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Implementation of a high sensitivity cardiac troponin I assay and risk of myocardial infarction or death at five years: observational analysis of a stepped wedge, cluster randomised controlled trial

Objective To evaluate the impact of implementing a high sensitivity assay for cardiac troponin I on long term outcomes in patients with suspected acute coronary syndrome. Design Secondary observational analysis of a stepped wedge, cluster randomised controlled trial. Setting 10 secondary and tertiary care centres in Scotland, UK. Participants 48 282 consecutive patients with suspected acute coronary syndrome. Myocardial injury was defined as any high sensitivity assay result for cardiac troponin I >99th centile of 16 ng/L in women and 34 ng/L in men. Intervention Hospital sites were randomly allocated to either early (n=5 hospitals) or late (n=5 hospitals) implementation of a high sensitivity cardiac troponin I assay with sex specific diagnostic thresholds. Main outcome measure The main outcome was myocardial infarction or death at five years. Results 10 360 patients had cardiac troponin concentrations greater than the 99th centile, of whom 1771 (17.1%) were reclassified b

United kingdomCity ofGlasgow cityDavida mcallisterImran sadatFrank finlaySiemens healthineersJasper boeddinghausMichael mcdermottHeather charlesJack pm andrewsJonathan maloCaelan taggartDallan walkerRicharda parkerDonogh maguire

Sociodemographic characteristics and longitudinal progression of multimorbidity: A multistate modelling analysis of a large primary care records dataset in England

In this multistate modelling analysis, Sida Chen and colleagues examine sociodemographic characteristics and longitudinal progression of multimorbidity using data from primary care records in England

United kingdomWest midlandsUnited kingdom generalCity ofSingula bioAstra zenecaEli lillyDavida mcallisterAdult psychiatric morbidity surveyAdult psychiatric morbidityHealth research board irelandResearch databaseScientific advisory committeeNational institute for health researchCancer research united kingdomClinical practice research datalink

Comorbidity and health-related quality of life in people with a chronic medical condition in randomised clinical trials: An individual participant data meta-analysis

Author summary Why was this study done? ➢ The EuroQol-5 dimension (EQ-5D) and SF-36 are questionnaire-based tools that combine measures of physical and mental health into overall quality of life scores. These scores are used in randomised controlled trials of drug treatments to estimate how treatments affect quality of life. These estimates then inform decisions about which treatments should be offered to people with specific conditions. ➢ Multimorbidity, the presence of 2 or more conditions, makes diagnosis and treatment more complex and is associated with worse quality of life in some settings. ➢ People with multimorbidity are underrepresented in clinical trials, and little is known about whether and how multimorbidity changes quality of life in clinical trials. This makes it difficult for clinicians and clinical guideline developers to determine how results from clinical trials should be applied to people with multimorbidity. What did the researchers do and find? ➢ To

City ofUnited kingdomGlasgow cityUnited statesDavidm kentBruce guthrieJim lewseyElainew butterlyEmma mcintoshDavida mcallisterPeter hanlonLauriej hanniganNickyj weltonFrancess mairAnoopsv shahEffectiveness center

Effect of Vaccination on Transmission of SARS-CoV-2

Effect of Vaccination on Transmission of SARS-CoV-2
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Glasgow cityUnited kingdomCity ofJennifer bishopHelenm colhounCiara gribbenDavid caldwellMartin reidDavida mcallisterPaulm mckeigueSharon hutchinsonDiane stocktonRachael woodPeter hanlonDavid goldbergJim mcmenamin

Weight gain and diabetes threaten progress in reducing heart attacks and strokes

Weight gain and diabetes threaten progress in reducing heart attacks and strokes
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