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Article: Leprosy interpreted as diabetes related complications.

Rawson, T M / Anjum, V

2014 Volume 86, Issue 2, Page(s) 65–67

MeSH term(s)	Ankle/pathology ; Diabetes Complications/diagnosis ; Diabetes Complications/pathology ; Diagnosis, Differential ; Diagnostic Errors ; Ear/pathology ; Humans ; Leprosy/diagnosis ; Leprosy/pathology
Language	English
Publishing date	2014-04
Publishing country	India
Document type	Case Reports ; Letter
ZDB-ID	605804-8
ISSN	0254-9395
ISSN	0254-9395
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Article: Scarlet fever: a guide for general practitioners.

Basetti, S / Hodgson, J / Rawson, T M / Majeed, A

London journal of primary care

2017 Volume 9, Issue 5, Page(s) 77–79

Abstract: There has been an increase in the incidence of scarlet fever with most cases presenting in General Practice and Emergency Departments. Cases present with a distinctive macro-papular rash, usually in children. This article aims to increase awareness of ... ...

Abstract	There has been an increase in the incidence of scarlet fever with most cases presenting in General Practice and Emergency Departments. Cases present with a distinctive macro-papular rash, usually in children. This article aims to increase awareness of scarlet fever by highlighting key symptoms and stating potential complications if untreated. In patients who have the typical symptoms, a prescription of a suitable antibiotic such as phenoxymethylpenicillin (Penicillin V) should be made immediately to reduce the risk of complications and the spread of infection.
Language	English
Publishing date	2017-08-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2542827-5
ISSN	1757-1480 ; 1757-1472
ISSN (online)	1757-1480
ISSN	1757-1472
DOI	10.1080/17571472.2017.1365677
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Article ; Online: Corrigendum to 'machine learning for clinical decision support in infectious diseases: a narrative review of current applications' clinical microbiology and infection (2020) 584-595.

Peiffer-Smadja, N / Rawson, T M / Ahmad, R / Buchard, A / Georgiou, P / Lescure, F-X / Birgand, G / Holmes, A H

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2020 Volume 26, Issue 8, Page(s) 1118

Language	English
Publishing date	2020-05-22
Publishing country	England
Document type	Journal Article ; Published Erratum
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2020.05.020
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Article ; Online: The Differences in Antibiotic Decision-making Between Acute Surgical and Acute Medical Teams: An Ethnographic Study of Culture and Team Dynamics.

Charani, E / Ahmad, R / Rawson, T M / Castro-Sanchèz, E / Tarrant, C / Holmes, A H

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2018 Volume 69, Issue 1, Page(s) 12–20

Abstract: Background: Cultural and social determinants influence antibiotic decision-making in hospitals. We investigated and compared cultural determinants of antibiotic decision-making in acute medical and surgical specialties.: Methods: An ethnographic ... ...

Abstract	Background: Cultural and social determinants influence antibiotic decision-making in hospitals. We investigated and compared cultural determinants of antibiotic decision-making in acute medical and surgical specialties. Methods: An ethnographic observational study of antibiotic decision-making in acute medical and surgical teams at a London teaching hospital was conducted (August 2015-May 2017). Data collection included 500 hours of direct observations, and face-to-face interviews with 23 key informants. A grounded theory approach, aided by Nvivo 11 software, analyzed the emerging themes. An iterative and recursive process of analysis ensured saturation of the themes. The multiple modes of enquiry enabled cross-validation and triangulation of the findings. Results: In medicine, accepted norms of the decision-making process are characterized as collectivist (input from pharmacists, infectious disease, and medical microbiology teams), rationalized, and policy-informed, with emphasis on de-escalation of therapy. The gaps in antibiotic decision-making in acute medicine occur chiefly in the transition between the emergency department and inpatient teams, where ownership of the antibiotic prescription is lost. In surgery, team priorities are split between 3 settings: operating room, outpatient clinic, and ward. Senior surgeons are often absent from the ward, leaving junior staff to make complex medical decisions. This results in defensive antibiotic decision-making, leading to prolonged and inappropriate antibiotic use. Conclusions: In medicine, the legacy of infection diagnosis made in the emergency department determines antibiotic decision-making. In surgery, antibiotic decision-making is perceived as a nonsurgical intervention that can be delegated to junior staff or other specialties. Different, bespoke approaches to optimize antibiotic prescribing are therefore needed to address these specific challenges.
MeSH term(s)	Anthropology, Cultural ; Anti-Bacterial Agents/administration & dosage ; Clinical Decision-Making ; Cross-Cultural Comparison ; Grounded Theory ; Hospitals, Teaching/standards ; Humans ; London ; Operating Rooms/standards ; Patient Care Team/statistics & numerical data ; Pharmacists/psychology ; Qualitative Research ; Surgeons/psychology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-10-16
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciy844
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Zs.MO 480: Show issues

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Article ; Online: Antibiotic prescribing in general medical and surgical specialties: a prospective cohort study.

