Tom Marshall
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View article: Exploring the genetic architecture of multiple long-term conditions using a genome-wide association study in the UK Biobank population
Exploring the genetic architecture of multiple long-term conditions using a genome-wide association study in the UK Biobank population Open
The prevalence of multiple long-term conditions (MLTC) is increasing. It is essential to develop strategies to prevent and manage MLTC; however, the biological mechanisms underlying MLTC are not yet clearly understood. We used UK Biobank d…
View article: A novel approach for mapping exposure to land cover at the small statistical geography level
A novel approach for mapping exposure to land cover at the small statistical geography level Open
Many studies linking spatial environmental exposures to health outcomes rely on small statistical geography units, such as Lower-layer Super Output Areas (LSOAs), to estimate exposure. However, these units commonly vary in size, particular…
View article: Within-individual variation of C-reactive protein (CRP) measurements in primary care: A retrospective cohort study
Within-individual variation of C-reactive protein (CRP) measurements in primary care: A retrospective cohort study Open
Background C-reactive protein (CRP) is a biomarker of inflammation used in diagnosis of inflammatory diseases and to guide treatment decisions. Variation in within-individual measured CRP may affect its clinical utility but estimates of wi…
View article: Less continuity with more complaints: a repeated cross-sectional study of the association between relational continuity of care and patient complaints in English general practice
Less continuity with more complaints: a repeated cross-sectional study of the association between relational continuity of care and patient complaints in English general practice Open
Objective Relational continuity of care is associated with better patient experience and health outcomes. In England, relational continuity of primary care has been declining over a decade, coinciding with an increase in patient complaints…
View article: Within-individual variation of HbA1c measurements in primary care: A retrospective cohort study
Within-individual variation of HbA1c measurements in primary care: A retrospective cohort study Open
Background HbA1c is a marker for diabetes mellitus that reflects average glucose concentrations over the previous eight to twelve weeks. It is used to aid in the diagnosis and management of diabetes. Variation in within-individual measured…
View article: Uterus didelphys in an ewe as a cause of dystocia
Uterus didelphys in an ewe as a cause of dystocia Open
A 2-year, full-term ewe was presented for straining and failure of parturition to progress. Vaginal delivery was achieved but resulted in a full thickness cervicouterine tear secondary to abnormal reproductive tract anatomy. Ewe was euthan…
View article: Effects of antibiotic prescribing for respiratory tract infection on future consultations in primary care: a systematic review and meta-analysis
Effects of antibiotic prescribing for respiratory tract infection on future consultations in primary care: a systematic review and meta-analysis Open
Objectives Prescribing antibiotics may reinforce patients’ beliefs that antibiotics are needed and increase future consultations for similar symptoms. This review determines the effect of antibiotic prescribing for respiratory infections i…
View article: Cardiovascular risk estimation and statin adherence<i>An historical cohort study</i>
Cardiovascular risk estimation and statin adherence<i>An historical cohort study</i> Open
Background Adherence to statins for the primary prevention of cardiovascular disease (CVD) is low. There is evidence that some facets of the initiation consultation, or the initiating clinician, are associated with adherence. CVD risk esti…
View article: Perspectives of Health Care Professionals on the Use of AI to Support Clinical Decision-Making in the Management of Multiple Long-Term Conditions: Interview Study
Perspectives of Health Care Professionals on the Use of AI to Support Clinical Decision-Making in the Management of Multiple Long-Term Conditions: Interview Study Open
Background Managing multiple long-term conditions (MLTC) is complex. Clinical management guidelines are typically focused on individual conditions and lack a robust evidence base for patients with MLTC. MLTC management is largely delivered…
View article: Quantifying, Understanding and Enhancing Relational Continuity of Care (QUERCC): a mixed-methods protocol
Quantifying, Understanding and Enhancing Relational Continuity of Care (QUERCC): a mixed-methods protocol Open
Introduction Relational continuity of care is where patients see the same clinicians over time. Evidence suggests relational continuity of care is valued by patients and clinicians and results in better health. While current National Healt…
View article: Federated Variational Inference for Bayesian Mixture Models
Federated Variational Inference for Bayesian Mixture Models Open
We present a federated learning approach for Bayesian model-based clustering of large-scale binary and categorical datasets. We introduce a principled 'divide and conquer' inference procedure using variational inference with local merge an…
View article: Building ADMISSION – A research collaborative to transform understanding of multiple long-term conditions for people admitted to hospital
Building ADMISSION – A research collaborative to transform understanding of multiple long-term conditions for people admitted to hospital Open
Background Multiple long-term conditions (MLTCs; commonly referred to as multimorbidity) are highly prevalent among people admitted to hospital and are therefore of critical importance to hospital-based healthcare systems. To date, most re…
View article: Perspectives of Health Care Professionals on the Use of AI to Support Clinical Decision-Making in the Management of Multiple Long-Term Conditions: Interview Study (Preprint)
Perspectives of Health Care Professionals on the Use of AI to Support Clinical Decision-Making in the Management of Multiple Long-Term Conditions: Interview Study (Preprint) Open
