2024
Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: an analysis of monthly changes in the quality and outcomes framework indicators in OpenSAFELY
Wiedemann M, Speed V, Cunningham C, Higgins R, Curtis H, Andrews C, Fisher L, Hopcroft L, Rentsch C, Mahalingasivam V, Tomlinson L, Morton C, Samuel M, Green A, Wood C, Brown A, Massey J, Walters C, Smith R, Inglesby P, Evans D, Maude S, Dillingham I, Walker A, Morley J, Mehrkar A, Bacon S, Bates C, Cockburn J, Parry J, Hester F, McManus R, Goldacre B, MacKenna B. Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: an analysis of monthly changes in the quality and outcomes framework indicators in OpenSAFELY. Open Heart 2024, 11: e002732. PMID: 39214534, DOI: 10.1136/openhrt-2024-002732.Peer-Reviewed Original ResearchConceptsBlood pressure screeningPressure screeningPercentage of patientsHypertension prevalenceHypertension managementPopulation-based cohort studyRecord of hypertensionCardiovascular disease managementClinical subgroupsQOF indicatorsScreening ratesPrimary careGeneral practiceHome statusNHS patientsOlder peopleBlood pressure measurementsCare schemesCohort studyDisease managementImpact of COVID-19COVID-19Framework indicatorsNational qualityNHS
2022
Recording of ’COVID-19 vaccine declined‘: a cohort study on 57.9 million National Health Service patients’ records in situ using OpenSAFELY, England, 8 December 2020 to 25 May 2021
Curtis HJ, Inglesby P, MacKenna B, Croker R, Hulme WJ, Rentsch CT, Bhaskaran K, Mathur R, Morton CE, Bacon SC, Smith RM, Evans D, Mehrkar A, Tomlinson L, Walker AJ, Bates C, Hickman G, Ward T, Morley J, Cockburn J, Davy S, Williamson EJ, Eggo RM, Parry J, Hester F, Harper S, O’Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Evans SJ, Douglas IJ, Smeeth L, Goldacre B. Recording of ’COVID-19 vaccine declined‘: a cohort study on 57.9 million National Health Service patients’ records in situ using OpenSAFELY, England, 8 December 2020 to 25 May 2021. Eurosurveillance 2022, 27: 2100885. PMID: 35983770, PMCID: PMC9389857, DOI: 10.2807/1560-7917.es.2022.27.33.2100885.Peer-Reviewed Original ResearchConceptsCOVID-19 vaccinationCOVID-19 vaccineCohort studyPriority patientsRetrospective cohort studyPrimary care recordsMore deprived areasUnvaccinated patientsSubsequent vaccinationSouth Asian peopleSouth Asian populationGeneral practicePatientsCare recordsClinical record systemsVaccinationNHS EnglandPatient recordsVaccineDeprived areasAsian populationsOpenSAFELYDemographic subgroupsRecord systemDemographic factorsDescribing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
Green A, Curtis H, Hulme W, Williamson E, McDonald H, Bhaskaran K, Rentsch C, Schultze A, MacKenna B, Mahalingasivam V, Tomlinson L, Walker A, Fisher L, Massey J, Andrews C, Hopcroft L, Morton C, Croker R, Morley J, Mehrkar A, Bacon S, Evans D, Inglesby P, Hickman G, Ward T, Davy S, Mathur R, Tazare J, Eggo R, Wing K, Wong A, Forbes H, Bates C, Cockburn J, Parry J, Hester F, Harper S, Douglas I, Evans S, Smeeth L, Goldacre B. Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY. BMC Medicine 2022, 20: 243. PMID: 35791013, PMCID: PMC9255436, DOI: 10.1186/s12916-022-02422-0.Peer-Reviewed Original ResearchConceptsPositive SARS-CoV-2 testSARS-CoV-2 testBreakthrough COVID-19Vaccine breakthroughBreakthrough casesCohort studyIncidence rateCOVID-19COVID-19-related hospital admissionsCOVID-19-related deathsVaccine breakthrough casesRetrospective cohort studyChronic kidney diseaseCritical care admissionSARS-CoV-2 variantsDeath registry dataCorresponding incidence ratesRoutine clinical dataHigh rateMedian followVaccine waningCare admissionHospital admissionSecond vaccinationSecondary careSafety of COVID-19 vaccination and acute neurological events: A self-controlled case series in England using the OpenSAFELY platform
