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1.

001-es BibID:BIBFORM112201
035-os BibID:(cikkazonosító)e0194772 (Scopus)85046072083 (WOS)000431013300003
Első szerző:Bowden, Bethan
Cím:Risk of suicide following an alcohol-related emergency hospital admission : an electronic cohort study of 2.8 million people / Bethan Bowden, Ann John, Laszlo Trefan, Jennifer Morgan, Daniel Farewell, David Fone
Dátum:2018
ISSN:1932-6203
Megjegyzések:Objective Alcohol misuse is a well-known risk factor for suicide however, the relationship between alcohol-related hospital admission and subsequent risk of death from suicide is unknown. We aimed to determine the risk of death from suicide following emergency admission to hospital with an alcohol-related cause. Methods We established an electronic cohort study of all 2,803,457 residents of Wales, UK, aged from 10 to under 100 years on 1 January 2006 with six years' follow-up. The outcome event was death from suicide defined as intentional self-harm (ICD-10 X60-84) or undetermined intent (Y10-34). The main exposure was an alcohol-related admission defined as a `wholly attributable' ICD-10 alcohol code in the admission record. Admissions were coded for the presence or absence of co-existing psychiatric morbidity. The analysis was by Cox regression with adjustments for confounding variables within the dataset. Results During the study follow-up period, there were 15,546,355 person years at risk with 28,425 alcohol-related emergency admissions and 1562 suicides. 125 suicides followed an admission (144.6 per 100,000 person years), of which 11 (9%) occurred within 4 weeks of discharge. The overall adjusted hazard ratio (HR) for suicide following admission was 26.8 (95% confidence interval (CI) 18.8 to 38.3), in men HR 9.83 (95% CI 7.91 to 12.2) and women HR 28.5 (95% CI 19.9 to 41.0). The risk of suicide remained substantial in subjects without known co-existing psychiatric morbidity: HR men 8.11 (95% CI 6.30 to 10.4) and women HR 24.0 (95% CI 15.5 to 37.3). The analysis was limited by the absence in datasets of potentially important confounding variables and the lack of information on alcohol-related harm and psychiatric morbidity in subjects not admitted to hospital. Conclusion Emergency alcohol-related hospital admission is associated with an increased risk of suicide. Identifying individuals in hospital provides an opportunity for psychosocial assessment and suicide prevention of a targeted at-risk group before their discharge to the community.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Plos One. - 13 : 4 (2018), p. 1-13. -
További szerzők:John, Ann Trefán László (1969-) (biostatisztikus, bioinformatikus) Morgan, Jennifer Farewell, Daniel Fone, David
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2.

001-es BibID:BIBFORM113422
Első szerző:Fone, David
Cím:Change in alcohol outlet density and alcohol-related harm to population health (CHALICE) : a comprehensive record-linked database study in Wales / David Fone, Jennifer Morgan, Richard Fry, Sarah Rodgers, Scott Orford, Daniel Farewell, Frank Dunstan, James White, Vas Sivarajasingam, Laszlo Trefan, Iain Brennan, Shin Lee, Narushige Shiode, Alison Weightman, Chris Webster and Ronan Lyons
Dátum:2016
ISSN:2050-4381 2050-439X
Megjegyzések:What was the problem/question? We know that excess alcohol consumption causes harmful effects to health and also leads to violence. We did not know whether or not a change in the availability of alcohol could lead to a change in the harm caused by alcohol. Our aim was to study patterns of harm in Wales related to changes in alcohol availability. We also wanted to see if the amount of harm was different in areas that were higher or lower in social deprivation. What did we do? To measure alcohol availability we took the average of the distances between all households and all licensed alcohol premises within a small geographical area. We then analysed the link between our new measure of alcohol availability and anonymised data from the Welsh Health Survey, hospital records and the police. We looked at harmful outcomes such as excessive alcohol consumption, hospital admissions and violent crimes. What did we find? We found that higher availability of alcohol and change over time were related to an increase in alcohol-related harm. We found that the patterns of harm were not the same across Wales. We found that more deprived local authority areas had higher levels of poorer health caused by alcohol and more violent crime. What does this mean? Our results suggest that changes in alcohol availability are related to the harmful effects of alcohol. We are now sharing our findings with the NHS, local government and alcohol charities. We aim to influence policy and practice to improve population health and reduce health inequality.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Public Health Research. - 4 : 3 (2016), p. 1-184. -
További szerzők:Morgan, Jennifer Fry, Richard Rodgers, Sarah Orford, Scott Farewell, Daniel Dunstan, Frank White, James Sivarajasingam, Vas Trefán László (1969-) (biostatisztikus, bioinformatikus) Brennan, Iain Lee, Shin Shiode, Narushige Weightman, Alison Webster, Chris Lyons, Ronan Anthony
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Intézményi repozitóriumban (DEA) tárolt változat
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3.

