Stephen O’Neill
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View article: Investigating impacts of health policies using staggered difference-in-differences: the effects of adoption of an online consultation system on prescribing patterns of antibiotics
Investigating impacts of health policies using staggered difference-in-differences: the effects of adoption of an online consultation system on prescribing patterns of antibiotics Open
Since the COVID-19 pandemic, most general practices in England have adopted online consultation (OC) systems for easier access and demand management. However, there are concerns that easier access could increase demand relating to low-risk…
View article: Which interventions optimize antibiotic prescribing in primary care in England? A survey and Qualitative Comparative Analysis of NHS Integrated Care Boards
Which interventions optimize antibiotic prescribing in primary care in England? A survey and Qualitative Comparative Analysis of NHS Integrated Care Boards Open
Background Optimizing antibiotic use is a UK Government priority. This study aimed to identify which combinations of interventions are associated with meeting primary care antibiotic prescribing targets in England’s National Health Service…
View article: How did labelling provision on menus for online food delivery change following England's calorie labelling regulations?
How did labelling provision on menus for online food delivery change following England's calorie labelling regulations? Open
This study assessed the provision of calorie labelling in the digital out-of-home food sector following the implementation of mandatory calorie labelling for large businesses in England in April 2022. Using online menu data from two major …
View article: Surgery or radiotherapy for early-stage cancer study (SORT) target trial protocol: stereotactic ablative radiotherapy (SABR) with curative intent versus surgical resection for early-stage non-small cell lung cancer (NSCLC)
Surgery or radiotherapy for early-stage cancer study (SORT) target trial protocol: stereotactic ablative radiotherapy (SABR) with curative intent versus surgical resection for early-stage non-small cell lung cancer (NSCLC) Open
Introduction Randomised controlled trials have aimed to assess the effectiveness of stereotactic ablative radiotherapy (SABR) with curative intent versus surgical resection for individuals diagnosed with early-stage non-small cell lung can…
View article: Long‐term outcomes following alternative second‐line oral glucose‐lowering treatments: Results from the real‐world progression in type 2 diabetes mellitus United Kingdom ( <scp>RAPIDS</scp> ‐ <scp>UK</scp> ) model
Long‐term outcomes following alternative second‐line oral glucose‐lowering treatments: Results from the real‐world progression in type 2 diabetes mellitus United Kingdom ( <span>RAPIDS</span> ‐ <span>UK</span> ) model Open
Aims To compare long‐term complications for people with type 2 diabetes mellitus (T2DM) following second‐line treatment in routine practice with sulphonylureas (SU), dipeptidyl peptidase‐4 inhibitors (DPP4i), or sodium‐glucose co‐transport…
View article: A heterogeneity analysis of health-related quality of life in early adults born very preterm or very low birthweight across the sociodemographic spectrum
A heterogeneity analysis of health-related quality of life in early adults born very preterm or very low birthweight across the sociodemographic spectrum Open
Preterm birth and very low birthweight (VP/VLBW) are associated with poorer health-related quality of life (HRQoL) outcomes extending into adulthood, yet it remains unclear how these effects differ across sociodemographic subgroups. This s…
View article: Changes in out-of-home food purchasing following England’s calorie labelling regulations: a population-level controlled interrupted time series
Changes in out-of-home food purchasing following England’s calorie labelling regulations: a population-level controlled interrupted time series Open
Background Large out-of-home (OOH) food businesses in England have been required by law to display calorie information on menus since 6 th April 2022. This study investigates whether the implementation of this policy was associated with ch…
View article: A mixed methods protocol for an impact and implementation evaluation of the Pharmacy First Services for management of common conditions in England
A mixed methods protocol for an impact and implementation evaluation of the Pharmacy First Services for management of common conditions in England Open
Objectives In response to high levels of demand for primary medical services in England, characterized by longer appointment waiting times and delayed referrals, the Government developed its National Health Service (NHS) Primary Care Recov…
View article: Generalized framework for identifying meaningful heterogenous treatment effects in observational studies: A parametric data-adaptive G-computation approach
Generalized framework for identifying meaningful heterogenous treatment effects in observational studies: A parametric data-adaptive G-computation approach Open
There has been a renewed interest in identifying heterogenous treatment effects (HTEs) to guide personalized medicine. The objective was to illustrate the use of a step-by-step transparent parametric data-adaptive approach (the generalized…
View article: Farm-level greenhouse gas mitigation: Understanding the effect of interactions and heterogeneity
Farm-level greenhouse gas mitigation: Understanding the effect of interactions and heterogeneity Open
Mitigation of climate change remains a central focus of the European Union (EU). Under its 2030 Climate Target Plan, the European Commission proposes to raise the EU's ambition in this area, targeting a reduction in greenhouse gas emission…
View article: Subgroup differences in public attitudes, preferences and self-reported behaviour related to deceased organ donation before and after the introduction of the ‘soft’ opt-out consent system in England: mixed-methods study
Subgroup differences in public attitudes, preferences and self-reported behaviour related to deceased organ donation before and after the introduction of the ‘soft’ opt-out consent system in England: mixed-methods study Open
Background In the UK, over 7,000 people are on the waiting list for an organ transplant and there are inequalities in need, access and waiting time for organs, with notable differences between minority ethnic groups. In May 2020, England c…
View article: An Approach for Combining Clinical Judgment with Machine Learning to Inform Medical Decision Making: Analysis of Nonemergency Surgery Strategies for Acute Appendicitis in Patients with Multiple Long-Term Conditions
An Approach for Combining Clinical Judgment with Machine Learning to Inform Medical Decision Making: Analysis of Nonemergency Surgery Strategies for Acute Appendicitis in Patients with Multiple Long-Term Conditions Open
Background Machine learning (ML) methods can identify complex patterns of treatment effect heterogeneity. However, before ML can help to personalize decision making, transparent approaches must be developed that draw on clinical judgment. …
