, Carmine %A Butt, Zahid %A Wong, Stanley %A Buxton, Jane %A Islam, Nazrul %A Yu, Amanda %A Darvishian, Maryam %A Gilbert, Mark %A Wong, Jason %A Chapinal, Nuria %A Binka, Mawuena %A Alvarez, Maria %A Tyndall, Mark %A Krajden, Mel %A Janjua, Naveed %X

Background & Aims

Direct-acting antiviral therapies (DAA) are an important tool for hepatitis C virus (HCV) elimination. However, reinfection among people who inject drugs (PWID) may hamper elimination targets. We therefore estimated HCV reinfection rates among DAA-treated individuals, including PWIDs.

Methods

We analyzed data from the BC Hepatitis Testers Cohort which included ∼1.7 million individuals screened for HCV in British Columbia, Canada. We followed HCV-infected individuals treated with DAAs who achieved a sustained virologic response (SVR) and had ≥1 subsequent HCV RNA measurement to April 22nd, 2018. Reinfection was defined as a positive RNA measurement after SVR. PWIDs were identified using a validated algorithm and classified based on recent (<3 years) or former (≥3 years before SVR) use. Crude reinfection rates per 100 person-years (PYs) were calculated. Poisson regression was used to model adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CI).

Results

Of 4,114 individuals who met inclusion, most were male (n=2,692, 65%), born before 1965 (n=3,411, 83%) and were either recent (n=875, 21%) or former PWIDs (n=1,793, 44%). Opioid-agonist therapy (OAT) was observed in 19% of PWIDs. We identified 40 reinfections during 2,767 PYs. Reinfection rates were higher among recent (3.1/100 PYs; IRR: 6.7, 95% CI: 1.9, 23.5) and former PWIDs (1.4/100 PYs; IRR: 3.7, 95% CI: 1.1, 12.9) than non-PWIDs (0.3/100 PYs). Among recent PWIDs, reinfection rates were higher among individuals born after 1975 (10.2/100 PYs) and those with co-infected with HIV (5.7/100 PYs). Only one PWID receiving daily OAT developed reinfection.

Conclusions

Population-level reinfection rates remain elevated after DAA therapy among PWIDs because of ongoing exposure risk. Engagement of PWIDs in harm-reduction and support services is needed to prevent reinfections.

Lay Summary

We estimated HCV reinfection rates after successful treatment with direct-acting antiviral therapies. Our findings showed that the risk of reinfection was highest among people with recent injection drug use. Among people who inject drugs, daily use of opioid-agonist therapy was associated with a lower risk of reinfection.

Keywords:

Hepatitis CDirect-Acting AntiviralReinfectionInjection Drug UseEpidemiologyCanada

%B Journal of Hepatology %I Elsevier %V 69 %P 1007-14 %@ 0168-8278 %G eng %U https://www.journal-of-hepatology.eu/article/S0168-8278(18)32288-8/fulltext %N 5 %! J. Hepatol. %0 Journal Article %J Pediatric Diabetes %D 2018 %T Type 1 diabetes outcomes: does distance to clinic matter? %A Fox, Danya A. %A Islam, Nazrul %A Amed, Shazhan %K access %K and evaluation %K Delivery of Health Care %K Diabetes Mellitus %K Health care quality %K Patient Satisfaction %K Pediatrics %K type 1 %X

Background and Objectives:

To access care, pediatric type 1 diabetes (T1D) patients living in British Columbia (BC), Canada, travel to the sole tertiary pediatric hospital (BC Children's Hospital; BCCH), or they receive community care from pediatric endocrinologists and/or pediatricians. We sought to determine whether HbA1C and patient reported outcomes were associated with (i) distance to clinic and (ii) tertiary vs. community care.

Methods

Patients were recruited from T1D clinics across BC. Clinical chart review and patient surveys were completed, including the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Clinic type was categorized as tertiary (BCCH) or community, and travel time to BCCH was categorized as <1 hour (h), 1-2h, or >2h.

Results

There were 189 participants. Age and duration of T1D were similar across groups. Mean number of visits/year for BCCH groups were 2.23, 2.24 and 2.05 for the <1h, 1-2h and >2h groups, respectively, vs. 3.26 for the community group. Adjusted mean difference in HbA1C was +0.65% (95% CI 0.15, 1.15) and +0.52% (95% CI 0.02, 1.02) for the BCCH >2h group compared to BCCH <1h group and community group, respectively. Child DTSQ scores were significantly lower in the BCCH >2h group compared to the BCCH <1h and community groups.

Conclusions

Children travelling >2h to T1D clinic at BCCH had significantly higher HbA1C values and lower satisfaction with care versus those travelling <1h to BCCH and those receiving community care. Access to care closer to home may benefit glycemic control in children with T1D and improve treatment satisfaction. Future research should determine whether these findings can be replicated in other regions.

%B Pediatric Diabetes %V 19 %P 1331-6 %G eng %U https://doi.org/10.1111/pedi.12749 %N 7 %R 10.1111/pedi.12749 %0 Journal Article %J BMJ Open %D 2018 %T Third-wave cognitive behaviour therapies for weight management: systematic review and network meta-analysis protocol %A Lawlor, Emma R %A Islam, Nazrul %A Griffin, Simon J %A Hill, Andrew J %A Hughes, Carly A %A Ahern, Amy L %X Introduction Behavioural and cognitive behavioural programmes are commonly used to assist with weight management, but there is considerable scope to improve their effectiveness, particularly in the longer term. Third-wave cognitive behaviour therapies (CBTs) have this potential and are increasingly used. This systematic review will assess the effect of third-wave CBTs for weight management on weight, psychological and physical health outcomes in adults with overweight or obesity.Methods and analysis The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance. We will include studies of any third-wave CBTs focusing on weight loss or weight maintenance for adults with a body mass index (BMI) >=25kg/m2. Eligible study designs will be randomised control trials, non-randomised trials, prospective cohort and case series. Outcomes of interest will be body weight/BMI, psychological and physical health, and adherence. We will search the following databases from inception to 16 January 2018: MEDLINE, CINAHL, Embase, Cochrane database (CENTRAL), PsycINFO, AMED, ASSIA and Web of Science. The search strategy will be based on the concepts: (1) third-wave CBTs and (2) overweight, obesity or weight management. No restrictions will be applied. We will search reference lists of relevant reviews and included articles. Two independent reviewers will screen articles for eligibility using a two-stage process. Two independent reviewers will extract data, assess risk of bias using Risk of Bias 2.0, Risk of Bias in Non-randomised studies of Interventions or Risk of Bias in Non-randomised Studies of Exposures checklist and assess quality using the Grading of Recommendations Assessment, Development and Evaluation tool. A random-effects network meta-analysis of outcomes, and sub-group analyses and meta-regression will be conducted, where data permit. If not appropriate, a narrative synthesis will be undertaken.Ethics and dissemination Ethical approval is not required as no primary data will be collected. The completed systematic review will be disseminated in a peer-reviewed journal, presented at conferences and used to inform the development of a weight management programme.PROSPERO registration number CRD42018088255. %B BMJ Open %I British Medical Journal Publishing Group %V 8 %G eng %U https://bmjopen.bmj.com/content/8/7/e023425 %N 7 %R 10.1136/bmjopen-2018-023425 %0 Journal Article %J Int J Drug Policy %D 2018 %T Identifying injection drug use and estimating population size of people who inject drugs using healthcare administrative datasets %A Janjua, NZ %A Islam, N %A Kuo, M %A Yu, A %A S. Wong %A Butt, ZA %A Gilbert, M %A Buxton, J %A Chapinal, N %A Samji, H %A Chong, M %A Alvarez, M %A Wong, J. %A Tyndall, MW %A Krajden, M %X

Background

Large linked healthcare administrative datasets could be used to monitor programs providing prevention and treatment services to people who inject drugs (PWID). However, diagnostic codes in administrative datasets do not differentiate non-injection from injection drug use (IDU). We validated algorithms based on diagnostic codes and prescription records representing IDU in administrative datasets against interview-based IDU data.

Methods

The British Columbia Hepatitis Testers Cohort (BC-HTC) includes ∼1.7 million individuals tested for HCV/HIV or reported HBV/HCV/HIV/tuberculosis cases in BC from 1990 to 2015, linked to administrative datasets including physician visit, hospitalization and prescription drug records. IDU, assessed through interviews as part of enhanced surveillance at the time of HIV or HCV/HBV diagnosis from a subset of cases included in the BC-HTC (n = 6559), was used as the gold standard. ICD-9/ICD-10 codes for IDU and injecting-related infections (IRI) were grouped with records of opioid substitution therapy (OST) into multiple IDU algorithms in administrative datasets. We assessed the performance of IDU algorithms through calculation of sensitivity, specificity, positive predictive, and negative predictive values.

Results

Sensitivity was highest (90–94%), and specificity was lowest (42–73%) for algorithms based either on IDU or IRI and drug misuse codes. Algorithms requiring both drug misuse and IRI had lower sensitivity (57–60%) and higher specificity (90–92%). An optimal sensitivity and specificity combination was found with two medical visits or a single hospitalization for injectable drugs with (83%/82%) and without OST (78%/83%), respectively. Based on algorithms that included two medical visits, a single hospitalization or OST records, there were 41,358 (1.2% of 11–65 years individuals in BC) recent PWID in BC based on health encounters during 3- year period (2013–2015).

