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Article ; Online: Not obsolete, yet.

Haroon, Shamil

The British journal of general practice : the journal of the Royal College of General Practitioners

2023 Volume 73, Issue 732, Page(s) 314–315

Language	English
Publishing date	2023-06-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/bjgp23X733341
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Article ; Online: Comorbidities and covid-19.

Adab, Peymané / Haroon, Shamil / O'Hara, Margaret E / Jordan, Rachel E

BMJ (Clinical research ed.)

2022 Volume 377, Page(s) o1431

MeSH term(s)	COVID-19/epidemiology ; Comorbidity ; Humans ; SARS-CoV-2
Language	English
Publishing date	2022-06-15
Publishing country	England
Document type	Editorial
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.o1431
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Article ; Online: The Time to Inflammatory Bowel Disease Diagnosis for Patients Presenting with Abdominal Symptoms in Primary Care and its Association with Emergency Hospital Admissions and Surgery: A Retrospective Cohort Study.

Umar, Nosheen / Harvey, Phil / Adderley, Nicola J / Haroon, Shamil / Trudgill, Nigel

Inflammatory bowel diseases

2024

Abstract: Background: Patients with inflammatory bowel disease (IBD) presenting to primary care may experience diagnostic delays. We aimed to evaluate this and assess whether time to diagnosis is associated with clinical outcomes.: Methods: A retrospective ... ...

Abstract	Background: Patients with inflammatory bowel disease (IBD) presenting to primary care may experience diagnostic delays. We aimed to evaluate this and assess whether time to diagnosis is associated with clinical outcomes. Methods: A retrospective cohort study using English primary care data from January 1, 2010, to December 31, 2019, linked to hospital admission data was undertaken. Patients were followed from the first IBD-related presentation in primary care to IBD diagnosis. Associations of time to diagnosis exceeding a year were assessed using a Robust Poisson regression model. Associations between time to diagnosis and IBD-related emergency hospital admissions and surgery were assessed using Poisson and Cox proportional hazards models, respectively. Results: Of 28 092 IBD patients, 60% had ulcerative colitis (UC) and 40% had Crohn's disease (CD). The median age was 43 (interquartile range, 30-58) years and 51.9% were female. Median time to diagnosis was 15.6 (interquartile range, 4.3-28.1) months. Factors associated with more than a year to diagnosis included female sex (adjusted risk ratio [aRR], 1.23; 95% CI, 1.21-1.26), older age (aRR, 1.05; 95% CI, 1.01-1.10; comparing >70 years of age with 18-30 years of age), obesity (aRR, 1.03; 95% CI, 1.00-1.06), smoking (aRR, 1.05; 95% CI, 1.02-1.08), CD compared with UC (aRR, 1.13; 95% CI, 1.11-1.16), and a fecal calprotectin over 500 μg/g (aRR, 0.89; 95% CI, 0.82-0.95). The highest quartile of time to diagnosis compared with the lowest was associated with IBD-related emergency admissions (incidence rate ratio, 1.06; 95% CI, 1.01-1.11). Conclusion: Longer times to IBD diagnoses were associated with being female, advanced age, obesity, smoking, and Crohn's disease. More IBD-related emergency admissions were observed in patients with a prolonged time to diagnosis.
Language	English
Publishing date	2024-04-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izae057
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Article ; Online: Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status.

d'Elia, Alexander / Baranskaya, Aliaksandra / Haroon, Shamil / Hammond, Ben / Adderley, Nicola J / Nirantharakumar, Krishnarajah / Chandan, Joht Singh / Falahee, Marie / Raza, Karim

Rheumatology (Oxford, England)

2024

Abstract: Objectives: To assess whether prodromal symptoms of rheumatoid arthritis (RA), as recorded in the Clinical Practice Research Datalink Aurum (CPRD) database of English primary care records, differ by ethnicity and socioeconomic status.: Methods: A ... ...

Abstract	Objectives: To assess whether prodromal symptoms of rheumatoid arthritis (RA), as recorded in the Clinical Practice Research Datalink Aurum (CPRD) database of English primary care records, differ by ethnicity and socioeconomic status. Methods: A cross-sectional study to determine the coding of common symptoms (≥0.1% in the sample) in the 24 months preceding RA diagnosis in CPRD Aurum, recorded between January 1st 2004 to May 1st 2022. Eligible cases were adults with a code for RA diagnosis. For each symptom, a logistic regression was performed with the symptom as dependent variable, and ethnicity and socioeconomic status as independent variables. Results were adjusted for sex, age, BMI, and smoking status. White ethnicity and the highest socioeconomic quintile were comparators. Results: In total, 70115 cases were eligible for inclusion, of which 66.4% female. Twenty-one symptoms were coded in > 0.1% of cases so were included in the analysis. Patients of South Asian ethnicity had higher frequency of codes for several symptoms, with the largest difference by odds ratio being muscle cramps (OR 1.71, 1.44-2.57) and shoulder pain (1.44, 1.25-1.66). Patients of Black ethnicity had higher prevalence of several codes including unintended weight loss (2.02, 1.25-3.28) and ankle pain (1.51, 1.02-2.23). Low socioeconomic status was associated with morning stiffness (1.74, 1.08-2.80) and falls (1.37, 2.03-1.82). Conclusion: There are significant differences in coded symptoms between demographic groups, which must be considered in clinical practice in diverse populations and to avoid algorithmic bias in prediction tools derived from routinely collected healthcare data.
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keae157
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Article ; Online: Post-hospitalisation asthma management in primary care: a retrospective cohort study.

