scholarly journals Validation of venous thromboembolism diagnoses in patients receiving rivaroxaban or warfarin in The Health Improvement Network

2020 ◽  
Vol 30 (2) ◽  
pp. 229-236
Author(s):  
Ana Ruigómez ◽  
Gunnar Brobert ◽  
Pareen Vora ◽  
Luis A. García Rodríguez
Keyword(s):  
Venous Thromboembolism ◽  
Health Improvement ◽  
The Health Improvement Network

scholarly journals Do statins reduce mortality in older people? Findings from a longitudinal study using primary care records

2021 ◽  
Vol 9 (2) ◽  
pp. e000780
Author(s):  
Lisanne Andra Gitsels ◽  
Ilyas Bakbergenuly ◽  
Nicholas Steel ◽  
Elena Kulinskaya
Keyword(s):  
Primary Care ◽  
Older People ◽  
Clinical Information ◽  
Cardiac Risk ◽  
Health Improvement ◽  
Network Database ◽  
Statin Prescription ◽  
The Health Improvement Network ◽  
Care Practices ◽  
Primary Care Practices

ObjectiveAssess whether statins reduce mortality in the general population aged 60 years and above.DesignRetrospective cohort study.SettingPrimary care practices contributing to The Health Improvement Network database, England and Wales, 1990–2017.ParticipantsCohort who turned age 60 between 1990 and 2000 with no previous cardiovascular disease or statin prescription and followed up until 2017.ResultsCurrent statin prescription was associated with a significant reduction in all-cause mortality from age 65 years onward, with greater reductions seen at older ages. The adjusted HRs of mortality associated with statin prescription at ages 65, 70, 75, 80 and 85 years were 0.76 (95% CI 0.71 to 0.81), 0.71 (95% CI 0.68 to 0.75), 0.68 (95% CI 0.65 to 0.72), 0.63 (95% CI 0.53 to 0.73) and 0.54 (95% CI 0.33 to 0.92), respectively. The adjusted HRs did not vary by sex or cardiac risk.ConclusionsUsing regularly updated clinical information on sequential treatment decisions in older people, mortality predictions were updated every 6 months until age 85 years in a combined primary and secondary prevention population. The consistent mortality reduction of statins from age 65 years onward supports their use where clinically indicated at age 75 and older, where there has been particular uncertainty of the benefits.

scholarly journals Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3861
Author(s):  
Jui-Ming Liu ◽  
Chin-Yao Shen ◽  
Wallis C. Y. Lau ◽  
Shih-Chieh Shao ◽  
Kenneth K. C. Man ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Incidence Rates ◽  
Androgen Deprivation ◽  
Health Improvement ◽  
The United Kingdom ◽  
Incident Dementia ◽  
The Health Improvement Network ◽  
The Uk ◽  
Incidence Of Dementia

The risk of dementia after androgen deprivation therapy (ADT) in patients with advanced prostate cancer (PCa) remains controversial. This study aimed to evaluate the association between ADT and the incidence of dementia in patients with PCa. We identified patients newly diagnosed with PCa in the National Health Insurance Database of Taiwan from 1 January 2002 to 30 June 2016 and in The Health Improvement Network of the United Kingdom (UK) from 1 January 1998 to 31 March 2018. We classified patients with PCa into ADT and ADT-naïve groups. Propensity score (PS) methods were used to minimize the differences in characteristics between the groups. We performed a Cox proportional hazard model to obtain the adjusted hazard ratio (HR) to compare the incidence of dementia between the groups. Our ADT group comprised 8743 and 73,816 patients in Taiwan and the UK, respectively, which were matched 1:1 to ADT-naïve patients by PS. The incidence rates of dementia in the ADT group were 2.74 versus 3.03 per 1000 person-years in the ADT naïve groups in Taiwan, and 2.81 versus 2.79 per 1000 person-years in the UK. There was no statistical difference between ADT and ADT-naïve groups (adjusted HR: 1.12; 95% confidence interval (CI): 0.87–1.43 in Taiwan and adjusted HR: 1.02; 95% CI: 0.85–1.23 in the UK). We found no association between the incidence of dementia and ADT in patients with advanced PCa in either database. Further studies are warranted to evaluate other possible triggers of incident dementia in patients receiving ADT for advanced PCa.

scholarly journals Validity of The Health Improvement Network (THIN) for epidemiologic studies of hepatitis C virus infection

2009 ◽  
Vol 18 (9) ◽  
pp. 807-814 ◽  
Author(s):  
Vincent Lo Re ◽  
Kevin Haynes ◽  
Kimberly A. Forde ◽  
A. Russell Localio ◽  
Rita Schinnar ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Epidemiologic Studies ◽  
Health Improvement ◽  
Hepatitis C Virus Infection ◽  
The Health Improvement Network

scholarly journals Incidence and risk of celiac disease after type 1 diabetes: A population‐based cohort study using the health improvement network database

2018 ◽  
Vol 19 (8) ◽  
pp. 1422-1428 ◽  
Author(s):  
Mary Ellen Vajravelu ◽  
Ron Keren ◽  
David R. Weber ◽  
Ritu Verma ◽  
Diva D. De León ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cohort Study ◽  
Celiac Disease ◽  
Population Based ◽  
Health Improvement ◽  
Network Database ◽  
The Health Improvement Network

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

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026714 ◽  
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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