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Matthewman J, Tadrous M, Mansfield K, Thiruchelvam D, Redelmeier D, Cheung A, Lega I, Prieto-Alhambra D, Cunliffe L, Langan S, Drucker A. 078 Association between oral corticosteroid prescribing patterns and appropriate fracture preventive care: UK and Ontario population-based cohort studies. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Langan S, Smith C, Collaborative T. 073 Risk of severe COVID-19 outcomes associated with immune-mediated inflammatory diseases and immune modifying therapies: a nationwide cohort study in the OpenSAFELY platform. J Invest Dermatol 2022. [PMCID: PMC9672437 DOI: 10.1016/j.jid.2022.09.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- S. Langan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C. Smith
- King’s College, London, United Kingdom
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Tully J, Tomaszewski N, Kidd S, Langan S, Abuabara K. 207 The impact of childhood stressful life events on atopic dermatitis disease activity and severity: A prospective study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kern C, Johanis M, Johanis M, Tahir P, Ye M, Mulick A, Allen I, McCulloch C, Langan S, Abuabara K. 155 Atopic dermatitis is associated with cardiovascular risk factors in pediatric patients: A systematic review and meta-analysis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Erlandson KM, Langan S, Lake JE, Sun J, Sharma A, Adrian S, Scherzinger A, Palella F, Kingsley L, Gange SJ, Tien PC, Yin MT, Brown TT. Differences in Muscle Quantity and Quality by HIV Serostatus and Sex. J Frailty Aging 2022; 11:309-317. [PMID: 35799438 PMCID: PMC9334131 DOI: 10.14283/jfa.2022.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE People with HIV (PWH) experience greater declines in both muscle function and muscle mass with aging. Whether changes in muscle quality and quantity with aging differ between men and women with HIV and the implications on muscle function are not established. DESIGN In coordinated substudies of the Multicenter AIDS Cohort Study and Women's Interagency HIV Study, participants completed physical function and falls assessments; total trunk/thigh density, inversely related to fatty infiltration, and area were quantified from computed tomography (CT) scans. METHODS Generalized linear models were used to explore variables affecting density/area, and associations between area/density and physical function and falls. RESULTS CT scans were available on 387 men (198 PWH) and 184 women (118 PWH). HIV serostatus was associated with greater lateralis, paraspinal, and hamstring area, but lower psoas area and density. Older age and female sex were associated with smaller trunk muscle area and lower density. Both lower muscle area and muscle density were associated with several measures of impaired physical function. The odds of falling were lower with greater hamstring density, but not associated with other measurers of muscle area or density. CONCLUSIONS In summary, older adults with HIV appear to have smaller and less dense (fattier) psoas, a key component in truncal stability and hip flexion that could have implications on physical function. The longitudinal associations of muscle area and density with physical function require careful investigation, with a particular focus on characteristics and interventions that can preserve muscle area, density, and function over time.
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Affiliation(s)
- K M Erlandson
- Kristine Erlandson, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80111, , (p) 303-724-4941 (f) 303-724-4926
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Matthewman J, Mansfield K, Prieto-Alhambra D, Mulick A, Smeeth L, Lowe K, Silverwood R, Langan S. 059 Atopic-eczema-associated fracture risk and oral corticosteroids: a population-based cohort study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mahil S, Yates M, Langan S, Yiu Z, Tsakok T, Dand N, Mason K, McAteer H, Meynell F, Coker B, Vincent A, Urmston D, Vesty A, Kelly J, Lancelot C, Moorhead L, Bachelez H, Bruce I, Capon F, Contreras C, Cope A, De La Cruz C, Di Meglio P, Gisondi P, Hyrich K, Jullien D, Lambert J, Marzo‐Ortega H, McInnes I, Naldi L, Norton S, Puig L, Sengupta R, Spuls P, Torres T, Warren R, Waweru H, Weinman J, Griffiths C, Barker J, Brown M, Galloway J, Smith C. Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey. Br J Dermatol 2021; 185:80-90. [PMID: 33368145 PMCID: PMC9214088 DOI: 10.1111/bjd.19755] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. OBJECTIVES We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. METHODS Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. RESULTS Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. CONCLUSIONS Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.