Punyadasa, Dhanusha / Simms-Williams, Nikita / Adderley, Nicola J / Thayakaran, Rasiah / Mansur, Adel H / Nirantharakumar, Krishnarajah / Nagakumar, Prasad / Haroon, Shamil

The British journal of general practice : the journal of the Royal College of General Practitioners

2024

Abstract: Background: Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge.: Aim: To evaluate asthma management in primary care following a hospital admission for asthma ... ...

Abstract	Background: Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge. Aim: To evaluate asthma management in primary care following a hospital admission for asthma and its associations with patient characteristics. Design and setting: A retrospective cohort study using English primary care data from the Clinical Practice Research Datalink Aurum database and linked Hospital Episode Statistics Admitted Patient Care data. Method: Patients with asthma aged ≥5 years who had at least one asthma-related hospital admission from 1 January 2017 to 31 December 2019 were included. The primary outcome was a composite of any of the following delivered in primary care within 28 days from hospital discharge: asthma review, asthma management plan, asthma medication prescriptions, demonstration of inhaler technique, or smoking cessation counselling. The association between patient characteristics and delivery of clinical care was assessed using logistic regression. Results: The study included 17 457 patients. A total of 10 515 (60.2%) patients received the primary outcome within 28 days of hospital discharge. There were 2311 (13.2%) who received an asthma review, 1459 (8.4%) an asthma management plan, 9996 (57.3%) an asthma medication, 1500 (8.6%) a demonstration of inhaler technique, and 52 (1.2% of smokers) had smoking cessation counselling. Patients from Black ethnic minority groups received less of this care (27%- 54% lower odds, depending on age). However, short-acting bronchodilator prescriptions in the previous year were associated with an increased likelihood of the primary outcome. Conclusion: A significant proportion of patients do not receive timely follow-up in primary care following asthma-related admissions to hospital, particularly among Black ethnic minority groups.
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/BJGP.2023.0214
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Article ; Online: Long COVID and self-management.

Brown, Kirsty / Yahyouche, Asma / Haroon, Shamil / Camaradou, Jenny / Turner, Grace

Lancet (London, England)

2021 Volume 399, Issue 10322, Page(s) 355

MeSH term(s)	COVID-19/complications ; COVID-19/therapy ; Chronic Disease/therapy ; Humans ; Observational Studies as Topic ; Self Medication ; Self-Management ; Surveys and Questionnaires ; United Kingdom/epidemiology ; Post-Acute COVID-19 Syndrome
Language	English
Publishing date	2021-11-26
Publishing country	England
Document type	Letter
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(21)02798-7
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Article ; Online: Digitally enabled decentralised research: opportunities to improve the efficiency of clinical trials and observational studies.

Aiyegbusi, Olalekan Lee / Davies, Elin Haf / Myles, Puja / Williams, Tim / Frost, Chris / Haroon, Shamil / Hughes, Sarah E / Wilson, Roger / McMullan, Christel / Subramanian, Anuradhaa / Nirantharakumar, Krishnarajah / Calvert, Melanie J

BMJ evidence-based medicine

2023 Volume 28, Issue 5, Page(s) 328–331

Language	English
Publishing date	2023-02-21
Publishing country	England
Document type	Journal Article
ISSN	2515-4478
ISSN (online)	2515-4478
DOI	10.1136/bmjebm-2023-112253
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Article ; Online: Long Covid symptoms and diagnosis in primary care: A cohort study using structured and unstructured data in The Health Improvement Network primary care database.

Shah, Anoop D / Subramanian, Anuradhaa / Lewis, Jadene / Dhalla, Samir / Ford, Elizabeth / Haroon, Shamil / Kuan, Valerie / Nirantharakumar, Krishnarajah

PloS one

2023 Volume 18, Issue 9, Page(s) e0290583

Abstract: Background: Long Covid is a widely recognised consequence of COVID-19 infection, but little is known about the burden of symptoms that patients present with in primary care, as these are typically recorded only in free text clinical notes.: Aims: To ... ...

