Susannah Fleming
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View article: The effects of Dexmedetomidine on Recovery from Acute KIdney INjury (DRAIN): a single-center retrospective review using the Medical Information Mart for Intensive Care, fourth edition (MIMIC-IV)
The effects of Dexmedetomidine on Recovery from Acute KIdney INjury (DRAIN): a single-center retrospective review using the Medical Information Mart for Intensive Care, fourth edition (MIMIC-IV) Open
Background: Dexmedetomidine may expedite recovery from acute kidney injury (AKI) in critically ill adults. Methods: This study utilizes data from the fourth edition of the Medical Information Mart for Intensive Care (MIMIC-IV). Adult patie…
View article: Effectiveness of Influenza-Prevention Interventions among Healthcare Workers: A Systematic Review and Meta-Analysis of Health Outcomes
Effectiveness of Influenza-Prevention Interventions among Healthcare Workers: A Systematic Review and Meta-Analysis of Health Outcomes Open
Background Although studies do not provide conclusive evidence of their benefits, influenza vaccinations and face masks are recommended and even mandated to prevent influenza infections in healthcare workers (HCWs). Objectives To summarise…
View article: Effectiveness of Influenza-Prevention Interventions amongHealthcare Workers: A Systematic Review and Meta-Analysis of Health Outcomes
Effectiveness of Influenza-Prevention Interventions amongHealthcare Workers: A Systematic Review and Meta-Analysis of Health Outcomes Open
Background:Although studies do not provide conclusive evidence of their benefits, influenza vaccinations and face masks are recommended and even mandated to prevent influenza infections in Healthcare Workers (HCWs).Objectives:To summarizet…
View article: Electronic safety-netting tool features considered important by UK general practice staff: an interview and Delphi consensus study
Electronic safety-netting tool features considered important by UK general practice staff: an interview and Delphi consensus study Open
Background The potential of the electronic health record to support safety netting has been recognised and a number of electronic safety-netting (E-SN) tools developed. Aim To establish the most important features of E-SN tools. Design & s…
View article: Primary care practice and cancer suspicion during the first three COVID-19 lockdowns in the UK: a qualitative study
Primary care practice and cancer suspicion during the first three COVID-19 lockdowns in the UK: a qualitative study Open
Background The COVID-19 pandemic has profoundly affected UK primary care, and as a result the route to cancer diagnosis for many patients. Aim To explore how the pandemic affected primary care practice, in particular cancer suspicion, refe…
View article: Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care
Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care Open
Background Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of…
View article: Accuracy of parents’ subjective assessment of paediatric fever with thermometer measured fever in a primary care setting
Accuracy of parents’ subjective assessment of paediatric fever with thermometer measured fever in a primary care setting Open
Background Fever is a common symptom of benign childhood illness but a high fever may be a sign of a serious infection. Temperature is often used by parents to check for illness in their children, and the presence of a high temperature can…
View article: Long-term monitoring in primary care for chronic kidney disease and chronic heart failure: a multi-method research programme
Long-term monitoring in primary care for chronic kidney disease and chronic heart failure: a multi-method research programme Open
Background Long-term monitoring is important in chronic condition management. Despite considerable costs of monitoring, there is no or poor evidence on how, what and when to monitor. The aim of this study was to improve understanding, meth…
View article: Frequency of Renal Monitoring — Creatinine and Cystatin C (FORM-2C): an observational cohort study of patients with reduced eGFR in primary care
Frequency of Renal Monitoring — Creatinine and Cystatin C (FORM-2C): an observational cohort study of patients with reduced eGFR in primary care Open
Background Monitoring is the mainstay of chronic kidney disease management in primary care; however, there is little evidence about the best way to do this. Aim To compare the effectiveness of estimated glomerular filtration rate (eGFR) de…
View article: Is current body temperature measurement practice fit-for-purpose?
