November 2015

Maternal Obesity During Pregnancy Associates With Premature Mortality and Major Cardiovascular Events in Later Life
Kuan Ken Lee, Edwin A. Raja, Amanda J. Lee, Sohinee Bhattacharya, Siladitya Bhattacharya, Jane E. Norman, Rebecca M. Reynolds. Hypertension. 2015;66(5):938-944. DOI: 10.1161/HYPERTENSIONAHA.115.05920

It is unknown that obesity during pregnancy impact on later health. The study aimed to determine whether maternal obesity during pregnancy associates with increased premature mortality and later life major cardiovascular events. Maternity records of women who gave birth to their first child between 1950 and 1976 (n=18 873) from the Aberdeen. Maternity and Neonatal databank were linked to the National Register of Deaths, Scotland and Scottish Morbidity Record. The effect of maternal BMI, at first antenatal visit on death and hospital admissions for cardiovascular events was tested using time-to-event analysis with Cox proportional hazard regression. The association between maternal BMI as continuous variable using restricted cubic spline, and mortality and major cardiovascular diseases had J-shape relationship. You may read the article to find an application of restricted cubic spline in the Cox PH model.

October 2015

Do Arabic weight-loss apps adhere to evidence-informed practices?
Aroub A. Alnasser, MSc, PhD student, Raja E. Amalraj, PhD, Arjuna Sathiaseelan, PhD, Abdulrahman S. Al-Khalifa, Prof,1 Debbi Marais, PhD2. Translational Behavioral Medicine: Practice, Policy and Research. Published online 13 october 2015 DOI: 10.​1007/​s13142-015-0347-7

Smart phone apps is used to promote weight loss. The study aimed to identify homogeneous groups of current Arab weight-loss apps and features that adhere to evidence-informed practices. A total of 65 smart phone apps were included and examined for adherence to 13 evidence-informed practices. Latent Class Analysis (LCA) identified two groups of apps: Self-monitoring (15% of apps) and advice-giving apps (85%). The median number of evidence-informed practices was 1 (1,2) with no apps having more than six and only nine apps including four to six. You may read the article to find how LCA was used.

September 2015

Outcomes of childhood asthma and wheezy bronchitis – a 50 year cohort study.
N Tagieva-Milne, G Devereux, S Fielding, S Turner, G Douglas. Am J Respir Crit Care Med. Published online 09 Sep 2015 DOI: 10.1164/rccm.201505-0870OC

The WHEASE study is a long-term cohort study which recruited children in 1964 and has followed them up at several intervals and most recently in 2014. We have found that COPD risk is increased with childhood asthma and that wheezy bronchitis was associated with reduced FEV1 (lung function) in the fifth decade, but not an accelerated rate of decline. In contrast adulthood onset wheeze was associated with accelerated lung function decline. This is one of the longest running cohorts in the respiratory field and provides important evidence on how childhood respiratory illness/disease can impact on outcomes in later life.

August 2015

General practice performance in referral for suspected cancer: influence of number of cases and case-mix on publically reported data.
Murchie, P., Chowdhury, A., Smith, SM., Campbell, N., Lee, AJ., Linden, D. & Burton, CD. (2015). British Journal of Cancer, vol 112, no. 11, pp. 1791-1798. DOI: 10.1038/bjc.2015.110

Criteria currently used to compare GP practices' annual cancer diagnosis rates are misleading and should be replaced. This article shows that most of the variation between practices’ urgent cancer referral figures can be explained by differences in the types of cancer being presented and not by poorer GP performance as is often reported.  We conclude that more ‘appropriate and robust’ methods need to be developed to fairly compare GP practices on their performance in diagnosing cancer. The study, published in the British Journal of Cancer, focused on data from more than 950,000 cancer cases from 8,303 general practices in NHS England over four years. Read the news article on the paper >>.

May 2015

A cohort study of influences, health outcomes and costs of patients’ health-seeking behaviour for minor ailments form primary and emergency care settings.
MC Watson, J Ferguson, GR Barton, V Maskrey, A Blyth, V Paudyal, CM Bond, R Holland, T Porteous, TH Sach, D Wright, S Fielding. BMJ Open 2015; 5: e006261. doi:10.1136/bmjopen-2014-006261.

The aim of this work was to compare health related and cost related outcomes of consultations for symptoms of minor ailments in emergency departments (EDs), general practices and community pharmacies. We found that similar health outcomes were obtained across the settings with substantially lower cost for pharmacy consultations. Therefore there is a need to shift demand for minor ailment management away from the higher cost settings of ED and general practice to the community pharmacy setting.