Abstract	Background: Long Covid is a widely recognised consequence of COVID-19 infection, but little is known about the burden of symptoms that patients present with in primary care, as these are typically recorded only in free text clinical notes. Aims: To compare symptoms in patients with and without a history of COVID-19, and investigate symptoms associated with a Long Covid diagnosis. Methods: We used primary care electronic health record data until the end of December 2020 from The Health Improvement Network (THIN), a Cegedim database. We included adults registered with participating practices in England, Scotland or Wales. We extracted information about 89 symptoms and 'Long Covid' diagnoses from free text using natural language processing. We calculated hazard ratios (adjusted for age, sex, baseline medical conditions and prior symptoms) for each symptom from 12 weeks after the COVID-19 diagnosis. Results: We compared 11,015 patients with confirmed COVID-19 and 18,098 unexposed controls. Only 20% of symptom records were coded, with 80% in free text. A wide range of symptoms were associated with COVID-19 at least 12 weeks post-infection, with strongest associations for fatigue (adjusted hazard ratio (aHR) 3.46, 95% confidence interval (CI) 2.87, 4.17), shortness of breath (aHR 2.89, 95% CI 2.48, 3.36), palpitations (aHR 2.59, 95% CI 1.86, 3.60), and phlegm (aHR 2.43, 95% CI 1.65, 3.59). However, a limited subset of symptoms were recorded within 7 days prior to a Long Covid diagnosis in more than 20% of cases: shortness of breath, chest pain, pain, fatigue, cough, and anxiety / depression. Conclusions: Numerous symptoms are reported to primary care at least 12 weeks after COVID-19 infection, but only a subset are commonly associated with a GP diagnosis of Long Covid.
MeSH term(s)	Adult ; Humans ; Chest Pain ; Cohort Studies ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing ; Dyspnea/diagnosis ; Dyspnea/epidemiology ; Fatigue/diagnosis ; Fatigue/epidemiology ; Post-Acute COVID-19 Syndrome ; Primary Health Care ; Male ; Female
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0290583
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Article ; Online: Perceptions on artificial intelligence-based decision-making for coexisting multiple long-term health conditions: protocol for a qualitative study with patients and healthcare professionals.

Gunathilaka, Niluka Jeewanthi / Gooden, Tiffany E / Cooper, Jennifer / Flanagan, Sarah / Marshall, Tom / Haroon, Shamil / D'Elia, Alexander / Crowe, Francesca / Jackson, Thomas / Nirantharakumar, Krishnarajah / Greenfield, Sheila

BMJ open

2024 Volume 14, Issue 2, Page(s) e077156

Abstract: Introduction: Coexisting multiple health conditions is common among older people, a population that is increasing globally. The potential for polypharmacy, adverse events, drug interactions and development of additional health conditions complicates ... ...

Abstract	Introduction: Coexisting multiple health conditions is common among older people, a population that is increasing globally. The potential for polypharmacy, adverse events, drug interactions and development of additional health conditions complicates prescribing decisions for these patients. Artificial intelligence (AI)-generated decision-making tools may help guide clinical decisions in the context of multiple health conditions, by determining which of the multiple medication options is best. This study aims to explore the perceptions of healthcare professionals (HCPs) and patients on the use of AI in the management of multiple health conditions. Methods and analysis: A qualitative study will be conducted using semistructured interviews. Adults (≥18 years) with multiple health conditions living in the West Midlands of England and HCPs with experience in caring for patients with multiple health conditions will be eligible and purposively sampled. Patients will be identified from Clinical Practice Research Datalink (CPRD) Aurum; CPRD will contact general practitioners who will in turn, send a letter to patients inviting them to take part. Eligible HCPs will be recruited through British HCP bodies and known contacts. Up to 30 patients and 30 HCPs will be recruited, until data saturation is achieved. Interviews will be in-person or virtual, audio recorded and transcribed verbatim. The topic guide is designed to explore participants' attitudes towards AI-informed clinical decision-making to augment clinician-directed decision-making, the perceived advantages and disadvantages of both methods and attitudes towards risk management. Case vignettes comprising a common decision pathway for patients with multiple health conditions will be presented during each interview to invite participants' opinions on how their experiences compare. Data will be analysed thematically using the Framework Method. Ethics and dissemination: This study has been approved by the National Health Service Research Ethics Committee (Reference: 22/SC/0210). Written informed consent or verbal consent will be obtained prior to each interview. The findings from this study will be disseminated through peer-reviewed publications, conferences and lay summaries.
MeSH term(s)	Adult ; Humans ; Aged ; Cross-Sectional Studies ; Artificial Intelligence ; State Medicine ; Multimorbidity ; Qualitative Research ; Polypharmacy
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-077156
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Article ; Online: Covid-19: breaking the chain of household transmission.

Haroon, Shamil / Chandan, Joht Singh / Middleton, John / Cheng, Kar Keung

BMJ (Clinical research ed.)

2020 Volume 370, Page(s) m3181

MeSH term(s)	COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Disease Transmission, Infectious/prevention & control ; Family Characteristics ; Female ; Humans ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Public Health ; Quarantine/legislation & jurisprudence ; Risk Assessment ; United Kingdom
Keywords	covid19
Language	English
Publishing date	2020-08-14
Publishing country	England
Document type	Editorial
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m3181
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