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Forbes H, Bhaskaran K, Grint D, Hu V, Langan S, McDonald H, Morton C, Smeeth L, Walker J, Warren‐Gash C. Incidence of acute complications of herpes zoster among immunocompetent adults in England: a matched cohort study using routine health data. Br J Dermatol 2021; 184:1077-1084. [PMID: 33216946 PMCID: PMC8607468 DOI: 10.1111/bjd.19687] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Herpes zoster can cause rare but serious complications; the frequency of these complications has not been well described. OBJECTIVES To quantify the risks of acute non-postherpetic neuralgia (PHN) zoster complications, to inform vaccination policy. METHODS We conducted a cohort study among unvaccinated immunocompetent adults with incident zoster, and age-, sex- and practice-matched control adults without zoster, using routinely collected health data from the UK Clinical Practice Research Datalink (years 2001 to 2018). Crude attributable risks of complications were estimated as the difference between Kaplan-Meier-estimated 3-month cumulative incidences in patients with zoster vs. controls. We used Cox models to obtain hazard ratios for our primary outcomes in patients with and without zoster. Primary outcomes were ocular, neurological, cutaneous, visceral and zoster-specific complications. We also assessed whether antivirals during acute zoster protected against the complications. RESULTS In total 178 964 incident cases of zoster and 1 799 380 controls were included. The absolute risks of zoster-specific complications within 3 months of zoster diagnosis were 0·37% [95% confidence interval (CI) 0·34-0·39] for Ramsay Hunt syndrome, 0·01% (95% CI 0·0-0·01) for disseminated zoster, 0·04% (95% CI 0·03-0·05) for zoster death and 0·97% (95% CI 0·92-1·00) for zoster hospitalization. For other complications, attributable risks were 0·48% (95% CI 0·44-0·51) for neurological complications, 1·33% (95% CI 1·28-1·39) for ocular complications, 0·29% (95% CI 0·26-0·32) for cutaneous complications and 0·78% (95% CI 0·73-0·84) for visceral complications. Attributable risks were higher among patients > 50 years old. Patients with zoster had raised risks of all primary outcomes relative to controls. Antiviral prescription was associated with reduced risk of neurological complications (hazard ratio 0·61, 95% CI 0·53-0·70). CONCLUSIONS Non-PHN complications of zoster were relatively common, which may affect cost-effectiveness calculations for zoster vaccination. Clinicians should be aware that zoster can lead to various complications, besides PHN.
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Affiliation(s)
- H.J. Forbes
- London School of Hygiene & Tropical MedicineLondonUK
| | - K. Bhaskaran
- London School of Hygiene & Tropical MedicineLondonUK
| | - D. Grint
- London School of Hygiene & Tropical MedicineLondonUK
- NIHR Health Protection Research Unit in ImmunisationLondonUK
| | - V.H. Hu
- London School of Hygiene & Tropical MedicineLondonUK
| | - S.M. Langan
- London School of Hygiene & Tropical MedicineLondonUK
| | - H.I. McDonald
- London School of Hygiene & Tropical MedicineLondonUK
- NIHR Health Protection Research Unit in ImmunisationLondonUK
| | - C. Morton
- London School of Hygiene & Tropical MedicineLondonUK
| | - L. Smeeth
- London School of Hygiene & Tropical MedicineLondonUK
| | - J.L. Walker
- London School of Hygiene & Tropical MedicineLondonUK
- NIHR Health Protection Research Unit in ImmunisationLondonUK
- Statistics, Modelling and Economics DepartmentPublic Health EnglandLondonUK
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Ye M, Hollenstein L, Mansfield K, Abuabara K, Langan S. 365 Adult atopic dermatitis is associated with lymphopenia in two large cohorts. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mulick A, Mansfield K, Silverwood R, Budu-Aggrey A, Roberts A, Custovic A, Pearce N, Irvine A, Smeeth L, Abuabara K, Langan S. 247 Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wong A, Frøslev T, Dearing L, Forbes H, Mulick A, Mansfield K, Silverwood R, Kjærsgaard A, Sørensen H, Smeeth L, Lewin A, Schmidt S, Langan S. The association between partner bereavement and melanoma: cohort studies in the U.K. and Denmark. Br J Dermatol 2020; 183:673-683. [PMID: 32128788 PMCID: PMC7587014 DOI: 10.1111/bjd.18889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psychological stress is commonly cited as a risk factor for melanoma, but clinical evidence is limited. OBJECTIVES This study aimed to evaluate the association between partner bereavement and (i) first-time melanoma diagnosis and (ii) mortality in patients with melanoma. METHODS We conducted two cohort studies using data from the U.K. Clinical Practice Research Datalink (1997-2017) and Danish nationwide registries (1997-2016). In study 1, we compared the risk of first melanoma diagnosis in bereaved vs. matched nonbereaved people using stratified Cox regression. In study 2 we estimated hazard ratios (HRs) for death from melanoma in bereaved compared with nonbereaved individuals with melanoma using Cox regression. We estimated HRs separately for the U.K. and for Denmark, and then pooled the data to perform a random-effects meta-analysis. RESULTS In study 1, the pooled adjusted HR for the association between partner bereavement and melanoma diagnosis was 0·88 [95% confidence interval (CI) 0·84-0·92] across the entire follow-up period. In study 2, we observed increased melanoma-specific mortality in people experiencing partner bereavement across the entire follow-up period (HR 1·17, 95% CI 1·06-1·30), with the peak occurring during the first year of follow-up (HR 1·31, 95% CI 1·07-1·60). CONCLUSIONS We found decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. These findings may be partly explained by delayed detection resulting from the loss of a partner who could notice skin changes. Stress may play a role in melanoma progression. Our findings indicate the need for a low threshold for skin examination in individuals whose partners have died. What is already known about this topic? Psychological stress has been proposed as a risk factor for the development and progression of cancer, including melanoma, but evidence is conflicting. Clinical evidence is limited by small sample sizes, potential recall bias associated with self-report, and heterogeneous stress definitions. What does this study add? We found a decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. While stress might play a role in the progression of melanoma, an alternative explanation is that bereaved people no longer have a close person to help notice skin changes, leading to delayed melanoma detection. Linked Comment: Talaganis et al. Br J Dermatol 2020; 183:607-608.