Conclusion

Algorithms for identifying PWID using diagnostic codes in linked administrative data could be used for tracking the progress of programing aimed at PWID. With population-based datasets, this tool can be used to inform much needed estimates of PWID population size.

%B Int J Drug Policy %V 55 %P 31-39 %G eng %U https://www.sciencedirect.com/science/article/pii/S0955395918300306 %0 Journal Article %J Pediatric Diabetes %D 2018 %T Incidence and prevalence trends of youth-onset type 2 diabetes in a cohort of Canadian youth: 2002-2013 %A Amed, S %A Islam, N %A Sutherland, J %A Reimer, K %X

OBJECTIVE:

Youth-onset type 2 diabetes is an emerging disease. We estimated incidence and prevalence trends of youth-onset type 2 diabetes between 2002 and 2013 in the Canadian province of British Columbia.

METHODS:

This population-based cohort study used a validated diabetes case-finding definition and algorithm to differentiate type 2 from type 1 diabetes to identify youth <20 years with type 2 diabetes within linked population-based administrative data. Age-standardized incidence and prevalence were calculated. JoinPoint regression and double exponential smooth modeling were used.

RESULTS:

From 2002/2003 to 2012/2013, the incidence of youth-onset type 2 diabetes increased from 3.45 (95% confidence interval, CI: 2.43, 4.80) to 5.16 (95% CI: 3.86, 6.78)/100 000. The annual percent change (APC) in incidence was 3.74 (95% CI: 1.61, 5.92; P = 0.003) overall, while it was 5.94 (95% CI: 1.84, 10.20; P = 0.009) and 0.53 (95% CI: -5.04, 6.43; P = 0.837) in females and males, respectively. The prevalence increased from 0.009% (95% CI: 0.007, 0.011) in 2002/2003 to 0.021% (95% CI: 0.018, 0.024) in 2012/2013 with an APC of 7.89 (95% CI: 6.41, 9.40; P < 0.0001). In females, it increased from 0.012% (95% CI: 0.009, 0.015) to 0.027% (95% CI: 0.023, 0.032) and in males from 0.007% (95% CI: 0.005, 0.009) to 0.015% (95% CI: 0.012, 0.019). By 2030, we forecast a prevalence of 0.046% (95% CI: 0.043, 0.048).

CONCLUSIONS:

Youth-onset type 2 diabetes is increasing with higher rates in females vs males. If these rates continue, in 2030, the number of cases will increase by 5-fold. These data are needed to set priorities for diabetes prevention in youth.

%B Pediatric Diabetes %V 19 %P 630-636 %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/pedi.12631/full %N 4 %0 Journal Article %J Pediatr Diabetes %D 2018 %T Type 1 Diabetes Incidence and prevalence trends in a cohort of Canadian children and youth %A Fox, DA %A Islam, N %A Sutherland, J %A Reimer, K %A Amed, S %X

Background and Objective

Incidence rates of type 1 diabetes have long been on the rise across the globe, however, there is emerging evidence that the rate of rise may be slowing. The objective of this study was to describe trends in the incidence and prevalence of type 1 diabetes in a sample of Canadian children and youth.

Methods

Cases were extracted using linked administrative datasets and a validated diabetes case-finding definition. Incidence and prevalence trends were analyzed using the JoinPoint regression analysis program.

Results

A small increase in the incidence of type 1 diabetes was observed over the 11-year period from 2002-2003 to 2012-2013. Total incident cases per year ranged from 201 (2005-2006) to 250 (2007-2008). Total prevalent cases per year ranged from 1790 (2002-2003) to 2264 (2012-2013). Incidence was highest among children aged 5 to 14 years, and lowest in the youngest (1-4 years) and oldest (15-19 years) age brackets. The most significant increase in incidence was in children aged 10 to 14 years. Age-standardized prevalence increased significantly throughout the study period.

Conclusion

These results are similar to data from the United States but differ from European data with respect to the annual percent change for incidence as well as age-specific incidence trends. In keeping with the low mortality rates associated with type 1 diabetes, the prevalence continues to rise.

