Faecal calprotectin testing in UK general practice: a retrospective cohort study using The Health Improvement Network database

BackgroundFaecal calprotectin (FC) testing to detect inflammatory bowel disease (IBD) was recommended for use in UK general practice in 2013. The actual use of FC testing following the national recommendations is unknown.AimTo characterise the use of FC testing for IBD in UK general practice.Design and settingA retrospective cohort study of routine electronic patient records from The Health Improvement Network database from UK general practice.MethodThe study included 6 965 853 adult patients (aged ≥18 years), between 2006 and 2016. FC test uptake, the patients tested, and patient management following testing were characterised.ResultsA total of 17 027 patients had 19 840 FC tests recorded. The mean age of tested patients was 44.2 years. The first FC tests were documented in 2009. FC test use was still increasing in 2016. By 2016, 66.8% (n = 493/738) of practices had started FC testing. About one-fifth (20.7%, n = 1253/6051) of tests were carried out in patients aged ≥60 years. Only 7.8% (n = 473/6051) of the FC test records were preceded by symptoms eligible for FC testing. Only 3.1% (n = 1720/55 477) of patients with eligible symptoms have received FC testing since the national recommendations were published. There was only a small number of patients with symptoms, FC test, and a IBD diagnosis. In total, 71.3% (n = 1416/1987) of patients with a positive and 47.7% (n = 1337/2805) with a negative FC test were referred or further investigated.ConclusionUptake of FC testing in clinical practice has been slow and inconsistent. The indication of non-compliance with national recommendations may suggest that these recommendations lack applicability to the general practice context.

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The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study

The Lancet Psychiatry ◽

10.1016/s2215-0366(19)30369-4 ◽

2019 ◽

Vol 6 (11) ◽

pp. 926-934 ◽

Cited By ~ 12

Author(s):

Joht S Chandan ◽

Tom Thomas ◽

Krishna M Gokhale ◽

Siddhartha Bandyopadhyay ◽

Julie Taylor ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Childhood Maltreatment ◽

Retrospective Cohort ◽

Population Based ◽

Health Improvement ◽

Network Database ◽

The Health Improvement Network ◽

The Uk

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Outcomes following feeding gastrostomy (FG) insertion in patients with learning disability: a retrospective cohort study using the health improvement network (THIN) database

BMJ Open ◽

10.1136/bmjopen-2018-026714 ◽

2019 ◽

Vol 9 (6) ◽

pp. e026714 ◽

Cited By ~ 1

Author(s):

Philip R Harvey ◽

Tom Thomas ◽

Joht Singh Chandan ◽

Neeraj Bhala ◽

Krishnarajah Nirantharakumar ◽

...

Keyword(s):

Cohort Study ◽

Learning Disability ◽

Incidence Rate ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Health Improvement ◽

History Of ◽

Study Population ◽

The Health Improvement Network

ObjectivesTo measure the rates of lower respiratory tract infection (LRTI) and mortality following feeding gastrostomy (FG) placement in patients with learning disability (LD). Following this to compare these rates between those having LRTI prior to FG placement and those with no recent LRTI.DesignRetrospective cohort study.Setting and participantsThe study population included patients with LD undergoing FG placement in the ‘The Health Improvement Network’ database. Patients with LRTI in the year prior (LYP) to their FG placement were compared with patients without a history of LRTI in the year prior (non-LYP) to FG placement. FG placement and LD were identified using Read codes previously developed by an expert panel.Main outcome measuresIncidence rate ratio (IRR) of developing LRTI and mortality following FG, comparing patients with LRTI in the year prior to FG placement to patients without a history of LRTI.Results214 patients with LD had a FG inserted including 743.4 person years follow-up. 53.7% were males and the median age was 27.6 (IQR 19.6 to 38.6) years. 27.1% were in the LYP patients. 18.7% had a LRTI in the year following FG, with an estimated incidence rate of 254 per 1000-person years. Over the study period the incidence rate of LRTI in LYP patients was 369 per 1000-person years, in non-LYP patients this was 91 per 1000-person years (adjusted IRR 4.21 (95% CI 2.68 to 6.63) p<0.001). 27.1% of patients died during study follow-up. Incidence rate of death was 80 and 45 per 1000-person year for LYP and non-LYP patients, respectively (adjusted IRR 1.80 (1.00 to 3.23) p=0.05).ConclusionIn LD patients, no clinically meaningful reduction in LRTI incidence was observed following FG placement. Mortality and LRTI were higher in patients with at least one LRTI in the year preceding FG placement, compared with those without a preceding LRTI.