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Affiliation(s)
- A.Y.S. Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - T. Frøslev
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - L. Dearing
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - H.J. Forbes
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
| | - A. Mulick
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - K.E. Mansfield
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - R.J. Silverwood
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Centre for Longitudinal StudiesDepartment of Social ScienceUniversity College LondonLondonU.K
| | - A. Kjærsgaard
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - H.T. Sørensen
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - L. Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
| | - A. Lewin
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - S.A.J. Schmidt
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
- Department of DermatologyAarhus University HospitalAarhusDenmark
| | - S.M. Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
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Blakeway H, Van‐de-Velde V, Allen V, Kravvas G, Palla L, Page M, Flohr C, Weller R, Irvine A, McPherson T, Roberts A, Williams H, Reynolds N, Brown S, Paternoster L, Langan S. What is the evidence for interactions between filaggrin null mutations and environmental exposures in the aetiology of atopic dermatitis? A systematic review. Br J Dermatol 2020; 183:443-451. [PMID: 31794059 PMCID: PMC7496176 DOI: 10.1111/bjd.18778] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Epidemiological studies indicate that gene-environment interactions play a role in atopic dermatitis (AD). OBJECTIVES To review the evidence for gene-environment interactions in AD aetiology, focusing on filaggrin (FLG) loss-of-function mutations. METHODS A systematic search from inception to September 2018 in Embase, MEDLINE and BIOSIS was performed. Search terms included all synonyms for AD and filaggrin/FLG; any genetic or epidemiological study design using any statistical methods were included. Quality assessment using criteria modified from guidance (ROBINS-I and Human Genome Epidemiology Network) for nonrandomized and genetic studies was completed, including consideration of power. Heterogeneity of study design and analyses precluded the use of meta-analysis. RESULTS Of 1817 papers identified, 12 studies fulfilled the inclusion criteria required and performed formal interaction testing. There was some evidence for FLG-environment interactions in six of the studies (P-value for interaction ≤ 0·05), including early-life cat ownership, older siblings, water hardness, phthalate exposure, higher urinary phthalate metabolite levels (which all increased AD risk additional to FLG null genotype) and prolonged breastfeeding (which decreased AD risk in the context of FLG null genotype). Major limitations of published studies were the low numbers of individuals (ranging from five to 94) with AD and FLG loss-of-function mutations and exposure to specific environmental factors, and variation in exposure definitions. CONCLUSIONS Evidence on FLG-environment interactions in AD aetiology is limited. However, many of the studies lacked large enough sample sizes to assess these interactions fully. Further research is needed with larger sample sizes and clearly defined exposure assessment. Linked Comment: Park and Seo. Br J Dermatol 2020; 183:411.