%B Pediatr Diabetes %V 19 %P 501-505 %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/pedi.12566/full %N 3 %0 Journal Article %J JAMA Pediatrics %D 2017 %T Acute kidney injury in children with type 1 diabetes hospitalized for diabetic ketoacidosis %A Hursh, BE %A Ronsley, R %A Islam, N %A Mammen, C %A Panagiotopoulos, C. %B JAMA Pediatrics %V 171 %P e170020 %G eng %U https://jamanetwork.com/journals/jamapediatrics/fullarticle/2610282 %N 5 %0 Journal Article %J Pediatric Diabetes %D 2017 %T Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital %A Rebecca Ronsley %A Islam, Nazrul %A Ronsley, Claire %A Metzger, Daniel L %A Constadina Panagiotopoulos %B Pediatric Diabetes %V 19 %P 333–338 %G eng %N 2 %0 Journal Article %J Journal of Hepatology %D 2017 %T Are DAAs reducing barriers for HIV co-infected and people who inject drugs? A population based cohort study %A Janjua, N %A Islam, N %A Wong, J. %A Yoshida, EM %A Ramji, A %A Samji, H %A Butt, ZA %A Chong, M %A Cook, D %A Alvarez, M %A others %B Journal of Hepatology %I Elsevier %V 66 %P S726–S727 %G eng %N 1 %0 Thesis %D 2017 %T Clearance, reinfection and re-clearance of hepatitis C %A Islam, Nazrul %I University of British Columbia %G eng %9 phd %0 Journal Article %J The Lancet %D 2017 %T Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016 %A Abajobir, Amanuel Alemu %A Abate, Kalkidan Hassen %A Abbafati, Cristiana %A Abbas, Kaja M %A Abd-Allah, Foad %A Abera, Semaw Ferede %A Abraha, Haftom Niguse %A Abu-Raddad, Laith J %A Abu-Rmeileh, Niveen M E %A Adedeji, Isaac Akinkunmi %A others %B The Lancet %I Elsevier %V 390 %P 1084–1150 %G eng %N 10100 %0 Journal Article %J Scientific Reports %D 2017 %T Hepatitis C cross-genotype immunity and implications for vaccine development %A Islam, Nazrul %A Krajden, Mel %A Shoveller, Jean %A Paul Gustafson %A Gilbert, Mark %A Wong, Jason %A Tyndall, Mark W %A Janjua, Naveed Z %B Scientific Reports %I Nature Publishing Group %V 7 %P 12326 %G eng %N 1 %0 Journal Article %J Journal of Hepatology %D 2017 %T The impact of sustained virological response on long term risk of decompensated cirrhosis: the BC hepatitis testers cohort %A Janjua, NZ %A Chong, M %A Butt, ZA %A Chapinal, N %A Islam, N %A Samji, H %A Darvishian, M %A Cook, D %A Alvarez, M %A Tyndall, M %A others %B Journal of Hepatology %I Elsevier %V 66 %P S497 %G eng %N 1 %0 Journal Article %J Horm Res Paediatr %D 2017 %T Pituitary Dysfunction in Pediatric Patients with Optic Nerve Hypoplasia: A Retrospective Cohort Study (1975–2014) %A Alyahyawi, N %A Dheensaw, K %A Islam, N %A Aroichane, M %A Amed, S %B Horm Res Paediatr %V 89 %P 22–30 %G eng %0 Journal Article %J Journal of Viral Hepatitis %D 2017 %T Role of primary T-cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort %A Islam, Nazrul %A Krajden, Mel %A Gilbert, Mark %A Paul Gustafson %A Yu, Amanda %A Kuo, Margot %A Chong, Mei %A Alvarez, Maria %A Wong, Jason %A Tyndall, Mark W %A others %B Journal of Viral Hepatitis %V 24 %P 421–429 %G eng %N 5 %0 Journal Article %J Journal of Viral Hepatitis %D 2017 %T Shift in disparities in Hepatitis C treatment from interferon to DAA era: A population-based cohort study %A Janjua, Naveed Z %A Islam, Nazrul %A Wong, Jason %A Yoshida, Eric M %A Ramji, Alnoor %A Samji, Hasina %A Butt, Zahid A %A Chong, Mei %A Cook, Darrel %A Alvarez, Maria %A others %B Journal of Viral Hepatitis %V 24 %P 624–630 %G eng %N 8 %0 Journal Article %J Pediatric Diabetes %D 2017 %T Type 1 diabetes incidence and prevalence trends in a cohort of Canadian children and youth %A Fox, DA %A Islam, N %A Sutherland, J %A Reimer, K %A Amed, S %B Pediatric Diabetes %V 19 %P 501–5 %G eng %N 3 %0 Generic %D 2017 %T Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016 %A Abajobir, Amanuel Alemu %A Abate, Kalkidan Hassen %A Abbafati, Cristiana %A Abbas, Kaja M %A Abd-Allah, Foad %A Abera, Semaw Ferede %A Abraha, Haftom Niguse %A Abu-Raddad, Laith J %A Abu-Rmeileh, Niveen M E %A Adedeji, Isaac Akinkunmi %A Adedoyin, Rufus Adesoji %A Adetifa, Ifedayo Morayo O %A Adetokunboh, Olatunji %A Afshin, Ashkan %A Aggarwal, Rakesh %A Agrawal, Anurag %A Agrawal, Sutapa %A Ahmad Kiadaliri, Aliasghar %A Ahmed, Muktar Beshir %A Aichour, Miloud Taki Eddine %A Aichour, Amani Nidhal %A Aichour, Ibthiel %A Aiyar, Sneha %A Akanda, Ali Shafqat %A Akinyemiju, Tomi F %A Akseer, Nadia %A Al Lami, Faris Hasan %A Alabed, Samer %A Alahdab, Fares %A Al-Aly, Ziyad %A Alam, Khurshid %A Alam, Noore %A Alasfoor, Deena %A Aldridge, Robert William %A Alene, Kefyalew Addis %A Al-Eyadhy, Ayman %A Alhabib, Samia %A Ali, Raghib %A Alizadeh-Navaei, Reza %A Aljunid, Syed M %A Alkaabi, Juma M %A Alkerwi, Ala'a %A Alla, François %A Allam, Shalini D %A Allebeck, Peter %A Al-Raddadi, Rajaa %A Alsharif, Ubai %A Altirkawi, Khalid A %A Alvis-Guzman, Nelson %A Amare, Azmeraw T %A Ameh, Emmanuel A %A Amini, Erfan %A Ammar, Walid %A Amoako, Yaw Ampem %A Anber, Nahla %A Andrei, Catalina Liliana %A Androudi, Sofia %A Ansari, Hossein %A Ansha, Mustafa Geleto %A Antonio, Carl Abelardo T %A Anwari, Palwasha %A Ärnlöv, Johan %A Arora, Megha %A Artaman, Al %A Aryal, Krishna Kumar %A Asayesh, Hamid %A Asgedom, Solomon Weldegebreal %A Asghar, Rana Jawad %A Assadi, Reza %A Assaye, Ashagre Molla %A Atey, Tesfay Mehari %A Atre, Sachin R %A Avila-Burgos, Leticia %A Avokpaho, Euripide Frinel G Arthur %A Awasthi, Ashish %A Babalola, Tesleem Kayode %A Bacha, Umar %A Badawi, Alaa %A Balakrishnan, Kalpana %A Balalla, Shivanthi %A Barac, Aleksandra %A Ryan M Barber %A Barboza, Miguel A %A Barker-Collo, Suzanne L %A Bärnighausen, Till %A Barquera, Simon %A Barregard, Lars %A Barrero, Lope H %A Baune, Bernhard T %A Bazargan-Hejazi, Shahrzad %A Bedi, Neeraj %A Beghi, Ettore %A Béjot, Yannick %A Bekele, Bayu Begashaw %A Bell, Michelle L %A Bello, Aminu K %A Bennett, Derrick A %A Bennett, James R %A Bensenor, Isabela M %A Benson, Jennifer %A Berhane, Adugnaw %A Berhe, Derbew Fikadu %A Bernabé, Eduardo %A Beuran, Mircea %A Beyene, Addisu Shunu %A Bhala, Neeraj %A Bhansali, Anil %A Bhaumik, Soumyadeep %A Bhutta, Zulfiqar A %A Bicer, Burcu Kucuk %A Bidgoli, Hassan Haghparast %A Bikbov, Boris %A Birungi, Charles %A Biryukov, Stan %A Bisanzio, Donal %A Bizuayehu, Habtamu Mellie %A Bjerregaard, Peter %A Blosser, Christopher D %A Boneya, Dube Jara %A Boufous, Soufiane %A Bourne, Rupert R A %A Brazinova, Alexandra %A Breitborde, Nicholas J K %A Brenner, Hermann %A Brugha, Traolach S %A Bukhman, Gene %A Bulto, Lemma Negesa Bulto %A Bumgarner, Blair Randal %A Burch, Michael %A Butt, Zahid A %A Cahill, Leah E %A Cahuana-Hurtado, Lucero %A Campos-Nonato, Ismael Ricardo %A Car, Josip %A Car, Mate %A Cárdenas, Rosario %A Carpenter, David O %A Carrero, Juan Jesus %A Carter, Austin %A Castañeda-Orjuela, Carlos A %A Castro, Franz F %A Castro, Ruben Estanislao %A Catalá-López, Ferrán %A Chen, Honglei %A Chiang, Peggy Pei-Chia %A Chibalabala, Mirriam %A Chisumpa, Vesper Hichilombwe %A Chitheer, Abdulaal A %A Choi, Jee-Young Jasmine %A Christensen, Hanne %A Christopher, Devasahayam Jesudas %A Ciobanu, Liliana G %A Cirillo, Massimo %A Cohen, Aaron J %A Colquhoun, Samantha M %A Coresh, Josef %A Criqui, Michael H %A Cromwell, Elizabeth A %A Crump, John A %A Lalit Dandona %A Dandona, Rakhi %A Dargan, Paul I %A das Neves, José %A Davey, Gail %A Davitoiu, Dragos V %A Davletov, Kairat %A de Courten, Barbora %A De Leo, Diego %A Degenhardt, Louisa %A Deiparine, Selina %A Dellavalle, Robert P %A Deribe, Kebede %A Deribew, Amare %A Des Jarlais, Don C %A Dey, Subhojit %A Dharmaratne, Samath D %A Dherani, Mukesh K %A Diaz-Torné, Cesar %A Eric L. Ding %A Dixit, Priyanka %A Djalalinia, Shirin %A Do, Huyen Phuc %A Doku, David Teye %A Donnelly, Christl Ann %A dos Santos, Kadine Priscila Bender %A Douwes-Schultz, Dirk %A Driscoll, Tim R %A Duan, Leilei %A Dubey, Manisha %A Duncan, Bruce Bartholow %A Dwivedi, Laxmi Kant %A Ebrahimi, Hedyeh %A El Bcheraoui, Charbel %A Ellingsen, Christian Lycke %A Enayati, Ahmadali %A Endries, Aman Yesuf %A Ermakov, Sergey Petrovich %A Eshetie, Setegn %A Eshrati, Babak %A Eskandarieh, Sharareh %A Esteghamati, Alireza %A Estep, Kara %A Fanuel, Fanuel Belayneh Bekele %A Faro, André %A Farvid, Maryam S %A Farzadfar, Farshad %A Feigin, Valery L %A Fereshtehnejad, Seyed-Mohammad %A Fernandes, Jefferson