Charani, E / de Barra, E / Rawson, T M / Gill, D / Gilchrist, M / Naylor, N R / Holmes, A H

Antimicrobial resistance and infection control

2019 Volume 8, Page(s) 151

Abstract: Background: Qualitative work has described the differences in prescribing practice across medical and surgical specialties. This study aimed to understand if specialty impacts quantitative measures of prescribing practice.: Methods: We prospectively ... ...

Abstract	Background: Qualitative work has described the differences in prescribing practice across medical and surgical specialties. This study aimed to understand if specialty impacts quantitative measures of prescribing practice. Methods: We prospectively analysed the antibiotic prescribing across general medical and surgical teams for acutely admitted patients. Over a 12-month period (June 2016 - May 2017) 659 patients (362 medical, 297 surgical) were followed for the duration of their hospital stay. Antibiotic prescribing across these cohorts was assessed using Chi-squared or Wilcoxon rank-sum, depending on normality of data. The t-test was used to compare age and length of stay. A logistic regression model was used to predict escalation of antibiotic therapy. Results: Surgical patients were younger ( Conclusions: Across both specialties, microbiology investigation results are not adequately used to diagnose infections and optimise their management. There is significant variation in antibiotic decision-making (including escalation patterns) between general surgical and medical teams. Antibiotic stewardship interventions targeting surgical specialties need to go beyond surgical prophylaxis. It is critical to focus on of review the patients initiated on therapeutic antibiotics in surgical specialties to ensure that escalation and continuation of therapy is justified.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship/methods ; Clinical Decision-Making ; Drug Prescriptions/statistics & numerical data ; Humans ; Logistic Models ; Practice Patterns, Physicians' ; Prospective Studies ; Specialties, Surgical
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-09-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-019-0603-6
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Article ; Online: Machine learning for clinical decision support in infectious diseases: a narrative review of current applications.

Peiffer-Smadja, N / Rawson, T M / Ahmad, R / Buchard, A / Georgiou, P / Lescure, F-X / Birgand, G / Holmes, A H

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2019 Volume 26, Issue 5, Page(s) 584–595

Abstract: Background: Machine learning (ML) is a growing field in medicine. This narrative review describes the current body of literature on ML for clinical decision support in infectious diseases (ID).: Objectives: We aim to inform clinicians about the use ... ...

Abstract	Background: Machine learning (ML) is a growing field in medicine. This narrative review describes the current body of literature on ML for clinical decision support in infectious diseases (ID). Objectives: We aim to inform clinicians about the use of ML for diagnosis, classification, outcome prediction and antimicrobial management in ID. Sources: References for this review were identified through searches of MEDLINE/PubMed, EMBASE, Google Scholar, biorXiv, ACM Digital Library, arXiV and IEEE Xplore Digital Library up to July 2019. Content: We found 60 unique ML-clinical decision support systems (ML-CDSS) aiming to assist ID clinicians. Overall, 37 (62%) focused on bacterial infections, 10 (17%) on viral infections, nine (15%) on tuberculosis and four (7%) on any kind of infection. Among them, 20 (33%) addressed the diagnosis of infection, 18 (30%) the prediction, early detection or stratification of sepsis, 13 (22%) the prediction of treatment response, four (7%) the prediction of antibiotic resistance, three (5%) the choice of antibiotic regimen and two (3%) the choice of a combination antiretroviral therapy. The ML-CDSS were developed for intensive care units (n = 24, 40%), ID consultation (n = 15, 25%), medical or surgical wards (n = 13, 20%), emergency department (n = 4, 7%), primary care (n = 3, 5%) and antimicrobial stewardship (n = 1, 2%). Fifty-three ML-CDSS (88%) were developed using data from high-income countries and seven (12%) with data from low- and middle-income countries (LMIC). The evaluation of ML-CDSS was limited to measures of performance (e.g. sensitivity, specificity) for 57 ML-CDSS (95%) and included data in clinical practice for three (5%). Implications: Considering comprehensive patient data from socioeconomically diverse healthcare settings, including primary care and LMICs, may improve the ability of ML-CDSS to suggest decisions adapted to various clinical contexts. Currents gaps identified in the evaluation of ML-CDSS must also be addressed in order to know the potential impact of such tools for clinicians and patients.
MeSH term(s)	Anti-Infective Agents/therapeutic use ; Artificial Intelligence ; Clinical Decision-Making ; Communicable Diseases/classification ; Communicable Diseases/diagnosis ; Communicable Diseases/therapy ; Decision Support Systems, Clinical/classification ; Decision Support Systems, Clinical/statistics & numerical data ; Decision Support Systems, Clinical/trends ; Early Diagnosis ; Humans ; Machine Learning/classification ; Machine Learning/statistics & numerical data ; Machine Learning/trends ; Patient Outcome Assessment ; Sepsis/diagnosis ; Sepsis/therapy
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2019-09-17
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2019.09.009
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Article ; Online: Promoting medical student engagement with antimicrobial stewardship through involvement in undergraduate research.

