Inhaled steroids and mortality in COPD: bias from unaccounted immortal time.
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Administration, Inhalation↗
Biomedical subjects
V A Kiri
Publications and source records attributed to V A Kiri.
Increasing prevalence of asthma in UK primary care during the 1990s.
OBJECTIVE: To estimate recent prevalence trends of physician-diagnosed asthma in primary care in the UK, and to test the hypothesis that the asthma epidemic in the UK peaked in the mid-1990s and is currently declining. METHODS: A retrospective cohort of asthma patients was obtained from the General Practice Research Database (GPRD). From January 1990 to February 1999, asthmatics were followed up to death, censoring or mention of chronic obstructive pulmonary disease (COPD) in their clinical record. Prevalence rates of ever and managed asthma were obtained by sex, age and calendar year. RESULTS AND CONCLUSION: From 1990 to 1998, annual prevalence rates of managed physician-diagnosed asthma in women rose from 3.01% (95%CI 2.99-3.03) to 5.14% (95%CI 5.10-5.18), and in men from 3.44% (95%CI 3.41-3.46) to 5.06% (95 %CI 5.02-5.10) (P for trend <0.01 in both). In 1998, prevalence rates of managed asthma in children aged 5-14 affected 7.86% (95%CI 7.71-8.00) of girls and 10.30% (95%CI 10.15-10.47) of boys. Increasing prevalence rates in adult asthma (maximum 4.11% in 1998, 95%CI 4.03-4.19) and elderly asthma (maximum 3.37% in 1998, 95%CI 3.29-3.46) were observed as well in 1998. The study shows that the burden of asthma in UK primary care during the 1990s was still increasing.
Adult↗
Talocalcaneal coalition. Diagnosis with the C-sign on lateral radiographs of the ankle.
We analysed 42 weight-bearing lateral radiographs of the ankle, 20 of which were from patients with a clinical and plain radiological diagnosis of talocalcaneal coalition (TCC) who subsequently had CT. The remainder were from 22 healthy volunteers with no clinical findings suggestive of hindfoot pathology. Four observers, blinded to the CT findings, independently evaluated the radiographs on two separate occasions. With the 95% confidence interval and using the CT findings as the comparison we calculated the sensitivity, specificity, accuracy, and positive and negative predictive values for the C-sign, and for other signs known to be associated with TCC. Similarly, we also calculated the interobserver and intraobserver reliability for these signs using the kappa statistic. Our results suggest that the C-sign is highly sensitive and specific for TCC. It is an accurate indicator and significantly more reliable than other previously recognised radiological signs of TCC. Features of the C-sign, however, cannot be relied upon to indicate whether the TCC is fibrous or bony.
Adult↗
Life expectancy in England: variations and trends by gender, health authority, and level of deprivation.
STUDY OBJECTIVES: To investigate variations and trends in life expectancy in English district health authorities in relation to gender and Jarman deprivation level. DESIGN: Mortality data for English health authorities from 1984-94, compiled by the Office for National Statistics, were assessed conventionally and using life table techniques. SETTING: District health authorities in England. MAIN OUTCOME MEASURES: Life expectancies in the 105 DHAs in relation to rank, to gender, and to deprivation category based on the census based Jarman score. CONCLUSIONS: Differences in life expectancy had widened over the decade and prosperous areas with greatest longevity had seen the largest gains. In most deprived areas improvements in life expectancy were negligible. The greatest gender differences in life expectancy were also seen in deprived areas.
Aged↗
Using the proportional hazards model to study heart valve replacement data.
The proportional hazards model is used to study the effect of various concomitant variables on the time to valve failure, mortality, or other complications, for patients who have had artificial heart valves inserted. The data are from a database, which is still being assembled as more information is acquired, at Killingbeck Hospital. A suite of computer programs, not specifically developed with this application in mind, has been used to carry out the exploratory data analysis, the estimation of parameters and the validation of the model. These three elements of the analysis are all illustrated. The present report is seen as a preliminary study to assess the usefulness of the proportional hazards model in this area. Follow-up work as more data are accumulated is intended.
Bioprosthesis↗