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Affiliation(s)
- H. Blakeway
- Faculty of Health SciencesUniversity of BristolBristol Medical SchoolOakfield HouseOakfield GroveBristolBS8 2BNU.K.
| | - V. Van‐de-Velde
- Department of DermatologyLauriston Building, Lauriston PlaceEdinburghEH3 9HAU.K.
| | - V.B. Allen
- Department of InfectionSt. Thomas’ HospitalWestminster Bridge RdLambeth, LondonSE1 7EHU.K.
| | - G. Kravvas
- Department of DermatologyLauriston Building, Lauriston PlaceEdinburghEH3 9HAU.K.
| | - L. Palla
- Department of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonU.K.
| | - M.J. Page
- School of Public Health and Preventive MedicineMonash UniversityLevel 4, 553 St Kilda RoadMelbourne3004Australia
| | - C. Flohr
- Unit for Population‐Based Dermatology ResearchSt John's Institute of DermatologyGuy's & St Thomas’ NHS Foundation Trust & King's College LondonStrand, LondonWC2R 2LSU.K.
| | - R.B. Weller
- Department of DermatologyLauriston Building, Lauriston PlaceEdinburghEH3 9HAU.K.
| | - A.D. Irvine
- Clinical MedicineTrinity College DublinDublinIreland,The National Children's Research CentreCrumlinIreland,DermatologyChildren's Health IrelandCrumlinIreland
| | - T. McPherson
- Churchill HospitalOld RoadHeadington, OxfordOX3 7LEU.K.
| | - A. Roberts
- Nottingham Support Group for Carers of Children with EczemaNottinghamU.K.
| | - H.C. Williams
- Centre of Evidence‐Based DermatologyUniversity of NottinghamNottinghamNG7 2NRU.K.
| | - N. Reynolds
- DermatologyRoyal Victoria InfirmaryNHS Foundation TrustNewcastle upon TyneU.K.,Institute of Cellular MedicineFaculty of Medical SciencesNewcastle UniversityNewcastle upon TyneU.K.
| | - S.J. Brown
- Skin Research Group, Division of Molecular and Clinical MedicineSchool of MedicineUniversity of DundeeDundeeDD1 9SYU.K.,Department of DermatologyNinewells HospitalDundeeDD1 9SYU.K.
| | - L. Paternoster
- MRC Integrative Epidemiology Unit at the University of BristolPopulation Health SciencesBristol Medical School, Oakfield House, Oakfield GroveBristolBS8 2BNU.K.
| | - S.M. Langan
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonWC1E 7HTU.K.,Health Data Research UKLondonU.K.
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Wong A, Frøslev T, Forbes H, Kjærsgaard A, Mulick A, Mansfield K, Silverwood R, Sørensen H, Smeeth L, Schmidt S, Langan S. Partner bereavement and risk of psoriasis and atopic eczema: cohort studies in the U.K. and Denmark. Br J Dermatol 2020; 183:321-331. [PMID: 31782133 PMCID: PMC7496681 DOI: 10.1111/bjd.18740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Stress is commonly cited as a risk factor for psoriasis and atopic eczema, but such evidence is limited. OBJECTIVES To investigate the association between partner bereavement (an extreme life stressor) and psoriasis or atopic eczema. METHODS We conducted cohort studies using data from the U.K. Clinical Practice Research Datalink (1997-2017) and Danish nationwide registries (1997-2016). The exposed cohort was partners who experienced partner bereavement. The comparison cohort was up to 10 nonbereaved partners, matched to each bereaved partner by age, sex, county of residence (Denmark) and general practice (U.K.). Outcomes were the first recorded diagnosis of psoriasis or atopic eczema. We estimated hazard ratios (HRs) and confidence intervals (CIs) using a stratified Cox proportional hazards model in both settings, which were then pooled in a meta-analysis. RESULTS The pooled adjusted HR for the association between bereavement and psoriasis was 1·01 (95% CI 0·98-1·04) across the entire follow-up. Similar results were found in other shorter follow-up periods. Pooled adjusted HRs for the association between bereavement and atopic eczema were 0·97 (95% CI 0·84-1·12) across the entire follow-up, 1·09 (95% CI 0·86-1·38) within 0-30 days, 1·18 (95% CI 1·04-1·35) within 0-90 days, 1·14 (95% CI 1·06-1·22) within 0-365 days and 1·07 (95% CI 1·02-1·12) within 0-1095 days. CONCLUSIONS We found a modest increase in the risk of atopic eczema within 3 years following bereavement, which peaked in the first 3 months. Acute stress may play a role in triggering onset of new atopic eczema or relapse of atopic eczema previously in remission. We observed no evidence for increased long-term risk of psoriasis and atopic eczema following bereavement.
