Biomedical subjects

Michelle Hazell

Publications and source records attributed to Michelle Hazell.

4 recordsLinked to original sources

PubMed2006

Smoking, respiratory symptoms and likely asthma in young people: evidence from postal questionnaire surveys in the Wythenshawe Community Asthma Project (WYCAP).

BACKGROUND: Although it is recognised that smoking is a major risk factor for subjects with chronic obstructive pulmonary disease and is associated with respiratory symptoms, there is less agreement concerning the relationship between asthma and smoking. This study aims to examine the relationship between cigarette smoking and asthma prevalence. METHOD: Data were used from two postal questionnaire surveys (1999 and 2001) in two general practice populations, using a respiratory questionnaire based on the ECRHQ and a generic quality of life questionnaire (EQ-5D). Only subjects less than 45 years old were included in the survey. An empirical definition of likely asthma was used based on respiratory questionnaire responses. Smoking was examined according to three categories, current smoker, ex smoker and never smoker. RESULTS: Almost 3500 subjects were included in the analyses. Current smokers had a higher prevalence of likely asthma compared to never smokers, odds ratio (OR) 1.59 (95% confidence interval (CI) 1.24 to 2.04). and also compared to ex smokers OR 1.79 (CI 1.25 to 2.56), but there was no difference between ex smokers and never smokers (OR 1.00 (0.75-1.35)). Current smoking was also positively associated with all symptoms but not with a history of hayfever/eczema. CONCLUSION: Although the positive association found between current smoking and obstructive airways disease is likely to be due to the effect of cigarettes on asthma, it could reflect an association with early COPD (GOLD stages 0 or 1). Smoking cessation has a beneficial effect on the prevalence of respiratory symptoms and is therefore of paramount importance among these young adults.

Adolescent↗

PubMed2005

The perceptions of occupational health in primary care.

AIM: A random sample of general practitioners (GPs), practice nurses (PNs) and practice managers (PMs) in Sheffield and Manchester was recruited into a study to evaluate the perceptions of occupational health (OH) in primary care. METHODS: Qualitative data were collected using focus groups with three groups of primary care sector professionals. Quantitative data were collected nationally from 295 GPs using a postal questionnaire. RESULTS: GPs and PNs had minimal OH training, and 60% of GPs reported constraints in addressing OH matters with patients. The lack of referral routes (63 and 67%, respectively) was also seen as a barrier. OH was regarded as a speciality, and primary care professionals preferred to refer patients with OH problems to specialist centres because they perceived barriers to their dealing with the issues. A total of 74% of GPs surveyed thought that speedier access to secondary care would help them to address OH problems. CONCLUSIONS: This study has identified some of the problems associated with delivering OH through primary care. It also demonstrated a need for greater emphasis on OH education in medical and nurse training, and a need for better advice for GPs, PNs and PMs regarding support services for OH.

Adult↗

PubMed2005

Screening for asthma by population ranking: a validation study.

PURPOSE: A neural network system was previously developed to rank a population in order of asthma probability based on responses to a postal questionnaire. Respondents ranked higher than a percentage point screening threshold are offered clinical review. The present study validates this system in a new population that had not been involved in system development. METHODS: The system was used to rank respondents to a community survey and to predict positive predictive value (PPV) for percentage point thresholds between the top 1% and 10% of the ranking. Respondents in the top 10% were invited for clinical review. Review information and expert opinion was used to designate respondents as clinically "asthmatic" or "non-asthmatic." PPV prediction for each threshold was compared with clinical status of respondents. RESULTS: As the threshold increased from 1% to 10%, the additional yield of clinical asthmatics decreased, indicating a ranking in asthma probability order (all 7 in the top 1% were clinical asthmatics compared with 91% of the top 5% and 83% of the top 10%). Percentages of clinical asthmatics were generally slightly higher than system PPV predictions. CONCLUSIONS: The system ranked the population in asthma probability order and estimated PPV conservatively, enabling health-care providers to predict resource implications of a screening program.

Asthma↗

PubMed2003

Health related quality of life in individuals with asthma related symptoms.

BACKGROUND: Where evidence is required for disease-area prioritisation (e.g. by national policymakers), impact on health related quality of life (HRQoL) can be considered equitably across diseases using quantitative data from generic HRQoL instruments. Before this can take place, it must be shown that the instrument captures HRQoL impairment associated with each disease area. AIM: To ascertain whether the HRQoL impairment associated with respiratory disease can be represented by responses to EQ-5D, a generic HRQoL questionnaire. METHOD: EQ-5D and a respiratory health questionnaire were sent to 10,471 adults registered with two general practices in Manchester, UK. EQ-5D examines 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and includes an overall rating via visual analogue scale. Societal valuations of domain responses were also considered. RESULTS: HRQoL was substantially reduced in respondents who were likely to have obstructive airways disease (mean EQ-5D(index) 0.63 compared to 0.82, t-test P < 0.001; mean EQ-5D(vas) 62.7 compared to 77.6, t-test P < 0.001) and was negatively associated with respiratory symptoms, older age and female gender. The association with respiratory problems remained following stratification by age and gender. The deficit in HRQoL associated with increasing age was more pronounced in those likely to have obstructive airways disease. CONCLUSION: HRQoL measured using EQ-5D is substantially reduced in respondents with respiratory symptoms enabling use of the instrument in inter-disease comparisons.

Adolescent↗