001-es BibID:BIBFORM112975
035-os BibID:(Scopus)85047382992 (WOS)000440723800006
Első szerző:Gartner, Andrea
Cím:Does selective migration alter socioeconomic inequalities in mortality in Wales? : a record-linked total population e-cohort study / Andrea Gartner, Daniel Farewell, Giles Greene, Laszlo Trefan, Alisha Davies, David Fone, Shantini Paranjothy
Dátum:2018
ISSN:2352-8273
Megjegyzések:Recent studies found evidence of health selective migration whereby healthy people move to less deprived areas and less healthy people move to or stay in more deprived areas. There is no consensus, however, on whether this influences health inequalities. Measures of socio-economic inequalities in mortality and life expectancy are widely used by government and health services to track changes over time but do not consider the effect of migration. This study aims to investigate whether and to what extent migration altered the observed socioeconomic gradient in mortality. Data for the population of Wales (3,136,881) registered with the National Health Service on 01/01/2006 and follow-up for 24 quarters were individually record-linked to ONS mortality files. This included moves between lower super output areas (LSOAs), deprivation quintiles and rural-urban class at each quarter, age, sex, and date of death. Cox regression models were used to estimate the hazard ratios for the deprivation quintiles in all-cause mortality, as well as deprivation change between the start and end of the study. We found evidence of health selective migration in some groups, for example people aged under 75 leaving the most deprived areas having a higher mortality risk than those they left behind, suggesting widening inequalities, but also found the opposite pattern for other migration groups. For all ages, those who lived in the most deprived quintile had a 57% higher risk of death than those in the least deprived quintile, allowing deprivation to vary with moves over time. There was little change in this risk when people were artificially kept in their deprivation quintile of origin (54% higher). Overall, migration during the six year window did not substantially alter the deprivation gradient in mortality in Wales between 2006 and 2011.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:SSM - Population Health. - 5 (2018), p. 48-54. -
További szerzők:Farewell, Daniel Greene, Giles Jeremy Trefán László (1969-) (biostatisztikus, bioinformatikus) Davies, Alisha Fone, David Paranjothy, Shantini
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Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM112203
035-os BibID:(WOS)000894823500025 (cikkazonosító)1373 (Scopus)85104890786
Első szerző:Trefán László (biostatisztikus, bioinformatikus)
Cím:Visualisation and optimisation of alcohol-related hospital admissions ICD-10 codes in Welsh e-cohort data / Laszlo Trefan, Ashley Akbari, Jennifer Siân Morgan, Daniel Mark Farewell, David Fone, Ronan A. Lyons, Hywel Merfyn Jones, Simon Moore
Dátum:2021
ISSN:2399-4908
Megjegyzések:Introduction The excessive consumption of alcohol is detrimental to long term health and increases the likelihood of hospital admission. However, definitions of alcohol-related hospital admission vary, giving rise to uncertainty in the effect of alcohol on alcohol-related health care utilization. Objectives To compare diagnostic codes on hospital admission and discharge and to determine the ideal combination of codes necessary for an accurate determination of alcohol-related hospital admission. Methods Routine population-linked e-cohort data were extracted from the Secure Anonymised Information Linkage (SAIL) Databank containing all alcohol-related hospital admissions (n,= 92,553) from 2006 to 2011 in Wales, United Kingdom. The distributions of the diagnostic codes recorded at admission and discharge were compared. By calculating a misclassification rate (sensitivity-like measure) the appropriate number of coding fields to examine for alcohol-codes was established. Results There was agreement between admission and discharge codes. When more than ten coding fields were used the misclassification rate was less than 1%. Conclusion With the data at present and alcohol-related codes used, codes recorded at admission and discharge can be used equivalently to identify alcohol-related admissions. The appropriate number of coding fields to examine was established: fewer than ten is likely to lead to under-reporting of alcohol-related admissions. The methods developed here can be applied to other medical conditions that can be described using a certain set of diagnostic codes, each of which can be a known sole cause of the condition and recorded in multiple positions in e-cohort data.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:International Journal of Population Data Science. - 6 : 1 (2021), p. 1-12. -
További szerzők:Akbari, Ashley Morgan, Jennifer Farewell, Daniel Fone, David Lyons, Ronan Anthony Jones, Hywel Merfyn Moore, Simon
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Intézményi repozitóriumban (DEA) tárolt változat
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5.