Walker JL, Schultze A, Tazare J, Tamborska A, Singh B, Donegan K, Stowe J, Morton CE, Hulme WJ, Curtis HJ, Williamson EJ, Mehrkar A, Eggo RM, Rentsch CT, Mathur R, Bacon S, Walker AJ, Davy S, Evans D, Inglesby P, Hickman G, MacKenna B, Tomlinson L, Ca Green A, Fisher L, Cockburn J, Parry J, Hester F, Harper S, Bates C, Evans SJ, Solomon T, Andrews NJ, Douglas IJ, Goldacre B, Smeeth L, McDonald HI. Safety of COVID-19 vaccination and acute neurological events: A self-controlled case series in England using the OpenSAFELY platform. Vaccine 2022, 40: 4479-4487. PMID: 35715350, PMCID: PMC9170533, DOI: 10.1016/j.vaccine.2022.06.010.Peer-Reviewed Original ResearchConceptsGuillain-Barré syndromeAcute neurological eventsBell's palsyCOVID-19 vaccinationTransverse myelitisChAdOx1 vaccineOpenSAFELY platformFirst doseNeurological eventsRate of GBSSelf-controlled case series designIncidence rate ratiosPrimary care dataRare adverse eventsSelf-controlled case seriesConditional Poisson regressionCOVID-19 vaccineCase series designBNT162b2 vaccineesChAdOx1 vaccinationVaccine recipientsAdverse eventsHospital admissionCase seriesAbsolute riskOverall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform
Bhaskaran K, Rentsch CT, Hickman G, Hulme WJ, Schultze A, Curtis HJ, Wing K, Warren-Gash C, Tomlinson L, Bates CJ, Mathur R, MacKenna B, Mahalingasivam V, Wong A, Walker AJ, Morton CE, Grint D, Mehrkar A, Eggo RM, Inglesby P, Douglas IJ, McDonald HI, Cockburn J, Williamson EJ, Evans D, Parry J, Hester F, Harper S, Evans SJ, Bacon S, Smeeth L, Goldacre B. Overall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform. PLOS Medicine 2022, 19: e1003871. PMID: 35077449, PMCID: PMC8789178, DOI: 10.1371/journal.pmed.1003871.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsCOVID-19 hospitalisationGeneral population controlsCOVID-19 groupCOVID-19 survivorsHospital admissionHigh riskInfluenza hospitalisationsCause mortalityCohort studyInfluenza patientsPrimary careGeneral populationInitial infectionAcute coronavirus disease 2019Lower respiratory tract infectionsSevere COVID-19 outcomesLong-term adverse outcomesCOVID-19 hospital admissionsSpecific causesPopulation controlsCause-specific hospitalisationRespiratory tract infectionsCause-specific outcomesPotential risk factors
2021
OpenSAFELY: impact of national guidance on switching anticoagulant therapy during COVID-19 pandemic
Collaborative T, Curtis HJ, MacKenna B, Walker AJ, Croker R, Mehrkar A, Morton C, Bacon S, Hickman G, Inglesby P, Bates C, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Schultze A, Rentsch CT, Williamson E, Hulme W, Tomlinson L, Mathur R, Drysdale H, Eggo RM, Wong AY, Forbes H, Parry J, Hester F, Harper S, Douglas I, Smeeth L, Goldacre B. OpenSAFELY: impact of national guidance on switching anticoagulant therapy during COVID-19 pandemic. Open Heart 2021, 8: e001784. PMID: 34785588, PMCID: PMC8595296, DOI: 10.1136/openhrt-2021-001784.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsBlood CoagulationBlood Coagulation TestsCOVID-19Drug MonitoringDrug PrescriptionsDrug SubstitutionDrug UtilizationEnglandFactor Xa InhibitorsFemaleHumansMaleMiddle AgedPatient SafetyPractice Guidelines as TopicPractice Patterns, Physicians'Primary Health CareRetrospective StudiesRisk AssessmentRisk FactorsState MedicineWarfarinConceptsWarfarin patientsNational Health ServiceCOVID-19 pandemicNational guidanceCare home residencyINR test resultsRenal function testsFrequent blood testingSafety alertsRoutine clinical dataAtrial fibrillation diagnosisElevated INRMedication changesOral anticoagulantsAnticoagulant therapyCohort studyAppropriate patientsINR testsFunction testsBlood testingPrimary careClinical dataDOACPatientsWarfarinAssociation between warfarin and COVID-19-related outcomes compared with direct oral anticoagulants: population-based cohort study