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Affiliation(s)
- A.Y.S. Wong
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
| | - T. Frøslev
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - H.J. Forbes
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research U.K.LondonU.K
| | - A. Kjærsgaard
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - A. Mulick
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
| | - K. Mansfield
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
| | - R.J. Silverwood
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
- Centre for Longitudinal StudiesDepartment of Social ScienceUniversity College LondonLondonU.K
| | - H.T. Sørensen
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - L. Smeeth
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research U.K.LondonU.K
| | - S.A.J. Schmidt
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
- Department of DermatologyAarhus University HospitalAarhusDenmark
| | - S.M. Langan
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research U.K.LondonU.K
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Yiu Z, Parisi R, Lunt M, Warren R, Griffiths C, Langan S, Ashcroft D. 399 Risk of hospitalization due to infection in patients with psoriasis: A population-based cohort study using the UK Clinical Practice Research Datalink. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kern C, Wan J, Lewinn K, Langan S, Abuabara K. 482 Longitudinal cohort study of the association between atopic dermatitis and depression throughout childhood. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Al-Alusi N, Ramirez F, Langan S, Abuabara K. 435 The association between tobacco smoke exposure during childhood and adolescence and atopic dermatitis activity and severity. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lee Y, Tomaszewski N, Langan S, Abuabara K. 466 The relationship between atopic dermatitis and childhood symptoms of attention deficit/hyperactivity disorder: A longitudinal cohort study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bhate K, Lin L, Barbieri J, Mathur R, Sinnott S, Langan S. 375 The association between antibiotics for acne and subsequent infection sequelae and antimicrobial resistance: A systematic review. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Gibson J, Dobbs T, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan S, Hutchings H, Lyons R, Whitaker I. The association of smoking and socioeconomic status on melanoma skin cancer. Br J Dermatol 2020. [DOI: 10.1111/bjd.18997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Gibson J, Dobbs T, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan S, Hutchings H, Lyons R, Whitaker I. 吸烟和社会经济地位与黑色素瘤皮肤癌的关联. Br J Dermatol 2020. [DOI: 10.1111/bjd.19008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan S, Santer M. How young people adapt to living with eczema. Br J Dermatol 2020. [DOI: 10.1111/bjd.18649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan S, Santer M. 年轻人如何适应与湿疹共存. Br J Dermatol 2020. [DOI: 10.1111/bjd.18666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Venables Z, Nijsten T, Wong K, Autier P, Broggio J, Deas A, Harwood C, Hollestein L, Langan S, Morgan E, Proby C, Rashbass J, Leigh I. Epidemiology of BCC and cSCC in the U.K. 2013‐15. Br J Dermatol 2019. [DOI: 10.1111/bjd.18275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Venables Z, Nijsten T, Wong K, Autier P, Broggio J, Deas A, Harwood C, Hollestein L, Langan S, Morgan E, Proby C, Rashbass J, Leigh I. 英国 2013–15 BCC 和 cSCC 的流行病学. Br J Dermatol 2019. [DOI: 10.1111/bjd.18287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Ye M, Langan S, Abuabara K. 214 Patterns of atopic eczema disease activity from birth through mid-adulthood in two British birth cohorts. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Smirnova J, Kobyletzki L, Lindberg M, Svensson Å, Langan S, Montgomery S. 特应性皮炎和教育程度. Br J Dermatol 2019. [DOI: 10.1111/bjd.17566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Smirnova J, Kobyletzki L, Lindberg M, Svensson Å, Langan S, Montgomery S. Atopic dermatitis and educational attainment. Br J Dermatol 2019. [DOI: 10.1111/bjd.17550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Solman L, Glover M, Beattie P, Buckley H, Clark S, Gach J, Giardini A, Helbling I, Hewitt R, Laguda B, Langan S, Martinez A, Murphy R, Proudfoot L, Ravenscroft J, Shahidullah H, Shaw L, Syed S, Wells L, Flohr C. BSPD guidelines for treatment of IH with propranolol. Br J Dermatol 2018. [DOI: 10.1111/bjd.17053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Solman L, Glover M, Beattie P, Buckley H, Clark S, Gach J, Giardini A, Helbling I, Hewitt R, Laguda B, Langan S, Martinez A, Murphy R, Proudfoot L, Ravenscroft J, Shahidullah H, Shaw L, Syed S, Wells L, Flohr C. 使用普萘洛尔治疗IH的BSPD指南. Br J Dermatol 2018. [DOI: 10.1111/bjd.17069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dizon M, Yu A, Singh R, Wan J, Chren M, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol 2018; 178:1280-1287. [PMID: 29336013 PMCID: PMC6033033 DOI: 10.1111/bjd.16340] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Routinely collected electronic health data obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in routinely collected electronic health data differ, and it is unknown how this might affect study results. OBJECTIVES To evaluate how patients with AD have been identified in studies using routinely collected electronic health data, to determine whether these methods were validated and to estimate how the method for identifying patients with AD affected variability in prevalence estimates. METHODS We systematically searched PubMed, Embase and Web of Science for studies using routinely collected electronic health data that reported on AD as a primary outcome. Studies of localized AD and other types of dermatitis were excluded. The protocol for this review was registered in PROSPERO (CRD42016037968). RESULTS In total, 59 studies met eligibility criteria. Medical diagnosis codes for inclusion and exclusion, number of occasions of a code, type of provider associated with a code and prescription data were used to identify patients with AD. Only two studies described validation of their methods and no study reported on disease severity. Prevalence estimates ranged from 0·18% to 38·33% (median 4·91%) and up to threefold variation in prevalence was introduced by differences in the method for identifying patients with AD. CONCLUSIONS This systematic review highlights the need for clear reporting of methods for identifying patients with AD in routinely collected electronic health data to allow for meaningful interpretation and comparison of results.