Rawson, T M / Moore, L S P / Gill, D / Lupton, M / Holmes, A H

The Journal of infection

2016 Volume 74, Issue 2, Page(s) 200–202

MeSH term(s)	Anti-Infective Agents ; Antimicrobial Stewardship ; Students, Medical
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2016-09-09
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2016.08.019
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Article ; Online: COVID-19 and the potential long-term impact on antimicrobial resistance

Rawson, T. M. / Moore, L. S. P. / Castro-Sanchez, E. / Charani, E. / Davies, F. / Satta, G. / Ellington, M. J. / Holmes, A. H.

2020

Abstract: The emergence of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has required an unprecedented response to control the spread of the infection and protect the most vulnerable within society. Whilst the pandemic has focused society on the ...

Abstract	The emergence of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has required an unprecedented response to control the spread of the infection and protect the most vulnerable within society. Whilst the pandemic has focused society on the threat of emerging infections and hand hygiene, certain infection control and antimicrobial stewardship policies may have to be relaxed. It is unclear whether the unintended consequences of these changes will have a net-positive or -negative impact on rates of antimicrobial resistance. Whilst the urgent focus must be on controlling this pandemic, sustained efforts to address the longer-term global threat of antimicrobial resistance should not be overlooked.
Keywords	HN Social history and conditions. Social problems. Social reform ; QR180 Immunology ; RA0421 Public health. Hygiene. Preventive Medicine ; covid19
Language	English
Publishing date	2020-05-20
Publisher	Oxford University Press
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Behaviour change interventions to influence antimicrobial prescribing: a cross-sectional analysis of reports from UK state-of-the-art scientific conferences.

Rawson, T M / Moore, L S P / Tivey, A M / Tsao, A / Gilchrist, M / Charani, E / Holmes, A H

Antimicrobial resistance and infection control

2017 Volume 6, Page(s) 11

Abstract: Background: To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to ... ...

Abstract	Background: To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. Methods: Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR) abstracts were identified using validated search criteria. Abstracts were independently reviewed by four researchers with reported behavioural interventions classified using a behaviour change taxonomy. Results: Conferences ran for 110 days with >57,000 delegates. 311/12,313(2.5%) AMS-AMR abstracts (oral and poster) were identified. 118/311(40%) were presented at the UK's infectious diseases/microbiology conference. 56/311(18%) AMS-AMR abstracts described behaviour change interventions. These were identified across 12/30(40%) conferences. The commonest abstract reporting behaviour change interventions were quality improvement projects [44/56 (79%)]. In total 71 unique behaviour change functions were identified. Policy categories; "guidelines" (16/71) and "service provision" (11/71) were the most frequently reported. Intervention functions; "education" (6/71), "persuasion" (7/71), and "enablement" (9/71) were also common. Only infection and primary care conferences reported studies that contained multiple behaviour change interventions. The remaining 10 specialties tended to report a narrow range of interventions focusing on "guidelines" and "enablement". Conclusion: Despite the benefits of behaviour change interventions on antimicrobial prescribing, very few AMS-AMR studies reported implementing them in 2015. AMS interventions must focus on promoting behaviour change towards antimicrobial prescribing. Greater focus must be placed on non-infection specialties to engage with the issue of behaviour change towards antimicrobial use.
Language	English
Publishing date	2017-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2666706-X
ISSN	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-017-0170-7
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Article ; Online: Age at Menarche and Time Spent in Education: A Mendelian Randomization Study.

Gill, D / Del Greco M, F / Rawson, T M / Sivakumaran, P / Brown, A / Sheehan, N A / Minelli, C

Behavior genetics

2017 Volume 47, Issue 5, Page(s) 480–485

Abstract: Menarche signifies the primary event in female puberty and is associated with changes in self-identity. It is not clear whether earlier puberty causes girls to spend less time in education. Observational studies on this topic are likely to be affected by ...

Abstract	Menarche signifies the primary event in female puberty and is associated with changes in self-identity. It is not clear whether earlier puberty causes girls to spend less time in education. Observational studies on this topic are likely to be affected by confounding environmental factors. The Mendelian randomization (MR) approach addresses these issues by using genetic variants (such as single nucleotide polymorphisms, SNPs) as proxies for the risk factor of interest. We use this technique to explore whether there is a causal effect of age at menarche on time spent in education. Instruments and SNP-age at menarche estimates are identified from a Genome Wide Association Study (GWAS) meta-analysis of 182,416 women of European descent. The effects of instruments on time spent in education are estimated using a GWAS meta-analysis of 118,443 women performed by the Social Science Genetic Association Consortium (SSGAC). In our main analysis, we demonstrate a small but statistically significant causal effect of age at menarche on time spent in education: a 1 year increase in age at menarche is associated with 0.14 years (53 days) increase in time spent in education (95% CI 0.10-0.21 years, p = 3.5 × 10
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	280238-7
ISSN	1573-3297 ; 0005-7851 ; 0001-8244
ISSN (online)	1573-3297
ISSN	0005-7851 ; 0001-8244
DOI	10.1007/s10519-017-9862-2
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