Wong A, Tomlinson L, Brown J, Elson W, Walker A, Schultze A, Morton C, Evans D, Inglesby P, MacKenna B, Bhaskaran K, Rentsch C, Powell E, Williamson E, Croker R, Bacon S, Hulme W, Bates C, Curtis H, Mehrkar A, Cockburn J, McDonald H, Mathur R, Wing K, Forbes H, Eggo R, Evans S, Smeeth L, Goldacre B, Douglas I. Association between warfarin and COVID-19-related outcomes compared with direct oral anticoagulants: population-based cohort study. Journal Of Hematology & Oncology 2021, 14: 172. PMID: 34666811, PMCID: PMC8525065, DOI: 10.1186/s13045-021-01185-0.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsPopulation-based cohort studyCOVID-19-related outcomesSevere COVID-19Oral anticoagulantsCohort studyHazard ratioLower riskNegative control outcome analysisSevere COVID-19 diseaseNon-valvular atrial fibrillationPrimary care dataCOVID-19 outcomesCOVID-19COVID-19 diseaseNegative control outcomesDOAC usersOpenSAFELY platformWarfarin usersHospital admissionAtrial fibrillationClinical evidenceCox regressionResultsA totalOutcome analysisOpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19
Curtis HJ, MacKenna B, Croker R, Inglesby P, Walker AJ, Morley J, Mehrkar A, Morton CE, Bacon S, Hickman G, Bates C, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Schultze A, Rentsch CT, Williamson EJ, Hulme WJ, McDonald HI, Tomlinson L, Mathur R, Drysdale H, Eggo RM, Wing K, Wong AY, Forbes H, Parry J, Hester F, Harper S, Evans SJ, Douglas IJ, Smeeth L, Goldacre B, . OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19. British Journal Of General Practice 2021, 72: bjgp.2021.0380. PMID: 34750105, PMCID: PMC8589464, DOI: 10.3399/bjgp.2021.0380.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesCOVID-19EnglandHumansPandemicsPrimary Health CareSARS-CoV-2State MedicineConceptsClinical activityGeneral practicePre-pandemic levelsNormal levelsPrimary care dataHealthcare activitiesAsthma reviewCohort studyRespiratory symptomsRespiratory infectionsDisease reviewDiseases codesRespiratory diseaseLaboratory testsNHS EnglandPatient recordsCare dataSustained dropCOVD-19 pandemicCOVID-19COVID-19 pandemicMost laboratory testsBroader recoverySmall reductionPandemicRisks of covid-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform
Williamson EJ, McDonald HI, Bhaskaran K, Walker AJ, Bacon S, Davy S, Schultze A, Tomlinson L, Bates C, Ramsay M, Curtis HJ, Forbes H, Wing K, Minassian C, Tazare J, Morton CE, Nightingale E, Mehrkar A, Evans D, Inglesby P, MacKenna B, Cockburn J, Rentsch CT, Mathur R, Wong AYS, Eggo RM, Hulme W, Croker R, Parry J, Hester F, Harper S, Douglas IJ, Evans SJW, Smeeth L, Goldacre B, Kuper H. Risks of covid-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform. The BMJ 2021, 374: n1592. PMID: 34261639, PMCID: PMC8278652, DOI: 10.1136/bmj.n1592.Peer-Reviewed Original ResearchConceptsCovid-19 related hospital admissionRelated hospital admissionsNon-COVID deathsHospital admissionOpenSAFELY platformDown syndromeCohort studyHazard ratioCerebral palsyDisability registersGeneral practiceCOVID-19COVID-19 hospital admissionsMain exposure groupsCOVID-19 vaccinationHospital admission dataPatient-level dataLow event ratesNon-COVID causesCOVID-19 testingTargeted preventive measuresWave 2Wave 1Electronic health recordsProfound learning disabilitiesClinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY
Walker AJ, MacKenna B, Inglesby P, Tomlinson L, Rentsch CT, Curtis HJ, Morton CE, Morley J, Mehrkar A, Bacon S, Hickman G, Bates C, Croker R, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Schultze A, Williamson EJ, Hulme WJ, McDonald HI, Mathur R, Eggo RM, Wing K, Wong AY, Forbes H, Tazare J, Parry J, Hester F, Harper S, O’Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Douglas IJ, Evans SJ, Smeeth L, Goldacre B, . Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY. British Journal Of General Practice 2021, 71: bjgp.2021.0301. PMID: 34340970, PMCID: PMC8340730, DOI: 10.3399/bjgp.2021.0301.Peer-Reviewed Original ResearchConceptsLong COVIDEnglish primary carePrimary careDiagnostic codesPopulation-based cohort studyAcute COVID-19Different diagnostic thresholdsProportion of peoplePlanning of servicesPersistent symptomsCohort studyGeneral practiceClinicians' understandingDiagnostic thresholdNHS EnglandPatient recordsClinical codesClinical codingCareCOVID-19East of EnglandPatientsDemographic factorsCOVIDWeeksSocial determinants of pertussis and influenza vaccine uptake in pregnancy: a national cohort study in England using electronic health records
Walker JL, Rentsch CT, McDonald HI, Bak J, Minassian C, Amirthalingam G, Edelstein M, Thomas S. Social determinants of pertussis and influenza vaccine uptake in pregnancy: a national cohort study in England using electronic health records. BMJ Open 2021, 11: e046545. PMID: 34155074, PMCID: PMC8217954, DOI: 10.1136/bmjopen-2020-046545.Peer-Reviewed Original ResearchConceptsPertussis vaccine uptakeVaccine uptakeNon-white ethnicityPregnant womenEligible pregnanciesSocial determinantsCohort studyNationwide population-based cohort studyClinical Practice Research DatalinkPopulation-based cohort studyGreater deprivationCare dataLow vaccine uptakeInfluenza vaccine uptakeSecondary care dataNational cohort studyPrimary care dataVaccine-preventable diseasesLow uptakeVaccine promotion strategiesElectronic health recordsInfluenza vaccinationMaternal ageSuccessive pregnanciesVaccination promotionEthnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform
Mathur R, Rentsch C, Morton C, Hulme W, Schultze A, MacKenna B, Eggo R, Bhaskaran K, Wong A, Williamson E, Forbes H, Wing K, McDonald H, Bates C, Bacon S, Walker A, Evans D, Inglesby P, Mehrkar A, Curtis H, DeVito N, Croker R, Drysdale H, Cockburn J, Parry J, Hester F, Harper S, Douglas I, Tomlinson L, Evans S, Grieve R, Harrison D, Rowan K, Khunti K, Chaturvedi N, Smeeth L, Goldacre B, Collaborative O. Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform. The Lancet 2021, 397: 1711-1724. PMID: 33939953, PMCID: PMC8087292, DOI: 10.1016/s0140-6736(21)00634-6.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionIntensive care unit admissionCOVID-19-related hospitalisationCare unit admissionObservational cohort studyCOVID-19 outcomesOutcomes of interestSouth Asian groupsOpenSAFELY platformICU admissionUnit admissionCohort studyEthnicity groupsMixed ethnicity groupCOVID-19-related hospital admissionsCOVID-19-related ICU admissionEthnic differencesAdverse COVID-19 outcomesMinority ethnic populationsSARS-CoV-2 testingMultivariable Cox regressionRisk of hospitalisationWhite groupPrimary care recordsPrimary care dataAssociation between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
Forbes H, Morton CE, Bacon S, McDonald HI, Minassian C, Brown JP, Rentsch CT, Mathur R, Schultze A, DeVito NJ, MacKenna B, Hulme WJ, Croker R, Walker AJ, Williamson EJ, Bates C, Mehrkar A, Curtis HJ, Evans D, Wing K, Inglesby P, Drysdale H, Wong AYS, Cockburn J, McManus R, Parry J, Hester F, Harper S, Douglas IJ, Smeeth L, Evans SJW, Bhaskaran K, Eggo RM, Goldacre B, Tomlinson LA. Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England. The BMJ 2021, 372: n628. PMID: 33737413, PMCID: PMC7970340, DOI: 10.1136/bmj.n628.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionIntensive care admissionHospital admissionCare admissionCohort studyCOVID-19Covid-19 related hospital admissionSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Respiratory syndrome coronavirus 2Wave 2Primary care dataRelated hospital admissionsSyndrome coronavirus 2Adults 65 yearsCohort of adultsCOVID-19 outcomesCoronavirus disease 2019COVID-19 mortalityRisk of infectionWave 1UK pandemicHazard ratioIntensive careAbsolute riskCase fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February
