Intracranial haemorrhage in children with inherited bleeding disorders in the UK 2003-2015: A national cohort study

ObjectivesThe UK Clinical Aptitude Test (UKCAT) previously piloted an assessment of ‘online confidence’, where candidates were asked to indicate how confident they were with their answers. This study examines the relationship between these ratings, the odds of receiving an offer to study medicine and subsequent undergraduate academic performance.DesignNational cohort study.SettingUK undergraduate medical selection.Participants56 785 UKCAT candidates who sat the test between 2013 and 2016 and provided valid responses to the online confidence pilot study.Primary outcome measuresTwo measures of ‘online confidence’ were derived: the well-established ‘confidence bias’, and; a novel ‘confidence judgement’ measure, developed using Item Response Theory in order to derive a more sophisticated metric of the ability to evaluate one’s own performance on a task. Regression models investigated the relationships between these confidence measures, application success and academic performance.ResultsOnline confidence was inversely related to cognitive performance. Relative underconfidence was associated with increased odds of receiving an offer to study medicine. For ‘confidence bias’ this effect was independent of potential confounders (OR 1.48, 1.15 to 1.91, p=0.002). While ‘confidence judgement’ was also a univariable predictor of application success (OR 1.22, 1.01 to 1.47, p=0.04), it was not an independent predictor. ‘Confidence bias’, but not ‘confidence judgement’, predicted the odds of passing the first year of university at the first attempt, independently of cognitive performance, with relative underconfidence positively related to academic success (OR 3.24, 1.08 to 9.72, p=0.04). No non-linear effects were observed, suggesting no ‘sweet spot’ exists in relation to online confidence and the outcomes studied.ConclusionsApplicants who either appear underconfident, or are better at judging their own performance on a task, are more likely to receive an offer to study medicine. However, online confidence estimates had limited ability to predict subsequent academic achievement. Moreover, there are practical challenges to evaluating online confidence in high-stakes selection.

Download Full-text

Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS)

10.1101/2020.05.08.20089268 ◽

2020 ◽

Cited By ~ 14

Author(s):

Marian Knight ◽

Kathryn Bunch ◽

Nicola Vousden ◽

Eddie Morris ◽

Nigel Simpson ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Surveillance System ◽

Perinatal Death ◽

Strong Association ◽

Population Based ◽

Overweight And Obesity ◽

National Cohort ◽

Level 3 ◽

The Uk

AbstractObjectiveTo describe a national cohort of pregnant women hospitalised with SARS-CoV-2 infection in the UK, identify factors associated with infection and describe outcomes, including transmission of infection, for mother and infant.DesignProspective national population-based cohort study using the UK Obstetric Surveillance System (UKOSS).SettingAll 194 obstetric units in the UKParticipants427 pregnant women admitted to hospital with confirmed Sars-CoV-2 infection between 01/03/2020 and 14/04/2020. 694 comparison women who gave birth between 01/11/2017 and 31/10/2018.Main outcome measuresIncidence of maternal hospitalisation, infant infection. Rates of maternal death, level 3 critical care unit admission, preterm birth, stillbirth, early neonatal death, perinatal death; odds ratios for infected versus comparison women.ResultsEstimated incidence of hospitalisation with confirmed SARS-CoV-2 in pregnancy 4.9 per 1000 maternities (95%CI 4.5-5.4). The median gestation at symptom onset was 34 weeks (IQR 29-38). Black or other minority ethnicity (aOR 4.49, 95%CI 3.37-6.00), older maternal age (aOR 1.35, 95%CI 1.01-1.81 comparing women aged 35+ with those aged 30-34), overweight and obesity (aORs 1.91, 95%CI 1.37-2.68 and 2.20, 95%CI 1.56-3.10 respectively compared to women with a BMI<25kg/m2) and pre-existing comorbidities (aOR 1.52, 95%CI 1.12-2.06) were associated with admission with SARS-CoV-2 during pregnancy. 247 women (58%) gave birth or had a pregnancy loss; 180 (73%) gave birth at term. 40 (9%) hospitalised women required respiratory support. Twelve infants (5%) tested positive for SARS-CoV-2 RNA, six of these infants within the first 12 hours after birth.ConclusionsThe majority of pregnant women hospitalised with SARS-CoV-2 were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes and transmission of SARS-CoV-2 to infants was uncommon. The strong association between admission with infection and black or minority ethnicity requires urgent investigation and explanation.Study RegistrationISRCTN 40092247

Download Full-text

Re: Caesarean scar pregnancy in the UK: a national cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.15324 ◽

2018 ◽

Vol 125 (13) ◽

pp. 1777-1777 ◽

Cited By ~ 1

Author(s):

Saumya Pandey ◽

Rajul Tyagi

Keyword(s):

Cohort Study ◽

Caesarean Scar ◽

Caesarean Scar Pregnancy ◽

National Cohort ◽

The Uk

Download Full-text

Distance travelled to hospital for emergency laparotomy and the effect of travel time on mortality: cohort study

BMJ Quality & Safety ◽

10.1136/bmjqs-2019-010747 ◽

2020 ◽

pp. bmjqs-2019-010747

Author(s):

Tom Salih ◽

Peter Martin ◽

Tom Poulton ◽

Charles M Oliver ◽

Mike G Bassett ◽

...