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Affiliation(s)
- M.P. Dizon
- Program for Clinical ResearchDepartment of DermatologyUniversity of CaliforniaSan Francisco School of MedicineSan FranciscoCAU.S.A.
| | - A.M. Yu
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - R.K. Singh
- University of California, Los AngelesDavid Geffen School of Medicine at UCLALos AngelesCAU.S.A.
| | - J. Wan
- Department of DermatologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
| | - M.‐M. Chren
- Department of DermatologyVanderbilt University Medical CenterNashvilleTN 37204U.S.A.
| | - C. Flohr
- Unit for Population‐Based Dermatology ResearchSt John's Institute of DermatologyGuy's & St Thomas' NHS Foundation Trust and King's College LondonChicagoILU.S.A.
| | - J.I. Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoILU.S.A.
| | - D.J. Margolis
- Department of DermatologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
- Department of Biostatistics, Epidemiology and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
| | - S.M. Langan
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K.
| | - K. Abuabara
- Program for Clinical ResearchDepartment of DermatologyUniversity of CaliforniaSan Francisco School of MedicineSan FranciscoCAU.S.A.
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Dizon M, Yu A, Singh R, Wan J, Chren MM, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol 2018. [DOI: 10.1111/bjd.16749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Dizon M, Yu A, Singh R, Wan J, Chren MM, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. 使用定期收集的健康数据的研究中特应性皮炎疾病定义的系统综述. Br J Dermatol 2018. [DOI: 10.1111/bjd.16761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Jain A, van Hoek A, Walker J, Forbes H, Langan S, Root A, Smeeth L, Thomass S. 带状疱疹疾病负担的不均衡:基于人群的队列研究. Br J Dermatol 2018. [DOI: 10.1111/bjd.16763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Jain A, van Hoek A, Walker J, Forbes H, Langan S, Root A, Smeeth L, Thomas S. Inequalities in zoster disease burden: a population-based cohort study to identify social determinants using linked data from the U.K. Clinical Practice Research Datalink. Br J Dermatol 2018; 178:1324-1330. [PMID: 29388189 PMCID: PMC6033149 DOI: 10.1111/bjd.16399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Zoster vaccination was introduced in England in 2013, where tackling health inequalities is a statutory requirement. However, specific population groups with higher zoster burden remain largely unidentified. OBJECTIVES To evaluate health inequalities in zoster disease burden prior to zoster vaccine introduction in England. METHODS This population-based cohort study used anonymized U.K. primary care data linked to hospitalization and deprivation data. Individuals aged ≥ 65 years without prior zoster history (N = 862 470) were followed from 1 September 2003 to 31 August 2013. Poisson regression was used to obtain adjusted rate ratios (ARRs) for the association of sociodemographic factors (ethnicity, immigration status, individuals' area-level deprivation, care home residence, living arrangements) with first zoster episode. Possible mediation by comorbidities and immunosuppressive medications was also assessed. RESULTS There were 37 014 first zoster episodes, with an incidence of 8·79 [95% confidence interval (CI) 8·70-8·88] per 1000 person-years at risk. In multivariable analyses, factors associated with higher zoster rates included care home residence (10% higher vs. those not in care homes), being a woman (16% higher vs. men), nonimmigrants (~30% higher than immigrants) and white ethnicity (for example, twice the rate compared with those of black ethnicity). Zoster incidence decreased slightly with increasing deprivation (ARR most vs. least deprived 0·96 (95% CI 0·92-0·99) and among those living alone (ARR 0·96, 95% CI 0·94-0·98). Mediating variables made little difference to the ARR of social factors but were themselves associated with increased zoster burden (ARR varied from 1·11 to 3·84). CONCLUSIONS The burden of zoster was higher in specific sociodemographic groups. Further study is needed to ascertain whether these individuals are attending for zoster vaccination.