View article: Exploring Heterogeneity in the Cost-Effectiveness of High-Flow Nasal Cannula Therapy in Acutely Ill Children—Insights From the Step-Up First-line Support for Assistance in Breathing in Children Trial Using a Machine Learning Method
Exploring Heterogeneity in the Cost-Effectiveness of High-Flow Nasal Cannula Therapy in Acutely Ill Children—Insights From the Step-Up First-line Support for Assistance in Breathing in Children Trial Using a Machine Learning Method Open
The estimated overall INB of HFNC is significantly larger for specific patient subgroups, suggesting that the cost-effectiveness of HFNC can be heterogeneous, which highlights the importance of considering patient characteristics in evalua…
View article: Going beyond randomised controlled trials to assess treatment effect heterogeneity across target populations
Going beyond randomised controlled trials to assess treatment effect heterogeneity across target populations Open
Methods have been developed for transporting evidence from randomised controlled trials (RCTs) to target populations. However, these approaches allow only for differences in characteristics observed in the RCT and real‐world data (overt he…
View article: Trends in organ donation in England, Scotland and Wales in the context of the COVID-19 pandemic and ‘opt-out’ legislation
Trends in organ donation in England, Scotland and Wales in the context of the COVID-19 pandemic and ‘opt-out’ legislation Open
Background In May 2020, England implemented soft ‘opt-out’ or ‘deemed consent’ for deceased donation with the intention of raising consent rates. However, this coincided with the COVID-19 pandemic, making it difficult to assess the early i…
View article: Are there patients with an intracapsular fracture of the hip who may benefit from an uncemented hemiarthroplasty?
Are there patients with an intracapsular fracture of the hip who may benefit from an uncemented hemiarthroplasty? Open
Aims Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular fracture of the hip. However, it remains unclear whether there are subgroups of patients who may benefit from the alternative operatio…
View article: Why did England change its law on deceased organ donation in 2019? The dynamic interplay between evidence and values
Why did England change its law on deceased organ donation in 2019? The dynamic interplay between evidence and values Open
In the three years since the law on adult deceased organ donation consent in England changed to include an opt-out system, there has been no discernible change to donation rates. The lack of a positive impact on donation rates was predicte…
View article: The association of comorbid dementia with length of stay, cost and mortality among older adults in US acute hospitals: An observational study
The association of comorbid dementia with length of stay, cost and mortality among older adults in US acute hospitals: An observational study Open
Comorbid dementia is associated with longer LOS and higher mortality in acute hospitals but lower inpatient costs and fewer procedures. This highlights potential communication issues between dementia patients and hospital staff, with patie…
View article: Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: emulation of a target trial using routinely collected health data
Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: emulation of a target trial using routinely collected health data Open
Objective To compare the effectiveness of three commonly prescribed oral antidiabetic drugs added to metformin for people with type 2 diabetes mellitus requiring second line treatment in routine clinical practice. Design Cohort study emula…
View article: A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England
A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England Open
Objectives To identify and assess the effectiveness of national antibiotic optimization interventions in primary and secondary care in England (2013–2022). Methods A systematic scoping review was conducted. Literature databases (Embase and…
View article: Heterogeneity within the Oregon Health Insurance Experiment: An application of causal forests
Heterogeneity within the Oregon Health Insurance Experiment: An application of causal forests Open
Existing evidence regarding the effects of Medicaid expansion, largely focused on aggregate effects, suggests health insurance impacts some health, healthcare utilization, and financial hardship outcomes. In this study we apply causal fore…
View article: Analysis of the marginal abatement cost curve for ammonia emissions: addressing farm system heterogeneity
Analysis of the marginal abatement cost curve for ammonia emissions: addressing farm system heterogeneity Open
Agriculture is responsible for 99.4% of ammonia (NH 3 ) emissions in the Republic of Ireland and the country has failed to comply with limits set down by the European Union National Emissions Ceiling Directive (NECD) for 9 of the last 11 r…
View article: Implementing mental health support teams in schools and colleges: the perspectives of programme implementers and service providers
Implementing mental health support teams in schools and colleges: the perspectives of programme implementers and service providers Open
This study raises questions about MHSTs' service scope, what role they should play in addressing remaining gaps in mental health provision, and how EMHPs can develop the skills to work effectively with diverse groups.
View article: How does a local instrumental variable method perform across settings with instruments of differing strengths? A simulation study and an evaluation of emergency surgery
How does a local instrumental variable method perform across settings with instruments of differing strengths? A simulation study and an evaluation of emergency surgery Open
Local instrumental variable (LIV) approaches use continuous/multi‐valued instrumental variables (IV) to generate consistent estimates of average treatment effects (ATEs) and Conditional Average Treatment Effects (CATEs). There is little ev…
View article: Early evaluation of the Children and Young People’s Mental Health Trailblazer programme: a rapid mixed-methods study
Early evaluation of the Children and Young People’s Mental Health Trailblazer programme: a rapid mixed-methods study Open
Background The Children and Young People’s Mental Health Trailblazer programme is funding the creation of new mental health support teams to work in schools and further education colleges. Mental health support teams directly support child…
View article: Investigating Impacts of Health Policies Using Staggered Difference-in-Differences: The Effects of Adoption of an Online Consultation System on Prescribing Patterns of Antibiotics
Investigating Impacts of Health Policies Using Staggered Difference-in-Differences: The Effects of Adoption of an Online Consultation System on Prescribing Patterns of Antibiotics Open
We use a recently proposed staggered difference-in-differences approach to investigate effects of adoption of an online consultation system in English general practice on antibiotic prescribing patterns. The target estimand is the average …