Keyword(s):

Cohort Study ◽

Travel Time ◽

Gastrointestinal Surgery ◽

Postoperative Mortality ◽

Continuous Variable ◽

Emergency Laparotomy ◽

Logistic Regression Models ◽

Urgent Surgery ◽

National Cohort ◽

The Uk

ObjectivesTo evaluate whether distance and estimated travel time to hospital for patients undergoing emergency laparotomy is associated with postoperative mortality.DesignNational cohort study using data from the National Emergency Laparotomy Audit.Setting171 National Health Service hospitals in England and Wales.Participants22 772 adult patients undergoing emergency surgery on the gastrointestinal tract between 2013 and 2016.Main outcome measuresMortality from any cause and in any place at 30 and 90 days after surgery.ResultsMedian on-road distance between home and hospital was 8.4 km (IQR 4.7–16.7 km) with a median estimated travel time of 16 min. Median time from hospital admission to operating theatre was 12.7 hours. Older patients live on average further from hospital and patients from areas of increased socioeconomic deprivation live on average less far away.We included estimated travel time as a continuous variable in multilevel logistic regression models adjusting for important confounders and found no evidence for an association with 30-day mortality (OR per 10 min of travel time=1.02, 95% CI 0.97 to 1.06, p=0.512) or 90-day mortality (OR 1.02, 95 % CI 0.97 to 1.06, p=0.472).The results were similar when we limited our analysis to the subgroup of 5386 patients undergoing the most urgent surgery. 30-day mortality: OR=1.02 (95% CI 0.95 to 1.10, p=0.574) and 90-day mortality: OR=1.01 (95% CI 0.94 to 1.08, p=0.858).ConclusionsIn the UK NHS, estimated travel time between home and hospital was not a primary determinant of short-term mortality following emergency gastrointestinal surgery.

Download Full-text

P86 PANC Study - Pancreatitis: A National Cohort Study

BJS Open ◽

10.1093/bjsopen/zrab032.085 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

◽

Blazej Rybinski

Keyword(s):

Acute Pancreatitis ◽

Cohort Study ◽

Resource Planning ◽

Population Characteristics ◽

Definitive Treatment ◽

Future Research ◽

Patient Demographics ◽

Dependency Care ◽

National Cohort ◽

The Uk

Abstract Introduction Pancreatitis is a common, yet complex, surgical presentation with an incidence of approximately 56 cases per 100,000 people per year in the UK. The management of pancreatitis can vary significantly between different regions, hospitals or clinicians despite a number of national and international guidelines. Historic regional studies in the UK have shown management to be suboptimal with regards to time to diagnosis, higher dependency care or dynamic CT for severe cases and time to definitive treatment of gallstones. Aim We aim to assess current variation in practice in the management of patients diagnosed with early acute pancreatitis. This will identify areas for future research need, and give the groundwork for a potential future model of ambulatory care in a select subgroup of patients. Study design Pancreatitis: A National Cohort Study (PANC Study) is a multicentre, prospective cohort audit which will be conducted through trainee-led research collaboratives in Spring 2021. All patients >18 years, presenting with a diagnosis of acute pancreatitis by modified Atlanta classification, will be included during the 2-month collection period. Data will only be collected for the first 30-days from presentation. The data collected will include patient demographics, admission observations and investigations, aetiology, management and complications and will be anonymised and uploaded onto an online platform for analysis. Conclusions Management of pancreatitis has not been previously assessed nationally in the UK. Obtaining data on population characteristics, management choices and patient outcomes will allow for resource planning so that the service provision reflects local and national population needs.

Download Full-text

Thoracic CT features of patients with BMPR2 mutation: preliminary analysis from the UK National Cohort Study of Idiopathic and Heritable PAH

10.1183/13993003.congress-2019.pa5454 ◽

2019 ◽

Author(s):

Marcella Cogliano ◽

Allan Lawrie ◽

David G. Kiely ◽

Robin A. Condliffe ◽

Smitha Rajaram ◽

...

Keyword(s):

Cohort Study ◽

Preliminary Analysis ◽

Thoracic Ct ◽

National Cohort ◽

The Uk ◽

Ct Features

Download Full-text

Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance

The Lancet Child & Adolescent Health ◽

10.1016/s2352-4642(20)30342-4 ◽

2020 ◽

Author(s):

Chris Gale ◽

Maria A Quigley ◽

Anna Placzek ◽

Marian Knight ◽

Shamez Ladhani ◽

...

Keyword(s):

Cohort Study ◽

Active Surveillance ◽

National Cohort ◽

The Uk

Download Full-text

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

BMJ ◽

10.1136/bmj.m2107 ◽

2020 ◽

pp. m2107 ◽

Cited By ~ 128

Author(s):

Marian Knight ◽

Kathryn Bunch ◽

Nicola Vousden ◽

Edward Morris ◽

Nigel Simpson ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Minority Groups ◽

Fetal Loss ◽

Population Based ◽

National Population ◽

Minority Ethnic Groups ◽

National Cohort ◽

The Uk ◽

In Pregnancy

AbstractObjectivesTo describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.DesignProspective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).SettingAll 194 obstetric units in the UK.Participants427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.Main outcome measuresIncidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.ResultsThe estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.ConclusionsMost pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.Study registrationISRCTN 40092247.

Download Full-text