BACKGROUND Managing multiple long-term conditions (MLTC) is complex. Clinical management guidelines are typically focused on individual conditions and lack a robust evidence base for patients with MLTC. MLTC management is largely delivere…
View article: The effects of antibiotic prescribing for respiratory tract infection on future consultations in primary care: a systematic review and meta-analysis
The effects of antibiotic prescribing for respiratory tract infection on future consultations in primary care: a systematic review and meta-analysis Open
Objectives Prescribing antibiotics may reinforce patients’ beliefs antibiotics are needed and increase future consultations for similar symptoms. This review determines the effect of antibiotic prescribing for respiratory infections in pri…
View article: Cardiovascular risk estimation and statin adherence: a historical cohort study protocol
Cardiovascular risk estimation and statin adherence: a historical cohort study protocol Open
Background Adherence to statins for the primary prevention of cardiovascular disease (CVD) is low. There is evidence that some facets of the initiation consultation, or the initiating clinician, are associated with adherence. CVD risk esti…
View article: Long-term trends in English general practice consultation rates from 1995 to 2021: a retrospective analysis of two electronic health records databases
Long-term trends in English general practice consultation rates from 1995 to 2021: a retrospective analysis of two electronic health records databases Open
Objectives Although primary care is central to healthcare provision, inconsistent methods and data sources mean that relatively little is known about long-term trends in general practice consultation rates. We aimed to explore long-term tr…
View article: Within-subject variation of C-reactive protein and high-sensitivity C-reactive protein: A systematic review and meta-analysis
Within-subject variation of C-reactive protein and high-sensitivity C-reactive protein: A systematic review and meta-analysis Open
Background C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP) are measures of inflammation used in diagnosis, to guide treatment decisions, and in disease prediction. Variability in measured CRP and hsCRP may affect t…
View article: Bayesian blockwise inference for joint models of longitudinal and multistate data with application to longitudinal multimorbidity analysis
Bayesian blockwise inference for joint models of longitudinal and multistate data with application to longitudinal multimorbidity analysis Open
Multistate models provide a useful framework for modelling complex event history data in clinical settings and have recently been extended to the joint modelling framework to appropriately handle endogenous longitudinal covariates, such as…
View article: Health screening clinic to reduce absenteeism and presenteeism among NHS Staff: eTHOS a pilot RCT
Health screening clinic to reduce absenteeism and presenteeism among NHS Staff: eTHOS a pilot RCT Open
Background Staff sickness absenteeism and presenteeism (attending work while unwell) incur high costs to the NHS, are associated with adverse patient outcomes and have been exacerbated by the COVID-19 pandemic. The main causes are mental a…
View article: Trends in clinical workload in UK primary care 2005–2019: a retrospective cohort study
Trends in clinical workload in UK primary care 2005–2019: a retrospective cohort study Open
Background Substantial increases in UK consulting rates, mean consultation duration, and clinical workload were observed between 2007 and 2014. To the authors’ knowledge, no analysis of more recent trends in clinical workload has been publ…
View article: 31P Surgical and chemotherapeutic strategies for stage IV pancreatic neuroendocrine carcinoma according to the latest WHO classification
31P Surgical and chemotherapeutic strategies for stage IV pancreatic neuroendocrine carcinoma according to the latest WHO classification Open
Chemotherapy is considered the primary treatment for stage IV pancreatic neuroendocrine carcinoma (pNEC). However, the optimal management of metastatic pNEC as defined by the updated WHO classification (2022) has not been adequately explor…
View article: Perceptions on artificial intelligence-based decision-making for coexisting multiple long-term health conditions: protocol for a qualitative study with patients and healthcare professionals
Perceptions on artificial intelligence-based decision-making for coexisting multiple long-term health conditions: protocol for a qualitative study with patients and healthcare professionals Open
Introduction Coexisting multiple health conditions is common among older people, a population that is increasing globally. The potential for polypharmacy, adverse events, drug interactions and development of additional health conditions co…
View article: Sociodemographic characteristics and longitudinal progression of multimorbidity: A multistate modelling analysis of a large primary care records dataset in England
Sociodemographic characteristics and longitudinal progression of multimorbidity: A multistate modelling analysis of a large primary care records dataset in England Open
Background Multimorbidity, characterised by the coexistence of multiple chronic conditions in an individual, is a rising public health concern. While much of the existing research has focused on cross-sectional patterns of multimorbidity, …
View article: Healthcare resource utilisation and economic burden attributable to back pain in primary care: A matched case-control study in the United Kingdom
Healthcare resource utilisation and economic burden attributable to back pain in primary care: A matched case-control study in the United Kingdom Open
Objective Incremental healthcare costs attributed to back pain, and characterisation by patient and clinical factors have rarely been documented. This study aimed to assess annual healthcare resource utilisation and costs associated with b…
View article: Within-individual variation of measured depression symptoms: A systematic review and meta-analysis
Within-individual variation of measured depression symptoms: A systematic review and meta-analysis Open
Background: Depression screening instruments are commonly used to assess the presence and severity of depression symptoms. However, there is little information on variation in depression screening scores over time within the same individua…