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Affiliation(s)
- A. Jain
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - A.J. van Hoek
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - J.L. Walker
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
- Statistics, Modelling and Economics DepartmentPublic Health England61 Colindale AvenueLondonNW9 5EQU.K.
| | - H.J. Forbes
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - S.M. Langan
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - A. Root
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - L. Smeeth
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
| | - S.L. Thomas
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTU.K.
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Jain A, van Hoek A, Walker J, Forbes H, Langan S, Root A, Smeeth L, Thomas S. Inequalities in zoster disease burden: a population-based cohort study to identify social determinants using linked data from the U.K. Clinical Practice Research Datalink. Br J Dermatol 2018. [DOI: 10.1111/bjd.16751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Sibbald C, Park C, Leonardi-Bee J, Ratib S, Thomas K, Langan S. 276 Systematic review of autoimmune comorbidities in vitiligo. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Transparent reporting of routinely-collected data studies is key to producing valid and reliable research that can inform decisions about patient care and health systems. This article discusses some of the unique challenges in using these data sources, and explains how the REporting of studies Conducted using Observational Routinely-collected Data (RECORD) guidelines were developed to help researchers and journals to maintain a high level of quality in reporting of healthcare studies using routinely-collected data.
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Affiliation(s)
- K Harron
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
| | - E Benchimol
- Department of Pediatrics and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.,Institute for Clinical Evaluative Sciences, Ottawa, Canada
| | - S Langan
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine
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Abuabara K, Kohn L, Langan S. 221 Does atopic dermatitis remain a disease of the advantaged in adulthood? A national birth cohort study. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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39
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Yu A, Okhovat J, Allen I, Langan S, Abuabara K. 228 The prevalence of eczema beyond childhood: A systematic review and meta-analysis of longitudinal studies. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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40
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Werner RN, Nikkels AF, Marinović B, Schäfer M, Czarnecka-Operacz M, Agius AM, Bata-Csörgő Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis. J Eur Acad Dermatol Venereol 2017; 31:9-19. [PMID: 27804172 DOI: 10.1111/jdv.13995] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/23/2016] [Indexed: 12/15/2022]
Abstract
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of postherpetic neuralgia and other complications. The guideline development followed a structured and predefined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this first part of the guideline, diagnostic means have been evaluated. The expert panel formally consented recommendations for the management of patients with (suspected) HZ, referring to the assessment of HZ patients, considering various specific clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.
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Affiliation(s)
- R N Werner
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A F Nikkels
- Department of Dermatology, University Medical Center of Liège, Liège, Belgium
| | - B Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Schäfer
- Department of Anesthesiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Czarnecka-Operacz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - A M Agius
- Department of Otorhinolaryngology, The Medical School, University of Malta, Msida, Malta
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - J Breuer
- Division of Infection and Immunity, University College London, London, UK
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - G E Gross
- Department of Dermatology and Venerology, Universitätsklinik Rostock, Rostock, Germany
| | - S Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R Lapid-Gortzak
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T H Lesser
- Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
| | - U Pleyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - G M Verjans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - P Wutzler
- Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany
| | - C Dressler
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - R Erdmann
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Rosumeck
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Nast
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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41
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Affiliation(s)
- S.-J. Sinnott
- Department of Non-Communicable Disease Epidemiology; London School of Hygiene & Tropical Medicine; Keppel St London WC1E 7HT U.K
| | - K. Bhate
- Department of Non-Communicable Disease Epidemiology; London School of Hygiene & Tropical Medicine; Keppel St London WC1E 7HT U.K
| | - D.J. Margolis
- Department of Dermatology and Centre for Clinical Epidemiology and Biostatistics; University of Pennsylvania; Philadelphia PA 19104-4283 U.S.A
| | - S.M. Langan
- Department of Non-Communicable Disease Epidemiology; London School of Hygiene & Tropical Medicine; Keppel St London WC1E 7HT U.K
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42
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Werner RN, Nikkels AF, Marinović B, Schäfer M, Czarnecka-Operacz M, Agius AM, Bata-Csörgő Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: Treatment. J Eur Acad Dermatol Venereol 2016; 31:20-29. [PMID: 27579792 DOI: 10.1111/jdv.13957] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/12/2016] [Indexed: 11/29/2022]
Abstract
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications. The guideline development followed a structured and pre-defined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence-Based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this second part of the guideline, therapeutic interventions have been evaluated. The expert panel formally consented recommendations for the treatment of patients with HZ (antiviral medication, pain management, local therapy), considering various clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.