Is current body temperature measurement practice fit-for-purpose? Open
There has been a marked rise in the number of avoidable deaths in health services around the world. At the same time there has been a growing increase in antibiotic resistant so-called "superbugs." We examine here the potential role of bod…
View article: Can party balloons replace autoinflation balloons to treat glue ear? A technical comparison
Can party balloons replace autoinflation balloons to treat glue ear? A technical comparison Open
Background Autoinflation balloons are used to treat patients with otitis media with effusion (OME) to help avoid surgery. Aim To compare the ability of party balloons with Otovent balloons to produce sufficient pressure for a Valsalva mano…
View article: Non-contact infrared thermometers compared with current approaches in primary care for children aged 5 years and under: a method comparison study
Non-contact infrared thermometers compared with current approaches in primary care for children aged 5 years and under: a method comparison study Open
Background Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the chi…
View article: CASNET2: evaluation of an electronic safety netting cancer toolkit for the primary care electronic health record: protocol for a pragmatic stepped-wedge RCT
CASNET2: evaluation of an electronic safety netting cancer toolkit for the primary care electronic health record: protocol for a pragmatic stepped-wedge RCT Open
Introduction Safety-netting in primary care is the best practice in cancer diagnosis, ensuring that patients are followed up until symptoms are explained or have resolved. Currently, clinicians use haphazard manual solutions. The ubiquitou…
View article: Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability
Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability Open
Background Guidelines recommend measuring temperature in children presenting with fever using electronic axillary or tympanic thermometers. Non-contact thermometry offers advantages, yet has not been tested against recommended methods in p…
View article: Trends of blood pressure and heart rate in normal pregnancies: a systematic review and meta-analysis
Trends of blood pressure and heart rate in normal pregnancies: a systematic review and meta-analysis Open
Background Current reference ranges for blood pressure and heart rate throughout pregnancy have a poor evidence base. Methods This is a systematic review and meta-analysis. We included studies measuring blood pressure or heart rate from he…
View article: Effects of antihypertensives, lipid-modifying drugs, glycaemic control drugs and sodium bicarbonate on the progression of stages 3 and 4 chronic kidney disease in adults: a systematic review and meta-analysis
Effects of antihypertensives, lipid-modifying drugs, glycaemic control drugs and sodium bicarbonate on the progression of stages 3 and 4 chronic kidney disease in adults: a systematic review and meta-analysis Open
Objective To evaluate the effects of drug interventions that may modify the progression of chronic kidney disease (CKD) in adults with CKD stages 3 and 4. Design Systematic review and meta-analysis. Methods Searching MEDLINE, EMBASE, Datab…
View article: Mixed-methods feasibility study of blood pressure self-screening for hypertension detection
Mixed-methods feasibility study of blood pressure self-screening for hypertension detection Open
Objective To assess the feasibility of using a blood pressure (BP) self-measurement kiosk—a solid-cuff sphygmomanometer combined with technology to integrate the BP readings into patient electronic medical records— to improve hypertension …
View article: Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension
Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension Open
Background Out-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement. Aim To investigate patient experience of out-o…
View article: Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK
Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK Open
Background Blood pressure (BP) self-screening, whereby members of the public have access to BP monitoring equipment outside of healthcare consultations, may increase the detection and treatment of hypertension. Currently in the UK such opp…
View article: Current and potential providers of blood pressure self-screening: a mixed methods study in Oxfordshire
Current and potential providers of blood pressure self-screening: a mixed methods study in Oxfordshire Open
Objectives To (1) establish the extent of opportunities for members of the public to check their own blood pressure (BP) outside of healthcare consultations (BP self-screening), (2) investigate the reasons for and against hosting such a se…
View article: Capillary refill time in sick children: a clinical guide for general practice
Capillary refill time in sick children: a clinical guide for general practice Open
Capillary refill time (CRT) is a simple and quick test requiring minimal equipment or time to perform. Prolonged CRT is a ‘red flag’ feature, identifying children with increased risk of significant morbidity or mortality.1–4 Although natio…
View article: Correction: Are Treatments More Effective than Placebos? A Systematic Review and Meta-Analysis
Correction: Are Treatments More Effective than Placebos? A Systematic Review and Meta-Analysis Open
Among studies with continuous outcomes in our systematic review comparing placebo effect sizes with treatment effect sizes we calculated mean differences between to estimate placebo effects, treatment effects, and the difference between pl…
View article: Trends of vital signs with gestational age in normal pregnancies: a systematic review protocol
Trends of vital signs with gestational age in normal pregnancies: a systematic review protocol Open
Introduction Vital signs (blood pressure, heart rate, temperature, oxygen saturation and respiratory rate) are thought to undergo changes during and immediately after pregnancy. However, these physiological changes are not taken into accou…
View article: The Diagnostic Value of Capillary Refill Time for Detecting Serious Illness in Children: A Systematic Review and Meta-Analysis
The Diagnostic Value of Capillary Refill Time for Detecting Serious Illness in Children: A Systematic Review and Meta-Analysis Open
Our results show that capillary refill time is a specific sign, indicating that it can be used as a "red-flag": children with prolonged capillary refill time have a four-fold risk of dying compared to children with normal capillary refill …
View article: Self-Screening and Non-Physician Screening for Hypertension in Communities: A Systematic Review
Self-Screening and Non-Physician Screening for Hypertension in Communities: A Systematic Review Open
Community-based non-physician or self-screening for raised BP can detect raised BP, which may lead to the identification of new cases of hypertension. However, current evidence is insufficient to recommend specific approaches or settings. …