G %A Fernandes, João C %A Feyissa, Tesfaye Regassa %A Filip, Irina %A Fischer, Florian %A Foigt, Nataliya %A Foreman, Kyle J %A Frank, Tahvi %A Franklin, Richard C %A Fraser, Maya %A Friedman, Joseph %A Frostad, Joseph J %A Fullman, Nancy %A Fürst, Thomas %A Furtado, Joao M %A Futran, Neal D %A Emmanuela Gakidou %A Gambashidze, Ketevan %A Gamkrelidze, Amiran %A Gankpé, Fortuné Gbètoho %A Garcia-Basteiro, Alberto L %A Gebregergs, Gebremedhin Berhe %A Gebrehiwot, Tsegaye Tewelde %A Gebrekidan, Kahsu Gebrekirstos %A Gebremichael, Mengistu Welday %A Gelaye, Amha Admasie %A Geleijnse, Johanna M %A Gemechu, Bikila Lencha %A Gemechu, Kasiye Shiferaw %A Genova-Maleras, Ricard %A Gesesew, Hailay Abrha %A Gething, Peter W %A Gibney, Katherine B %A Gill, Paramjit Singh %A Gillum, Richard F %A Giref, Ababi Zergaw %A Girma, Bedilu Weji %A Giussani, Giorgia %A Goenka, Shifalika %A Gomez, Beatriz %A Gona, Philimon N %A Gopalani, Sameer Vali %A Goulart, Alessandra Carvalho %A Nicholas Graetz %A Gugnani, Harish Chander %A Gupta, Prakash C %A Gupta, Rahul %A Gupta, Rajeev %A Gupta, Tanush %A Gupta, Vipin %A Haagsma, Juanita A %A Hafezi-Nejad, Nima %A Hakuzimana, Alex %A Halasa, Yara A %A Hamadeh, Randah Ribhi %A Hambisa, Mitiku Teshome %A Hamidi, Samer %A Hammami, Mouhanad %A Hancock, Jamie %A Handal, Alexis J %A Hankey, Graeme J %A Hao, Yuantao %A Harb, Hilda L %A Hareri, Habtamu Abera %A Harikrishnan, Sivadasanpillai %A Haro, Josep Maria %A Hassanvand, Mohammad Sadegh %A Havmoeller, Rasmus %A Hay, Roderick J %A Hay, Simon I %A He, Fei %A Heredia-Pi, Ileana Beatriz %A Herteliu, Claudiu %A Hilawe, Esayas Haregot %A Hoek, Hans W %A Horita, Nobuyuki %A Hosgood, H Dean %A Hostiuc, Sorin %A Hotez, Peter J %A Hoy, Damian G %A Hsairi, Mohamed %A Htet, Aung Soe %A Hu, Guoqing %A Huang, John J %A Huang, Hsiang %A Iburg, Kim Moesgaard %A Igumbor, Ehimario Uche %A Ileanu, Bogdan Vasile %A Inoue, Manami %A Irenso, Asnake Ararsa %A Irvine, Caleb M S %A Islam, Sheikh Mohammed Shariful %A Islam, Nazrul %A Jacobsen, Kathryn H %A Jaenisch, Thomas %A Jahanmehr, Nader %A Jakovljevic, Mihajlo B %A Javanbakht, Mehdi %A Jayatilleke, Achala Upendra %A Jeemon, Panniyammakal %A Jensen, Paul N %A Jha, Vivekanand %A Jin, Ye %A John, Denny %A John, Oommen %A Johnson, Sarah Charlotte %A Jonas, Jost B %A Jürisson, Mikk %A Kabir, Zubair %A Kadel, Rajendra %A Kahsay, Amaha %A Kalkonde, Yogeshwar %A Kamal, Ritul %A Kan, Haidong %A Karch, André %A Karema, Corine Kakizi %A Karimi, Seyed M %A Karthikeyan, Ganesan %A Kasaeian, Amir %A Kassaw, Nigussie Assefa %A Kassebaum, Nicholas J %A Kastor, Anshul %A Katikireddi, Srinivasa Vittal %A Kaul, Anil %A Kawakami, Norito %A Kazanjan, Konstantin %A Keiyoro, Peter Njenga %A Kelbore, Sefonias Getachew %A Kemp, Andrew Haddon %A Kengne, Andre Pascal %A Keren, Andre %A Kereselidze, Maia %A Kesavachandran, Chandrasekharan Nair %A Ketema, Ezra Belay %A Khader, Yousef Saleh %A Khalil, Ibrahim A %A Khan, Ejaz Ahmad %A Khan, Gulfaraz %A Khang, Young-Ho %A Khera, Sahil %A Khoja, Abdullah Tawfih Abdullah %A Khosravi, Mohammad Hossein %A Kibret, Getiye Dejenu %A Kieling, Christian %A Kim, Yun Jin %A Kim, Cho-il %A Kim, Daniel %A Kim, Pauline %A Kim, Sungroul %A Kimokoti, Ruth W %A Kinfu, Yohannes %A Kishawi, Sami %A Kissoon, Niranjan %A Kivimaki, Mika %A Knudsen, Ann Kristin %A Kokubo, Yoshihiro %A Kopec, Jacek A %A Kosen, Soewarta %A Koul, Parvaiz A %A Koyanagi, Ai %A Kravchenko, Michael %A Krohn, Kristopher J %A Kuate Defo, Barthelemy %A Kuipers, Ernst J %A Kulikoff, Xie Rachel %A Kulkarni, Veena S %A Kumar, G Anil %A Kumar, Pushpendra %A Kumsa, Fekede Asefa %A Kutz, Michael %A Lachat, Carl %A Lagat, Abraham K %A Lager, Anton Carl Jonas %A Lal, Dharmesh Kumar %A Lalloo, Ratilal %A Lambert, Nkurunziza %A Lan, Qing %A Lansingh, Van C %A Larson, Heidi J %A Larsson, Anders %A Laryea, Dennis Odai %A Lavados, Pablo M %A Laxmaiah, Avula %A Lee, Paul H %A Leigh, James %A Leung, Janni %A Leung, Ricky %A Levi, Miriam %A Li, Yongmei %A Liao, Yu %A Liben, Misgan Legesse %A Stephen S Lim %A Linn, Shai %A Lipshultz, Steven E %A Liu, Shiwei %A Lodha, Rakesh %A Logroscino, Giancarlo %A Alan D. Lopez %A Lorch, Scott A %A Lorkowski, Stefan %A Lotufo, Paulo A %A Rafael Lozano %A Lunevicius, Raimundas %A Lyons, Ronan A %A Ma, Stefan %A Macarayan, Erlyn RachelleKing %A Machado, Isis Eloah %A Mackay, Mark T %A Magdy Abd El Razek, Mohammed %A Magis-Rodriguez, Carlos %A Mahdavi, Mahdi %A Majdan, Marek %A Majdzadeh, Reza %A Majeed, Azeem %A Malekzadeh, Reza %A Malhotra, Rajesh %A Malta, Deborah Carvalho %A Mantovani, Lorenzo G %A Manyazewal, Tsegahun %A Mapoma, Chabila C %A Marczak, Laurie B %A Marks, Guy B %A Martin, Elena Alvarez %A Martinez-Raga, Jose %A Martins-Melo, Francisco Rogerlândio %A Massano, João %A Maulik, Pallab K %A Mayosi, Bongani M %A Mazidi, Mohsen %A McAlinden, Colm %A McGarvey, Stephen Theodore %A McGrath, John J %A McKee, Martin %A Mehata, Suresh %A Mehndiratta, Man Mohan %A Mehta, Kala M %A Meier, Toni %A Mekonnen, Tefera Chane %A Meles, Kidanu Gebremariam %A Memiah, Peter %A Memish, Ziad A %A Mendoza, Walter %A Mengesha, Melkamu Merid %A Mengistie, Mubarek Abera %A Mengistu, Desalegn Tadese %A Menon, Geetha R %A Menota, Bereket Gebremichael %A Mensah, George A %A Meretoja, Tuomo J %A Meretoja, Atte %A Mezgebe, Haftay Berhane %A Micha, Renata %A Mikesell, Joseph %A Miller, Ted R %A Mills, Edward J %A Minnig, Shawn %A Mirarefin, Mojde %A Mirrakhimov, Erkin M %A Misganaw, Awoke %A Mishra, Shiva Raj %A Mohammad, Karzan Abdulmuhsin %A Mohammadi, Alireza %A Mohammed, Kedir Endris %A Mohammed, Shafiu %A Mohan, Murali B V %A Mohanty, Sanjay K %A Mokdad, Ali H %A Mollenkopf, Sarah K %A Molokhia, Mariam %A Monasta, Lorenzo %A Montañez Hernandez, Julio Cesar %A Montico, Marcella %A Mooney, Meghan D %A Moore, Ami R %A Moradi-Lakeh, Maziar %A Moraga, Paula %A Morawska, Lidia %A Mori, Rintaro %A Morrison, Shane D %A Mruts, Kalayu Birhane %A Mueller, Ulrich O %A Mullany, Erin %A Muller, Kate %A Christopher J.L. Murray %A Murthy, Gudlavalleti Venkata Satyanarayana %A Murthy, Srinivas %A Musa, Kamarul Imran %A Nachega, Jean B %A Nagata, Chie %A Nagel, Gabriele %A Naghavi, Mohsen %A Naidoo, Kovin S %A Nanda, Lipika %A Nangia, Vinay %A Nascimento, Bruno Ramos %A Natarajan, Gopalakrishnan %A Negoi, Ionut %A Nguyen, Cuong Tat %A Nguyen, Quyen Le %A Nguyen, Trang Huyen %A Nguyen, Grant %A Ningrum, Dina Nur Anggraini %A Nisar, Muhammad Imran %A Nomura, Marika %A Nong, Vuong Minh %A Norheim, Ole F %A Norrving, Bo %A Noubiap, Jean Jacques N %A Nyakarahuka, Luke %A O'Donnell, Martin J %A Obermeyer, Carla Makhlouf %A Ogbo, Felix Akpojene %A Oh, In-Hwan %A Okoro, Anselm %A Oladimeji, Olanrewaju %A Olagunju, Andrew Toyin %A Olusanya, Bolajoko Olubukunola %A Olusanya, Jacob Olusegun %A Oren, Eyal %A Ortiz, Alberto %A Osgood-Zimmerman, Aaron %A Ota, Erika %A Owolabi, Mayowa O %A Oyekale, Abayomi Samuel %A PA, Mahesh %A Pacella, Rosana E %A Pakhale, Smita %A Pana, Adrian %A Panda, Basant Kumar %A Panda-Jonas, Songhomitra %A Park, Eun-Kee %A Parsaeian, Mahboubeh %A Patel, Tejas %A Patten, Scott B %A Patton, George C %A Paudel, Deepak %A Pereira, David M %A Perez-Padilla, Rogelio %A Perez-Ruiz, Fernando %A Perico, Norberto %A Pervaiz, Aslam %A Pesudovs, Konrad %A Peterson, Carrie Beth %A Petri, William Arthur %A Petzold, Max %A Phillips, Michael Robert %A Piel, Frédéric B %A Pigott, David M %A Pishgar, Farhad %A Plass, Dietrich %A Polinder, Suzanne %A Popova, Svetlana %A Postma, Maarten J %A Poulton, Richie G %A Pourmalek, Farshad %A Prasad, Narayan %A Purwar, Manorama %A Qorbani, Mostafa %A Quintanilla, Beatriz Paulina Ayala %A Rabiee, Rynaz H S %A Radfar, Amir %A Rafay, Anwar %A Rahimi-Movaghar, Afarin %A Rahimi-Movaghar, Vafa %A Rahman, Mohammad Hifz Ur %A Rahman, Sajjad Ur %A Rahman, Mahfuzar %A Rai, Rajesh Kumar %A Rajsic, Sasa %A Ram, Usha %A Rana, Saleem M %A Ranabhat, Chhabi Lal %A Rao, Paturi Vishnupriya %A Rawaf, Salman %A Ray, Sarah E %A Rego, Maria Albertina Santiago %A Rehm, Jürgen %A Reiner, Robert C %A Remuzzi, Giuseppe %A Renzaho, Andre M N %A Resnikoff, Serge %A Rezaei, Satar %A Rezai, Mohammad Sadegh %A Ribeiro, Antonio L %A Rivas, Jacqueline Castillo %A Rokni, Mohammad Bagher %A Ronfani, Luca %A Roshandel, Gholamreza %A Roth, Gregory A %A Rothenbacher, Dietrich %A Roy, Ambuj %A Rubagotti, Enrico %A Ruhago, George Mugambage %A Saadat, Soheil %A Sabde, Yogesh Damodar %A Sachdev, Perminder S %A Sadat, Nafis %A Safdarian, Mahdi %A Safi, Sare %A Safiri, Saeid %A Sagar, Rajesh %A Sahathevan, Ramesh %A Sahebkar, Amirhossein %A Sahraian, Mohammad Ali %A Salama, Joseph %A Salamati, Payman %A Joshua A. Salomon %A Salvi, Sundeep Santosh %A Samy, Abdallah M %A Sanabria, Juan Ramon %A Sanchez-Niño, Maria Dolores %A Santos, Itamar S %A Santric Milicevic, Milena M %A Sarmiento-Suarez, Rodrigo %A Sartorius, Benn %A Satpathy, Maheswar %A Sawhney, Monika %A Saxena, Sonia %A Saylan, Mete I %A Schmidt, Maria Inês %A Schneider, Ione J C %A Schulhofer-Wohl, Sam %A Schutte, Aletta E %A Schwebel, David C %A Schwendicke, Falk %A Seedat, Soraya %A Seid, Abdulbasit Musa %A Sepanlou, Sadaf G %A Servan-Mori, Edson E %A Shackelford, Katya Anne %A Shaheen, Amira %A Shahraz, Saeid %A Shaikh, Masood Ali %A Shamsipour, Mansour %A Shamsizadeh, Morteza %A Sharma, Jayendra %A Sharma, Rajesh %A She, Jun %A Shen, Jiabin %A Shetty, Balakrishna P %A Shi, Peilin %A Kenji Shibuya %A Shifa, Girma Temam %A Shigematsu, Mika %A Shiri, Rahman %A Shiue, Ivy %A Mark G. Shrime %A Sigfusdottir, Inga Dora %A Silberberg, Donald H %A Silpakit, Naris %A Silva, Diego Augusto Santos %A Silva, João Pedro %A Silveira, Dayane Gabriele Alves %A Sindi, Shireen %A Singh, Jasvinder A %A Singh, Prashant Kumar %A Singh, Abhishek %A Singh, Virendra %A Sinha, Dhirendra Narain %A Skarbek, Katarzyna A Kissimova- %A Skiadaresi, Eirini %A Sligar, Amber %A Smith, David L %A Sobaih, Badr H A %A Sobngwi, Eugene %A Samir Soneji %A Soriano, Joan B %A Sreeramareddy, Chandrashekhar T %A Srinivasan, Vinay %A Stathopoulou, Vasiliki %A Steel, Nicholas %A Dan J. Stein %A Steiner, Caitlyn %A Stöckl, Heidi %A Stokes, Mark Andrew %A Strong, Mark %A Sufiyan, Muawiyyah Babale %A Suliankatchi, Rizwan Abdulkader %A Sunguya, Bruno F %A Sur, Patrick J %A Swaminathan, Soumya %A Sykes, Bryan L %A Szoeke, Cassandra E I %A Tabarés-Seisdedos, Rafael %A Tadakamadla, Santosh Kumar %A Tadese, Fentaw %A Tandon, Nikhil %A Tanne, David %A Tarajia, Musharaf %A Tavakkoli, Mohammad %A Taveira, Nuno %A Tehrani-Banihashemi, Arash %A Tekelab, Tesfalidet %A Tekle, Dejen Yemane %A Temsah, Mohamad-Hani %A Terkawi, Abdullah Sulieman %A Tesema, Cheru Leshargie %A Tesssema, Belay %A Theis, Andrew %A Thomas, Nihal %A Thompson, Alex H %A Thomson, Alan J %A Thrift, Amanda G %A Tiruye, Tenaw Yimer %A Tobe-Gai, Ruoyan %A Tonelli, Marcello %A Topor-Madry, Roman %A Topouzis, Fotis %A Tortajada, Miguel %A Tran, Bach Xuan %A Truelsen, Thomas %A Trujillo, Ulises %A Tsilimparis, Nikolaos %A Tuem, Kald Beshir %A Tuzcu, Emin Murat %A Tyrovolas, Stefanos %A Ukwaja, Kingsley Nnanna %A Undurraga, Eduardo A %A Uthman, Olalekan A %A Uzochukwu, Benjamin S Chudi %A van Boven, Job F M %A Varakin, Yuri Y %A Varughese, Santosh %A Vasankari, Tommi %A Vasconcelos, Ana Maria Nogales %A Velasquez, Ilais Moreno %A Venketasubramanian, Narayanaswamy %A Vidavalur, Ramesh %A Violante, Francesco S %A Vishnu, Abhishek %A Vladimirov, Sergey K %A Vlassov, Vasiliy Victorovich %A Vollset, Stein Emil %A Vos, Theo %A Waid, Jillian L %A Wakayo, Tolassa %A Haidong Wang %A Wang, Yuan-Pang %A Weichenthal, Scott %A Weiderpass, Elisabete %A Weintraub, Robert G %A Werdecker, Andrea %A Wesana, Joshua %A Wijeratne, Tissa %A Wilkinson, James D %A Wiysonge, Charles Shey %A Woldeyes, Belete Getahun %A Wolfe, Charles D A %A Workicho, Abdulhalik %A Workie, Shimelash Bitew %A Xavier, Denis %A Xu, Gelin %A Yaghoubi, Mohsen %A Yakob, Bereket %A Yalew, Ayalnesh Zemene %A Yan, Lijing L %A Yano, Yuichiro %A Yaseri, Mehdi %A Ye, Pengpeng %A Yimam, Hassen Hamid %A Yip, Paul %A Yirsaw, Biruck Desalegn %A Yonemoto, Naohiro %A Yoon, Seok-Jun %A Yotebieng, Marcel %A Younis, Mustafa Z %A Zaidi, Zoubida %A Zaki, Maysaa El Sayed %A Zeeb, Hajo %A Zenebe, Zerihun Menlkalew %A Zerfu, Taddese Alemu %A Zhang, Anthony Lin %A Zhang, Xueying %A Zodpey, Sanjay %A Zuhlke, Liesl Joanna %X Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0.5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Sociodemographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86.9 years (95% UI 86.7-87.2), and for men in Singapore, at 81.3 years (78.8-83.7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. %B The Lancet %I Elsevier %V 390 %P 1084 %8 2017-09 %@ 01406736 %G en %U http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31833-0/fulltext %N 10100 %M doi:10.1016/S0140-6736(17)31833-0 %R 10.1016/S0140-6736(17)31833-0 %0 Journal Article %J Horm Res Paediatr %D 2017 %T Pituitary dysfunction in pediatric patients with optic nerve hypoplasia: A retrospective cohort study (1975–2014) %A Alyahyawi, N %A Dheensaw, K %A Islam, N %A Aroichane, M %A Amed, S %X Background/Aims: The risk factors for pituitary hormone dysfunction (PHD) in children with optic nerve hypoplasia (ONH) are not well understood. This study identified the type, timing, and predictors of PHD in children with ONH. Methods: ONH patient charts were reviewed retrospectively. The incidence rate of PHD was calculated assuming a Poisson distribution. Predictors of PHD were identified through a multivariable Cox proportional hazards model. Results: Among 144 subjects with ONH, 49.3% (n = 71) developed PHD over 614.7 person-years of follow-up. The incidence was 11.55 (95% confidence interval [CI]: 9.02–14.57/100 person-years). The median time to first PHD was 2.88 (interquartile range: 0.02–18.72) months. Eighty-two percent developed their first PHD by their 5th and 90% by their 10th birthday, and 89% within 5 years of ONH diagnosis. Prematurity (adjusted hazard ratio [aHR]: 0.33; 95% CI: 0.1–1.07), blindness (aHR: 1.72; 95% CI: 1.03–2.86), maternal substance abuse (aHR: 1.51; 95% CI: 0.91–2.48), abnormal posterior pituitary (aHR: 3.8; 95% CI: 2.01–7.18), and hypoplastic/absent anterior pituitary (aHR: 2.52; 95% CI: 1.29–4.91) were significant predictors of PHD. Conclusions:The clinical predictors of PHD included blindness, pituitary gland abnormalities, and maternal substance abuse. These predictors help clinical decision-making related to the need for and frequency of hormone testing in pediatric patients with ONH. %B Horm Res Paediatr %G eng %U https://www.karger.com/Article/Abstract/484046 %0 Journal Article %J Scientific Reports %D 2017 %T Hepatitis C cross-genotype immunity and implications for vaccine development %A Islam, N %A Krajden, M %A Shoveller, J %A Gustafson, P %A Gilbert, M %A Wong, J. %A Tyndall, MW %A Janjua, NZ %X While about a quarter of individuals clear their primary hepatitis C (HCV) infections spontaneously, clearance (spontaneous or treatment-induced) does not confer sterilizing immunity against a future infection. Since successful treatment does not prevent future infections either, an effective vaccine is highly desirable in preventing HCV (re)infection. However, development of an effective vaccine has been complicated by the diversity of HCV genotypes, and complexities in HCV immunological responses. Smaller studies on humans and chimpanzees reported seemingly opposing results regarding cross-neutralizing antibodies. We report a lack of cross-genotype immunity in the largest cohort of people to date. In the adjusted Cox proportional hazards model, reinfection with a heterologous HCV genotype (adjusted Hazard Ratio [aHR]: 0.45, 95% CI: 0.25–0.84) was associated with a 55% lower likelihood of re-clearance. Among those who cleared their first infection spontaneously, the likelihood of re-clearance was 49% lower (aHR: 0.51, 95% CI: 0.27–0.94) when reinfected with a heterologous HCV genotype. These findings indicate that immunity against a particular HCV genotype does not offer expanded immunity to protect against subsequent infections with a different HCV genotype. A prophylactic HCV vaccine boosted with multiple HCV genotype may offer a broader and more effective protection. %B Scientific Reports %V 7 %P 12326 %G eng %U https://www.nature.com/articles/s41598-017-10190-8 %N 1 %0 Journal Article %J Pediatr Diabetes %D 2017 %T Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital %A Rebecca Ronsley %A Islam, Nazrul %A Ronsley, Claire %A Metzger, Daniel L %A Constadina Panagiotopoulos %X