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Cancer as a risk factor for urinary tract calculi: a retrospective cohort study using ‘The Health Improvement Network’

Urolithiasis ◽

10.1007/s00240-019-01127-z ◽

2019 ◽

Vol 47 (6) ◽

pp. 541-547

Author(s):

Ankush Mittal ◽

Motaz Elmahdy Hassan ◽

Joht Singh Chandan ◽

Brian H. Willis ◽

Krishnarajah Nirantharakumar ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Urinary Tract ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Health Improvement ◽

Urinary Tract Calculi ◽

The Health Improvement Network

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Clinical importance of the drug interaction between statins and CYP3A4 inhibitors: a retrospective cohort study in The Health Improvement Network

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.3199 ◽

2012 ◽

Vol 21 (5) ◽

pp. 494-506 ◽

Cited By ~ 20

Author(s):

Christopher G. Rowan ◽

Steven M. Brunelli ◽

Jeffrey Munson ◽

James Flory ◽

Peter P. Reese ◽

...

Keyword(s):

Cohort Study ◽

Drug Interaction ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinical Importance ◽

Health Improvement ◽

Cyp3a4 Inhibitors ◽

The Health Improvement Network

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An Analysis of Dental Implants Survival and Success

Revista de Chimie ◽

10.37358/rc.18.9.6554 ◽

2018 ◽

Vol 69 (9) ◽

pp. 2465-2466

Author(s):

Iustin Olariu ◽

Roxana Radu ◽

Teodora Olariu ◽

Andrada Christine Serafim ◽

Ramona Amina Popovici ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Medical History ◽

Retrospective Cohort Study ◽

Odds Ratio ◽

Retrospective Cohort ◽

Demographic Data ◽

Kaplan Meier ◽

Number Of Patients ◽

Health Related

Osseointegration of a dental implant may encounter a variety of problems caused by various factors, as prior health-related problems, patients� habits and the technique of the implant inserting. Retrospective cohort study of 70 patients who received implants between January 2011- April 2016 in one dental unit, with Kaplan-Meier method to calculate the probability of implants�s survival at 60 months. The analysis included demographic data, age, gender, medical history, behavior risk factors, type and location of the implant. For this cohort the implants�survival for the first 6 months was 92.86% compared to the number of patients and 97.56% compared to the number of total implants performed, with a cumulative failure rate of 2.43% after 60 months. Failures were focused exclusively on posterior mandible implants, on the percentage of 6.17%, odds ratio (OR) for these failures being 16.76 (P = 0.05) compared with other localisations of implants, exclusively in men with median age of 42 years.

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The incidence and prevalence of inflammatory bowel disease in UK primary care: a retrospective cohort study of the IQVIA Medical Research Database

BMC Gastroenterology ◽

10.1186/s12876-021-01716-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karoline Freeman ◽

Ronan Ryan ◽

Nicholas Parsons ◽

Sian Taylor-Phillips ◽

Brian H. Willis ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

General Practice ◽

Cohort Study ◽

Medical Research ◽

Bowel Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Research Database ◽

Care Providers ◽

Inflammatory Bowel

Abstract Background Our knowledge of the incidence and prevalence of inflammatory bowel disease (IBD) is uncertain. Recent studies reported an increase in prevalence. However, they excluded a high proportion of ambiguous cases from general practice. Estimates are needed to inform health care providers who plan the provision of services for IBD patients. We aimed to estimate the IBD incidence and prevalence in UK general practice. Methods We undertook a retrospective cohort study of routine electronic health records from the IQVIA Medical Research Database covering 14 million patients. Adult patients from 2006 to 2016 were included. IBD was defined as an IBD related Read code or record of IBD specific medication. Annual incidence and 12-month period prevalence were calculated. Results The prevalence of IBD increased between 2006 and 2016 from 106.2 (95% CI 105.2–107.3) to 142.1 (95% CI 140.7–143.5) IBD cases per 10,000 patients which is a 33.8% increase. Incidence varied across the years. The incidence across the full study period was 69.5 (95% CI 68.6–70.4) per 100,000 person years. Conclusions In this large study we found higher estimates of IBD incidence and prevalence than previously reported. Estimates are highly dependent on definitions of disease and previously may have been underestimated.

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