001-es BibID:BIBFORM112202
035-os BibID:(cikkazonosító)581 (Scopus)85076323499
Első szerző:Trefán László (biostatisztikus, bioinformatikus)
Cím:Electronic Longitudinal Alcohol Study in Communities (ELAStiC) Wales - protocol for platform development / Trefan, L., Akbari, A., Paranjothy, S., Farewell, D. M., Gartner, A., Fone, D., Greene, G. J., Evans, A., Smith, A., Adekanmbi, V., Kennedy, J., Lyons, R. A., Moore, S.
Dátum:2019
ISSN:2399-4908
Megjegyzések:Introduction Excessive alcohol consumption has adverse effects on health and there is a recognised need for the longitudinal analysis of population data to improve our understanding of the patterns of alcohol use, harms to consumers and those in their immediate environment. The UK has a number of linkable, longitudinal databases that if assembled properly could support valuable research on this topic. Aims and Objectives This paper describes the development of a broad set of cross-linked cohorts, e-cohorts, surveys and linked electronic healthcare records (EHRs) to construct an alcohol-specific analytical platform in the United Kingdom using datasets on the population of Wales. The objective of this paper is to provide a description of existing key datasets integrated with existing, routinely collected electronic health data on a secure platform, and relevant derived variables to enable population-based research on alcohol-related harm in Wales. We illustrate our use of these data with some exemplar research questions that are currently under investigation. Methods Record-linkage of routine and observational datasets. Routine data includes hospital admissions, general practice, and cohorts specific to children. Two observational studies were included. Routine socioeconomic descriptors and mortality data were also linked. Conclusion We described a record-linked, population-based research protocol for alcohol related harm on a secure platform. As the datasets used here are available in many countries, ELAStiC provides a template for setting up similar initiatives in other countries. We have also defined a number of alcohol specific variables using routinely-collected available data that can be used in other epidemiological studies into alcohol related outcomes. With over 10 years of longitudinal data, it will help to understand alcohol-related disease and health trajectories across the lifespan.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:International Journal of Population Data Science. - 4 : 1 (2019), p. 1-14. -
További szerzők:Akbari, Ashley Paranjothy, Shantini Farewell, Daniel Gartner, Andrea Fone, David Greene, Giles Jeremy Evans, Anette Smith, Ann Adekanmbi, Victor Kennedy, Jonathan Lyons, Ronan Anthony Moore, Simon
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Intézményi repozitóriumban (DEA) tárolt változat
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6.

001-es BibID:BIBFORM112199
035-os BibID:(Scopus)85066619998 (cikkazonosító)e0217598 (WOS)000470086200024
Első szerző:Trefán László (biostatisztikus, bioinformatikus)
Cím:Epidemiology of alcohol-related emergency hospital admissions in children and adolescents : an e-cohort analysis in Wales in 2006-2011 / Laszlo Trefan, Andrea Gartner, Amy Alcock, Daniel Farewell, Jennifer Morgan, David Fone, Shantini Paranjothy
Dátum:2019
ISSN:1932-6203
Megjegyzések:Objective Harmful levels of alcohol consumption in young people are prevalent and of increasing public concern in the western world. Rates of alcohol-related emergency hospital admissions in children and young people between 10 to 17 years were described, and the reasons for these admissions and their association with socio-demographic factors were examined. Methods E-cohort data were extracted from the Secure Anonymised Information Linkage Databank, which contained alcohol-related emergency hospital admissions (N = 2968) from 2006 to 2011 in children and adolescents aged 10 to 17 years in Wales. A generalised linear mixed model was fitted using a log-link with a population offset to the data to calculate incident rate ratios (IRRSs). Results There was a general decreasing trend from 2006 to 2011 in the number and rate of alcoholrelated emergency hospital admissions; the mean age of admission was 15.4 (standard deviation 1.4) years. In each of the four youngest age groups (10?13,14,15,16 years), females had higher IRRs than males. Males had slightly higher IRR compared to females only in the oldest age group (17 years). IRRs increased with increasing deprivation. The majority (92%) of the admissions lasted one day and most of the admissions (70%) occured during the last three days of the week with a peak on Saturday. The length of stay in hospital was longer in cases when self-harm were present. Multiple admissions showed high prevalance of serio us self-harm cases in females. The number of admissions with injuries and falls were higher for males than females. Conclusion Female children and adolescents were more likely to be admitted to hospital for alcoholrelated reasons. These data illustrate the significant burden of alcohol-related harm in young people and highlight the need for interventions and policies that promote safe drinking practices among young people to prevent future alcohol-related harm during the life-course.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Plos One. - 14 : 6 (2019), p. 1-17. -
További szerzők:Gartner, Andrea Alcock, Amy Farewell, Daniel Morgan, Jennifer Fone, David Paranjothy, Shantini
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Intézményi repozitóriumban (DEA) tárolt változat
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