Objective

To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion.

Methods

A retrospective chart review was conducted of all DKA admissions to British Columbia Children's Hospital (BCCH) during September 2008 to December 2013. Data collection included diabetes history, estimation of dehydration, insulin and fluid infusion rates, and frequency of laboratory investigations. Markers of adherence included appropriate use of a fluid bolus, normal saline and insulin infusion time, fluid intake and outputs, and the frequency of blood work during the insulin infusion. A log-linear regression model was fitted to assess the factors associated with insulin infusion duration.

Results

Of 157 children (median [interquartile range] age: 10.6 years [5.0, 13.8]) hospitalized for DKA, 45% (n = 70) were male, 55% (n = 86) were transferred from other hospitals, and 26% (n = 40) were admitted to intensive care unit. Thirty-five percent of subjects estimated to have mild or moderate dehydration received fluid boluses. In the adjusted analysis, the average duration on DKA protocol was 39% (95% confidence interval [CI]: 12%, 67%) longer for children admitted with severe dehydration (compared to those with mild dehydration).

Conclusions

Health care providers’ adherence to the BCCH DKA protocol is poor. More severe dehydration at presentation is associated with longer duration of insulin infusion. Further knowledge translation initiatives focused on accurate estimation of volume depletion to ensure appropriate initial fluid resuscitation—as well as careful monitoring during DKA hospitalization—are important, especially in community centers.

%B Pediatr Diabetes %V 19 %P 333-338 %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/pedi.12556/full %N 2 %0 Journal Article %J JAMA Pediatr %D 2017 %T Acute kidney injury in children with type 1 diabetes hospitalized for diabetic ketoacidosis %A Brenden E. Hursh %A Rebecca Ronsley %A Islam, Nazrul %A Cherry Mammen %A Constadina Panagiotopoulos %X

Importance  Acute kidney injury (AKI) in children is associated with poor short-term and long-term health outcomes; however, the frequency of AKI in children hospitalized for diabetic ketoacidosis (DKA) has not been previously examined.

Objectives  To determine the proportion of children hospitalized for DKA who develop AKI and to identify the associated clinical and biochemical markers of AKI.

Design, Setting, and Participants  This medical record review of all DKA admissions from September 1, 2008, through December 31, 2013, was conducted at British Columbia Children’s Hospital, the tertiary pediatric hospital in British Columbia, Canada. Children aged 18 years or younger with type 1 diabetes and DKA and with complete medical records available for data analysis were included (n = 165). All data collection occurred between September 8, 2014, and June 26, 2015. Data analysis took place from August 25, 2015, to June 8, 2016.

Main Outcomes and Measures  Acute kidney injury was defined using Kidney Disease/Improving Global Outcomes serum creatinine criteria. Multinomial logistic regression was used to identify potential factors associated with AKI.

Results  Of the 165 children hospitalized for DKA, 106 (64.2%) developed AKI (AKI stage 1, 37 [34.9%]; AKI stage 2, 48 [45.3%]; and AKI stage 3, 21 [19.8%]). Two children required hemodialysis. In the adjusted multinomial logistic regression model, a serum bicarbonate level less than 10 mEq/L (compared with ≥10 mEq/L) was associated with a 5-fold increase in the odds of severe (stage 2 or 3) AKI (adjusted odds ratio [aOR], 5.22; 95% CI, 1.35-20.22). Each increase of 5 beats/min in initial heart rate was associated with a 22% increase in the odds of severe AKI (aOR, 1.22; 95% CI, 1.07-1.39). Initial corrected sodium level of 145 mEq/L or greater (compared with 135-144 mEq/L) was associated with a 3-fold increase in the odds of mild (stage 1) AKI (aOR, 3.29; 95% CI, 1.25-8.66). There were no cases of mortality in patients with or without AKI.

Conclusions and Relevance  This study is the first to date to document that a high proportion of children hospitalized for DKA develop AKI. Acute kidney injury was associated with markers of volume depletion and severe acidosis. Acute kidney injury is concerning because it is associated with increased morbidity and mortality as well as increased risk of chronic renal disease, a finding that is especially relevant among children who are already at risk for diabetic nephropathy. Strategies are needed to improve the diagnosis, management, and follow-up of AKI in children with type 1 diabetes.

%B JAMA Pediatr %V 171 %P e170020 %G eng %U http://jamanetwork.com/journals/jamapediatrics/fullarticle/2610282 %N 5 %0 Journal Article %J J Viral Hepat %D 2017 %T Shift in disparities in Hepatitis C treatment from interferon to DAA era: A population‐based cohort study %A Janjua, Naveed Z %A Islam, Nazrul %A Wong, Jason %A Yoshida, Eric M %A Ramji, Alnoor %A Samji, Hasina %A Butt, Zahid A %A Chong, Mei %A Cook, Darrel %A Alvarez, Maria %X We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015. HCV treatments were classified as older interferon-based treatments including pegylated interferon/ribavirin (PegIFN/RBV) with/without boceprevir or telaprevir, DAAs with RBV or PegIFN/RBV, and newer interferon-free DAAs. Of 11 886 people treated for HCV between 2000 and 2015, 1164 (9.8%) received interferon-free DAAs (ledipasvir/sofosbuvir: n=1075; 92.4%), while 452 (3.8%) received a combination of DAAs and RBV or PegIFN/RBV. Compared to those receiving interferon-based treatment, people with HIV co-infection (adjusted odds ratio [aOR]: 2.96, 95% CI: 2.31-3.81), cirrhosis (aOR: 1.77, 95% CI: 1.45-2.15), decompensated cirrhosis (aOR: 1.72, 95% CI: 1.31-2.28), diabetes (aOR: 1.30, 95% CI: 1.10-1.54), a history of injection drug use (aOR: 1.34, 95% CI: 1.09-1.65) and opioid substitution therapy (aOR: 1.30, 95% CI: 1.01-1.67) were more likely to receive interferon-free DAAs. Socio-economically marginalized individuals were significantly less likely (most deprived vs most privileged: aOR: 0.71, 95% CI: 0.58-0.87) to receive DAAs. In conclusion, there is a shift in prescription of new HCV treatments to previously excluded groups (eg HIV-co-infected), although gaps remain for the socio-economically marginalized populations. %B J Viral Hepat %V 24 %P 624-30 %G eng %U http://dx.doi.org/10.1111/jvh.12684 %N 8 %0 Journal Article %J Lancet Gastroenterol Hepatol %D 2017 %T Incidence, risk factors, and prevention of hepatitis C reinfection: a population-based cohort study %A Islam, Nazrul %A Krajden, Mel %A Shoveller, Jean %A Paul Gustafson %A Gilbert, Mark %A Buxton, Jane A %A Wong, Jason %A Tyndall, Mark W %A Janjua, Naveed Z %X
Background

People remain at risk of reinfection with hepatitis C virus (HCV), even after clearance of the primary infection. We identified factors associated with HCV reinfection risk in a large population-based cohort study in British Columbia, Canada, and examined the association of opioid substitution therapy and mental health counselling with reinfection.

Methods

We obtained data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for HCV or HIV at the British Columbia Centre for Disease Control Public Health Laboratory during 1990–2013 (when data were available). We defined cases of HCV reinfection as individuals with a positive HCV PCR test after either spontaneous clearance (two consecutive negative HCV PCR tests spaced ≥28 days apart without treatment) or a sustained virological response (SVR; two consecutive negative HCV PCR tests spaced ≥28 days apart 12 weeks after completing interferon-based treatment). We calculated incidence rates of HCV reinfection (per 100 person-years of follow-up) and corresponding 95% CIs assuming a Poisson distribution, and used a multivariable Cox proportional hazards model to examine reinfection risk factors (age, birth cohort, sex, year of HCV diagnosis, HCV clearance type, HIV co-infection, number of mental health counselling visits, levels of material and social deprivation, and alcohol and injection drug use), and the association of opioid substitution therapy and mental health counselling with HCV reinfection among people who inject drugs (PWID).