Grint D, Wing K, Williamson E, McDonald H, Bhaskaran K, Evans D, Evans S, Walker A, Hickman G, Nightingale E, Schultze A, Rentsch C, Bates C, Cockburn J, Curtis H, Morton C, Bacon S, Davy S, Wong A, Mehrkar A, Tomlinson L, Douglas I, Mathur R, Blomquist P, MacKenna B, Ingelsby P, Croker R, Parry J, Hester F, Harper S, DeVito N, Hulme W, Tazare J, Goldacre B, Smeeth L, Eggo R. Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February. Eurosurveillance 2021, 26: 2100256. PMID: 33739254, PMCID: PMC7976383, DOI: 10.2807/1560-7917.es.2021.26.11.2100256.Peer-Reviewed Original ResearchUse of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts
Wong AY, MacKenna B, Morton CE, Schultze A, Walker AJ, Bhaskaran K, Brown JP, Rentsch CT, Williamson E, Drysdale H, Croker R, Bacon S, Hulme W, Bates C, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, Tomlinson L, Mathur R, Wing K, Forbes H, Eggo RM, Parry J, Hester F, Harper S, Evans SJ, Smeeth L, Douglas IJ, Goldacre B, Collaborative T. Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts. Annals Of The Rheumatic Diseases 2021, 80: 943-951. PMID: 33478953, PMCID: PMC7823433, DOI: 10.1136/annrheumdis-2020-219517.Peer-Reviewed Original ResearchConceptsNon-steroidal anti-inflammatory drugsPrescribed non-steroidal anti-inflammatory drugsRheumatoid arthritis/osteoarthritisArthritis/osteoarthritisCurrent NSAID usersMultivariable-adjusted modelsAnti-inflammatory drugsNSAID prescriptionsNSAID usersGeneral populationCOVID-19Risk of deathNational Health Service EnglandRoutine therapeutic useRoutine clinical dataCohort studyCurrent useCox regressionClinical dataCohort analysisLower riskEvidence of differencesDeath dataTherapeutic useDeath
2020
Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform
Schultze A, Walker AJ, MacKenna B, Morton CE, Bhaskaran K, Brown JP, Rentsch CT, Williamson E, Drysdale H, Croker R, Bacon S, Hulme W, Bates C, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, Tomlinson L, Mathur R, Wing K, Wong AYS, Forbes H, Parry J, Hester F, Harper S, Evans SJW, Quint J, Smeeth L, Douglas IJ, Goldacre B, Collaborative O. Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform. The Lancet Respiratory Medicine 2020, 8: 1106-1120. PMID: 32979987, PMCID: PMC7515601, DOI: 10.1016/s2213-2600(20)30415-x.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, InhalationAdolescentAdrenal Cortex HormonesAdultAgedAged, 80 and overAsthmaBetacoronavirusCohort StudiesCoronavirus InfectionsCOVID-19Electronic Health RecordsEnglandFemaleHumansMaleMiddle AgedMuscarinic AntagonistsPandemicsPneumonia, ViralProportional Hazards ModelsPulmonary Disease, Chronic ObstructiveRegression AnalysisSARS-CoV-2Young AdultConceptsChronic obstructive pulmonary diseaseCOVID-19-related deathsIndex dateObstructive pulmonary diseaseElectronic health recordsOpenSAFELY platformRespiratory medicationsCOPD cohortHazard ratioPulmonary diseaseAsthma cohortPrimary care electronic health recordsSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Respiratory syndrome coronavirus 2High-dose ICSHigh-dose ICSsRegular ICS useΒ-agonistsObservational cohort studyUK Medical Research CouncilRisk of deathCox regression modelAcute respiratory diseaseSyndrome coronavirus 2