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Affiliation(s)
- R N Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A F Nikkels
- Department of Dermatology, University Medical Center of Liège, Liège, Belgium
| | - B Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Schäfer
- Department of Anesthesiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Czarnecka-Operacz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - A M Agius
- Department of Otorhinolaryngology, The Medical School, University of Malta, Msida, Malta
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - J Breuer
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G E Gross
- Department of Dermatology and Venerology, Universitätsklinik Rostock, Rostock, Germany
| | - S Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R Lapid-Gortzak
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T H Lesser
- Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
| | - U Pleyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - G M Verjans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - P Wutzler
- Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany
| | - C Dressler
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - R Erdmann
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Rosumeck
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
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Ren Z, Hsu D, Brieva J, Silverberg N, Langan S, Silverberg J. Hospitalization, inpatient burden and comorbidities associated with bullous pemphigoid in the U.S.A. Br J Dermatol 2016; 176:87-99. [DOI: 10.1111/bjd.14821] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Z. Ren
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
- The Graduate School Northwestern University Chicago IL 60611 U.S.A
| | - D.Y. Hsu
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
| | - J. Brieva
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
| | - N.B. Silverberg
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY U.S.A
| | - S.M. Langan
- Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London U.K
| | - J.I. Silverberg
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
- Departments of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
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Hsu D, Brieva J, Sinha A, Langan S, Silverberg J. Comorbidities and inpatient mortality for pemphigus in the U.S.A. Br J Dermatol 2016; 174:1290-8. [DOI: 10.1111/bjd.14463] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 01/16/2023]
Affiliation(s)
- D.Y. Hsu
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
| | - J. Brieva
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
| | - A.A. Sinha
- Department of Dermatology Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY U.S.A
| | - S.M. Langan
- Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London U.K
| | - J.I. Silverberg
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
- Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL 60611 U.S.A
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Affiliation(s)
- S.M. Langan
- London School of Hygiene and Tropical Medicine; London U.K
| | - E.I. Benchimol
- Children's Hospital of Eastern Ontario (CHEO) Research Institute; Ottawa Ontario Canada
- School of Epidemiology; Public Health and Preventive Medicine; Faculty of Medicine; University of Ottawa; Ottawa Canada
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Langan S, Smeeth L, West J. Reply to: Validation of database search strategies for the epidemiological study of pemphigus and pemphigoid. Br J Dermatol 2016; 174:696-7. [DOI: 10.1111/bjd.14397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S.M. Langan
- Faculty of Epidemiology and Population Health; London School of Hygiene and Tropical Medicine; London U.K
| | - L. Smeeth
- Faculty of Epidemiology and Population Health; London School of Hygiene and Tropical Medicine; London U.K
| | - J. West
- Department of Epidemiology; University of Nottingham; Nottingham U.K
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Chen MY, Langan S, Benchimol EI. Routinely collected electronic health data and STI research: RECORD extension to the STROBE guidelines. Sex Transm Infect 2015; 92:2-3. [PMID: 26668088 DOI: 10.1136/sextrans-2015-052360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/14/2015] [Indexed: 11/03/2022] Open
Affiliation(s)
- M Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia Central Clinical School, Monash University, Melbourne, Australia
| | - S Langan
- London School of Hygiene and Tropical Medicine, London, UK St John's Institute of Dermatology, London, UK
| | - E I Benchimol
- Department of Pediatrics and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada Institute for Clinical Evaluative Sciences, Ottawa, Canada
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Langan S, Schmitt J, Williams H, Smith S, Thomas K. How are eczema ‘flares’ defined? A systematic review and recommendation for future studies. Br J Dermatol 2014; 170:548-56. [DOI: 10.1111/bjd.12747] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 01/06/2023]
Affiliation(s)
- S.M. Langan
- Department of Epidemiology and Population Health; London School of Hygiene and Tropical Medicine; Keppel Street London WC1E 7HT U.K
| | - J. Schmitt
- Centre for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus, der Technischen Universität Dresden; Dresden Germany
| | - H.C. Williams
- Centre of Evidence-based Dermatology; University of Nottingham; Nottingham U.K
| | - S. Smith
- Centre of Evidence-based Dermatology; University of Nottingham; Nottingham U.K
| | - K.S. Thomas
- Centre of Evidence-based Dermatology; University of Nottingham; Nottingham U.K
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Patel A, Langan S, Batchelor J. A randomized trial of methotrexate vs. azathioprine for severe atopic eczema: a critical appraisal. Br J Dermatol 2012; 166:701-4; discussion 704. [DOI: 10.1111/j.1365-2133.2012.10872.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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