Findings

5915 individuals with HCV were included in this study after clearance (3690 after spontaneous clearance and 2225 after SVR). 452 (8%) patients developed reinfection; 402 (11%) after spontaneous clearance and 50 (2%) who had achieved SVR. Individuals were followed up for a median of 5·4 years (IQR 2·9–8·7), and the median time to reinfection was 3·0 years (1·5–5·4). The overall incidence rate of reinfection was 1·27 (95% CI 1·15–1·39) per 100 person-years of follow-up over a total of 35 672 person-years, with significantly higher rates in the spontaneous clearance group (1·59, 1·44–1·76) than in the SVR group (0·48, 0·36–0·63). With the adjusted Cox proportional hazards model, we noted higher reinfection risks in the spontaneous clearance group (adjusted hazard ratio [HR] 2·71, 95% CI 2·00–3·68), individuals co-infected with HIV (2·25, 1·78–2·85), and PWID (1·53, 1·21–1·92) than with other reinfection risk factors. Among the 1604 PWID with a current history of injection drug use, opioid substitution therapy was significantly associated with a lower risk of reinfection (adjusted HR 0·73, 95% CI 0·54–0·98), as was engagement with mental health counselling services (0·71, 0·54–0·92).

Interpretation

The incidence of HCV reinfection was higher among HIV co-infected individuals, those who spontaneously cleared HCV infection, and PWID. HCV treatment complemented with opioid substitution therapy and mental health counselling could reduce HCV reinfection risk among PWID. These findings support policies of post-clearance follow-up of PWID, and provision of harm-reduction services to minimise HCV reinfection and transmission.

%B Lancet Gastroenterol Hepatol %V 2 %P 200-210 %G eng %U http://www.thelancet.com/journals/langas/article/PIIS2468-1253(16)30182-0/fulltext %N 3 %0 Conference Paper %B Hepatology %D 2016 %T Re-clearance of hepatitis C: Role of previous clearance and reinfection with a heterologous genotype %A Islam, Nazrul %A Krajden, Mel %A Shoveller, Jean %A Paul Gustafson %A Gilbert, Mark %A Wong, Jason %A Tyndall, Mark %A Janjua, Naveed Z %B Hepatology %I WILEY-BLACKWELL %V 63 %P 375A %G eng %N S1 %0 Conference Paper %B Hepatology %D 2016 %T Role of primary T cell immunodeficiency and Hepatitis B on spontaneous clearance of Hepatitis C %A Islam, Nazrul %A Krajden, Mel %A Gilbert, Mark %A Paul Gustafson %A Tyndall, Mark %A Janjua, Naveed Z %B Hepatology %I WILEY-BLACKWELL %V 63 %P 385A %G eng %N S1 %0 Journal Article %J Paediatr Perinat Epidemiol %D 2016 %T Social support and exclusive breast feeding among Canadian women %A Laugen, Chris M %A Islam, Nazrul %A Janssen, Patricia A %B Paediatr Perinat Epidemiol %V 30 %P 430–8 %G eng %N 5 %0 Conference Proceedings %B Hepatology %D 2016 %T Impact of drug use and opioid substitution therapy on hepatitis C reinfection: The BC Hepatitis Testers Cohort %A Islam, Nazrul %A Krajden, Mel %A Shoveller, Jean %A Paul Gustafson %A Gilbert, Mark %A Buxton, Jane A %A Wong, Jason %A Tyndall, Mark %A Janjua, Naveed Z %B Hepatology %V 63 %P 31A-32A %G eng %N S1 %0 Conference Proceedings %B Hepatology %D 2016 %T Re-clearance of hepatitis C: Role of previous clearance and reinfection with a heterologous genotype %A Islam, Nazrul %A Krajden, Mel %A Shoveller, Jean %A Paul Gustafson %A Gilbert, Mark %A Wong, Jason %A Tyndall, Mark %A Janjua, Naveed Z %B Hepatology %V 63 %P 375A-375A %G eng %N S1 %0 Conference Proceedings %B Hepatology %D 2016 %T Role of primary T cell immunodeficiency and Hepatitis B on spontaneous clearance of Hepatitis C %A Islam, Nazrul %A Krajden, Mel %A Gilbert, Mark %A Paul Gustafson %A Tyndall, Mark %A Janjua, Naveed Z %B Hepatology %V 63 %P 385A-385A %@ 0270-9139 %G eng %N S1 %0 Journal Article %J J Viral Hepat %D 2016 %T Role of primary T‐cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort %A Islam, Nazrul %A Krajden, Mel %A Gilbert, Mark %A Paul Gustafson %A Yu, Amanda %A Kuo, Margot %A Chong, Mei %A Alvarez, Maria %A Wong, Jason %A Tyndall, Mark W %X T-cell host immune response against hepatitis C virus (HCV) has been suggested to play an important role in determining HCV infection outcome. However, data from human studies are not available. This study examined the effect of primary T-cell deficiency along with other factors on the spontaneous clearance of HCV in a large population-based cohort in British Columbia, Canada. The BC Hepatitis Testers Cohort includes all individuals tested for HCV in BC in 1990-2013 linked with data on their medical visits, hospitalizations and prescription drugs. HCV-positive individuals with at least one valid HCV PCR test on/after HCV diagnosis (n=46 783) were included in this study. To examine factors associated with the spontaneous clearance of HCV, multivariable logistic regression was fitted on the full sample, and Cox proportional hazards model on the HCV seroconverters. Spontaneous clearance was observed in 25.1% (n=11 737) of those tested for HCV. After adjusting for potential confounders, the odds of spontaneous clearance of HCV was lower in people with primary T-cell immunodeficiency (adjusted odds ratio [aOR]: 0.55, 95% CI: 0.32-0.94), and higher in females (aOR: 1.61, 95% CI: 1.54-1.68) and in those coinfected with HBV (aOR: 2.31, 95% CI: 1.93-2.77). Similar results were observed in HCV seroconverters except HBV coinfection was not significant. In conclusion, primary T-cell immunodeficiency is associated with a lower spontaneous clearance of HCV while female sex and coinfection with HBV are associated with a higher spontaneous clearance. %B J Viral Hepat %7 November 25, 2016 %V 24 %P 421-429 %G eng %U http://dx.doi.org/10.1111/jvh.12650 %N 5 %0 Journal Article %J Paediatr Perinat Epidemiol %D 2016 %T Social support and exclusive breast feeding among Canadian women %A Laugen, Chris M %A Islam, Nazrul %A Janssen, Patricia A %B Paediatr Perinat Epidemiol %V 30 %P 430-8 %G eng %U http://dx.doi.org/10.1111/ppe.12303 %N 5 %0 Journal Article %J Proc Obstet Gynecol %D 2015 %T Effects of a community-based intervention package on postnatal care seeking behavior in rural Bangladesh: a cluster-randomized controlled trial %A Islam, Mohammad Tajul %A Islam, Nazrul %A Christophi, Costas %A Yoshimura, Yukie %B Proc Obstet Gynecol %I Department of Obstetrics and Gynecology, The University of Iowa Hospitals … %V 5 %P 1 %G eng %N 3 %0 Journal Article %J J Affect Disord %D 2015 %T Gender differences in depression and condom use among sexually active Canadians %A Islam, Nazrul %A Laugen, Chris %B J Affect Disord %I Elsevier %V 174 %P 511–5 %G eng %0 Journal Article %J Research and Reports in Neonatology %D 2015 %T Newborn care practices in rural Bangladesh %A Islam, MT %A Islam, N %A Yoshimura, Y %A Nisha, MK %A Yasmin, N %B Research and Reports in Neonatology %V 5 %P 65–72 %G eng %0 Journal Article %J PharmacoEconomics %D 2015 %T Systematic review of cost-effectiveness analyses of treatments for psoriasis %A Wei Zhang %A Islam, Nazrul %A Ma, Canice %A Anis, Aslam H %B PharmacoEconomics %I Springer International Publishing %V 33 %P 327–340 %G eng %N 4 %0 Journal Article %J Res Rep Neonatol %D 2015 %T Newborn care practices in rural Bangladesh %A Islam, MT %A Islam, N %A Yoshimura, Y %A Nisha, MK %A Yasmin, N %B Res Rep Neonatol %V 5 %P 65-72 %G eng %U https://doi.org/10.2147/RRN.S87122 %0 Journal Article %J Proc Obstet Gynecol %D 2015 %T Effects of a community-based intervention package on postnatal care seeking behavior in rural Bangladesh: a cluster-randomized controlled trial %A Islam, Mohammad Tajul %A Islam, Nazrul %A Christophi, Costas %A Yoshimura, Yukie %B Proc Obstet Gynecol %V 5 %P 1 %G eng %U http://ir.uiowa.edu/cgi/viewcontent.cgi?article=1274&context=pog %N 3 %0 Journal Article %J J Affect Disord %D 2015 %T Gender differences in depression and condom use among sexually active Canadians %A Islam, Nazrul %A Laugen, Chris %B J Affect Disord %V 174 %P 511-5 %G eng %0 Journal Article %J PharmacoEconomics %D 2015 %T Systematic review of cost-effectiveness analyses of treatments for psoriasis %A Wei Zhang %A Islam, Nazrul %A Ma, Canice %A Anis, Aslam H %B PharmacoEconomics %V 33 %P 327-340 %@ 1170-7690 %G eng %U http://dx.doi.org/10.1007/s40273-014-0244-9 %N 4 %0 Journal Article %J Int J Health Policy Manag %D 2014 %T The dilemma of physician shortage and international recruitment in Canada %A Islam, Nazrul %B Int J Health Policy Manag %I Kerman University of Medical Sciences %V 3 %P 29–32 %G eng %N 1 %0 Journal Article %J Acta Derm Venereol %D 2014 %T Error reporting the test statistics and significance levels, and arguable model building %A Islam, Nazrul %B Acta Derm Venereol %V 94 %P 252 %G eng %N 2 %0 Journal Article %J IJARR %D 2014 %T Meeting New Perspectives in Health Services and Policy Research: Student Reflections on Interdisciplinary Training %A Islam, Nazrul %A Munro, Sarah %A Rivers, Robert %A Vishniakov, Dmitry %A Wilcox, Elizabeth %A Sheps, Sam %B IJARR %I Progressive Academic Publishing, UK %V 2 %P 26–31 %G eng %N 9 %0 Journal Article %J Reprod Health %D 2014 %T Practices and determinants of delivery by skilled birth attendants in Bangladesh %A Islam, Nazrul %A Islam, Mohammad Tajul %A Yoshimura, Yukie %B Reprod Health %V 11 %P 86 %G eng %0 Journal Article %J Int J Health Policy Manag %D 2014 %T The dilemma of physician shortage and international recruitment in Canada %A Islam, Nazrul %B Int J Health Policy Manag %V 3 %P 29-32 %G eng %U http://ijhpm.com/article_2850_278771f585f846f21fd3b26bfc9176e9.pdf %N 1 %0 Journal Article %J Acta Derm Venereol %D 2014 %T Error reporting the test statistics and significance levels, and arguable model building %A Islam, Nazrul %B Acta Derm Venereol %V 94 %P 252 %G eng %0 Journal Article %J IJARR %D 2014 %T Meeting New Perspectives in Health Services and Policy Research: Student Reflections on Interdisciplinary Training %A Islam, Nazrul %A Munro, Sarah %A Rivers, Robert %A Vishniakov, Dmitry %A Wilcox, Elizabeth %A Sheps, Sam %B IJARR %V 2 %P 26-31 %G eng %0 Journal Article %J Reprod Health %D 2014 %T Practices and determinants of delivery by skilled birth attendants in Bangladesh %A Islam, Nazrul %A Islam, Mohammad Tajul %A Yoshimura, Yukie %B Reprod Health %V 11 %P 86 %G eng %U http://dx.doi.org/10.1186/1742-4755-11-86 %0 Journal Article %J Travel Med Infect Dis. %D 2013 %T An epidemiological overview of malaria in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios K %B Travel Med Infect Dis. %I Elsevier %V 11 %P 29–36 %G eng %N 1 %0 Conference Paper %B Canadian Society for Epidemiology and Biostatistics Biennial Conference %D 2013 %T High-risk Groups, Treatment Seeking Behavior and Risk Factors of Malaria in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios %B Canadian Society for Epidemiology and Biostatistics Biennial Conference %I Canadian Society for Epidemiology & Biostatistics %P 27 %G eng %0 Conference Paper %B Research Advances in Malaria Conference. Malaria transmission: from the mosquito midgut to the mammalian liver %D 2013 %T Potential of Plasmodium knowlesi, the fifth malarial pathogen, in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios %B Research Advances in Malaria Conference. Malaria transmission: from the mosquito midgut to the mammalian liver %I Johns Hopkins Bloomberg School of Public Health %P 16 %G eng %0 Journal Article %J Int J Phys Soc Sci %D 2013 %T Symmetry of Odds Ratio %A Islam, Nazrul %B Int J Phys Soc Sci %V 3 %P 580–2 %G eng %N 12 %0 Journal Article %J Travel Med Infect Dis %D 2013 %T An epidemiological overview of malaria in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios K %B Travel Med Infect Dis %V 11 %P 29-36 %G eng %U http://www.travelmedicinejournal.com/article/S1477-8939(13)00007-0/pdf %N 1 %0 Conference Proceedings %B Canadian Society for Epidemiology and Biostatistics Biennial Conference %D 2013 %T High-risk Groups, Treatment Seeking Behavior and Risk Factors of Malaria in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios %B Canadian Society for Epidemiology and Biostatistics Biennial Conference %I Canadian Society for Epidemiology & Biostatistics %C St. John's, NL %P 27 %G eng %0 Conference Proceedings %B Research Advances in Malaria Conference. Malaria transmission: from the mosquito midgut to the mammalian liver %D 2013 %T Potential of Plasmodium knowlesi, the fifth malarial pathogen, in Bangladesh %A Islam, Nazrul %A Bonovas, Stefanos %A Nikolopoulos, Georgios %B Research Advances in Malaria Conference. Malaria transmission: from the mosquito midgut to the mammalian liver %I Johns Hopkins Bloomberg School of Public Health %C Baltimore, MD %P 16 %G eng %0 Journal Article %J Int J Phys Soc Sci %D 2013 %T Symmetry of Odds Ratio %A Islam, Nazrul %B Int J Phys Soc Sci %V 3 %P 580-2 %G eng %N 12 %0 Journal Article %J J. U. A. Med. Col. %D 2011 %T Oral Health Edification and Changing Behaviour to Eradicate the Dental Carries in Bangladesh. %A Alam, Raisul %A Chowdhury, Ariful Bari %A Islam, Nazrul %A Ahsan, Gias Uddin %A Khan, Nazmul Ahsan %B J. U. A. Med. Col. %V 16 %P 56–60 %G eng %N 2 %0 Journal Article %J BJMS %D 2011 %T Unmet need for Mass Campaign in reducing the risk of Cervical Cancer among Bangladeshi married women. %A Khan, Nazmul Ahsan %A Islam, Nazrul %A Chowdhury, Ariful Bari %A Deen, Nadia Sultana %A Ahsan, Gias Uddin %B BJMS %V 17 %P 147–52 %G eng %N 2 %0 Journal Article %J BJMS %D 2011 %T Unmet need for Mass Campaign in reducing the risk of Cervical Cancer among Bangladeshi married women %A Khan, Nazmul Ahsan %A Islam, Nazrul %A Chowdhury, Ariful Bari %A Deen, Nadia Sultana %A Ahsan, Gias Uddin %B BJMS %V 17 %P 147-52 %G eng %N 2 %0 Conference Paper %B Joint International Tropical Medicine Meeting, Bangkok, Thailand %D 2010 %T Awareness on breast cancer among the women of reproductive age in Bangladesh. %A Ahsan, Gias Uddin %A Khan, Nazmul Ahsan %A Salam, Shak Abdus %A Rahman, Md Ashikur %A Islam, Nazrul %B Joint International Tropical Medicine Meeting, Bangkok, Thailand %P 235 %G eng %0 Journal Article %J BJMS %D 2010 %T Gender disparities in mental health status among the school-going adolescents of Dhaka, Bangladesh %A Islam, Nazrul %A Khan, Nazmul Ahsan %A Ahsan, Gias Uddin %A Saifuddin, Kazi %B BJMS %V 16 %P 151–8 %G eng %N 2 %0 Conference Paper %B Joint International Tropical Medicine Meeting, Bangkok, Thailand %D 2010 %T Preventive awareness on HIV/AIDS among rickshaw pullers of Narayanganj district of Bangladesh. %A Ahsan, Gias Uddin %A Khan, Nazmul Ahan %A Salam, Shak Abdus %A Rahman, Md Ashikur %A Islam, Nazrul %A Jahan, Mobashera %B Joint International Tropical Medicine Meeting, Bangkok, Thailand %P 256 %G eng %0 Conference Proceedings %B Joint International Tropical Medicine Meeting %D 2010 %T Awareness on breast cancer among the women of reproductive age in Bangladesh %A Ahsan, Gias Uddin %A Khan, Nazmul Ahsan %A Salam, Shak Abdus %A Rahman, Md Ashikur %A Islam, Nazrul %B Joint International Tropical Medicine Meeting %C Bangkok, Thailand %P 235 %G eng %0 Conference Proceedings %B Joint International Tropical Medicine Meeting %D 2010 %T Preventive awareness on HIV/AIDS among rickshaw pullers of Narayanganj district of Bangladesh %A Ahsan, Gias Uddin %A Khan, Nazmul Ahan %A Salam, Shak Abdus %A Rahman, Md Ashikur %A Islam, Nazrul %A Jahan, Mobashera %B Joint International Tropical Medicine Meeting %C Bangkok, Thailand %P 256 %G eng %0 Journal Article %J BJMS %D 2010 %T Gender disparities in mental health status among the school-going adolescents of Dhaka, Bangladesh %A Islam, Nazrul %A Khan, Nazmul Ahsan %A Ahsan, Gias Uddin %A Saifuddin, Kazi %B BJMS %V 16 %P 151-8 %G eng %N 2