Full Text Journal Articles by
Author Christina Pagel

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Linkage of National Congenital Heart Disease Audit data to hospital, critical care and mortality national datasets to enable research focused on quality improvement

Ferran Espuny Pujol, Christina Pagel, Katherine Brown, James Doidge, Richard Feltbower, Rodney Franklin, Arturo Gonzalez-Izquierdo, Doug Gould, Lee Norman, John Stickley, Julie Taylor, Sonya Crowe,

<h4>Objectives</h4> To link five national datasets (three registries, two administrative) and create longitudinal health care trajectories for patients with congenital heart disease (CHD), describing the quality and the summary statistics of the linked dataset. <h4>Design</h4> Bespoke linkage of record-level patient identifiers across five national datasets. Generation of spells of care ... Read more >>

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Understanding COVID-19 trajectories from a nationwide linked electronic health record cohort of 56 million people: phenotypes, severity, waves & vaccination

Johan Thygesen, Christopher Tomlinson, Sam Hollings, Mehrdad Mizani, Alex Handy, Ashley Akbari, Amitava Banerjee, Jennifer Cooper, Alvina Lai, Ken Li, Bilal Mateen, Naveed Sattar, Reecha Sofat, Ana Torralbo, Honghan Wu, Angela Wood, Jonathan Sterne, Christina Pagel, William Whiteley, Cathie Sudlow, Harry Hemingway, Spiros Denaxas,

<h4>Background</h4> Updatable understanding of the onset and progression of individuals COVID-19 trajectories underpins pandemic mitigation efforts. In order to identify and characterize individual trajectories, we defined and validated ten COVID-19 phenotypes from linked electronic health records (EHR) on a nationwide scale using an extensible framework. <h4>Methods</h4> Cohort study of 56.6 ... Read more >>

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Cohort study of intervened functionally univentricular heart in England and Wales (2000-2018).

Elena Hadjicosta, Rodney Franklin, Anna Seale, Oliver Stumper, Victor Tsang, David R Anderson, Christina Pagel, Sonya Crowe, Ferran Espuny Pujol, Deborah Ridout, Kate L Brown,

<h4>Objective</h4>Given the paucity of long-term outcome data for complex congenital heart disease (CHD), we aimed to describe the treatment pathways and survival for patients who started interventions for functionally univentricular heart (FUH) conditions, excluding hypoplastic left heart syndrome.<h4>Methods</h4>We performed a retrospective cohort study using all procedure records from the National ... Read more >>

Heart (Heart (British Cardiac Society))
[2021, :]

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Vaccinating adolescents against SARS-CoV-2 in England: a risk-benefit analysis.

Deepti Gurdasani, Samir Bhatt, Anthony Costello, Spiros Denaxas, Seth Flaxman, Trisha Greenhalgh, Stephen Griffin, Zoë Hyde, Aris Katzourakis, Martin McKee, Susan Michie, Oliver Ratmann, Stephen Reicher, Gabriel Scally, Christopher Tomlinson, Christian Yates, Hisham Ziauddeen, Christina Pagel,

<h4>Objective</h4>To offer a quantitative risk-benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.<h4>Setting</h4>England.<h4>Design</h4>Following the risk-benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12-17 ... Read more >>

J R Soc Med (Journal of the Royal Society of Medicine)
[2021, :1410768211052589]

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Vaccinations or Non-Pharmaceutical Interventions: Safe Reopening of Schools in England

Carolina Cuesta-Lazaro, Arnau Quera-Bofarull, Joseph Aylett-Bullock, Bryan Lawrence, Kevin Fong, Miguel Icaza-Lizaola, Aidan Sedgewick, Henry Truong, Ian Vernon, Julian Williams, Christina Pagel, Frank Krauss,

With high levels of the Delta variant of COVID-19 circulating in England during September 2021, schools are set to reopen with few school-based non-pharmaceutical interventions (NPIs). In this paper, we present simulation results obtained from the individual-based model, JUNE, for English school opening after a prior vaccination campaign using an ... Read more >>

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Tackling the pandemic with (biased) data.

Christina Pagel, Christian A Yates,

[Figure: see text]. ... Read more >>

Science (Science (New York, N.Y.))
[2021, 374(6566):403-404]

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The World Health Network: a global citizens' initiative.

Yaneer Bar-Yam, Deepti Gurdasani, Michael G Baker, Gabriel Scally, Simone George, Amanda Kvalsvig, Sinéad Ní Fhaoláin, Shu-Ti Chiou, John Drury, Stephen Duckett, Eric L Ding, Carlos Gershenson, Christine Gibson, Trisha Greenhalgh, Adam Hamdy, Zoë Hyde, Tiffany James, Jose L Jimenez, Martin McKee, Susan Michie, Christina Pagel, Cecile Philippe, Kim Prather, Sunil K Raina, Walter Ricciardi, Meir Rubin, Tomás Ryan, Matthias F Schneider, Anthony Staines, Robert West, Hisham Ziauddeen,

Lancet (Lancet (London, England))
[2021, 398(10311):1567-1568]

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What was the impact of the first wave of COVID-19 on the delivery of care to children and adults with congenital heart disease? A qualitative study using online forums.

Jo Wray, Christina Pagel, Adrian H Chester, Fiona Kennedy, Sonya Crowe,

<h4>Objectives</h4>Globally, healthcare systems have been stretched to the limit by the COVID-19 pandemic. Significant changes have had to be made to the way in which non-COVID-19-related care has been delivered. Our objective was to understand, from the perspective of patients with a chronic, life-long condition (congenital heart disease, CHD) and ... Read more >>

BMJ Open (BMJ open)
[2021, 11(9):e049006]

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Schools: a gaping hole in England's covid strategy.

Christina Pagel,

BMJ (BMJ (Clinical research ed.))
[2021, 374:n2115]

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The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study.

Harrison Wilde, Thomas Mellan, Iwona Hawryluk, John M Dennis, Spiros Denaxas, Christina Pagel, Andrew Duncan, Samir Bhatt, Seth Flaxman, Bilal A Mateen, Sebastian J Vollmer,

<h4>Background</h4>The literature paints a complex picture of the association between mortality risk and ICU strain. In this study, we sought to determine if there is an association between mortality risk in intensive care units (ICU) and occupancy of beds compatible with mechanical ventilation, as a proxy for strain.<h4>Methods</h4>A national retrospective ... Read more >>

BMC Med (BMC medicine)
[2021, 19(1):213]

Cited: 1 time

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The road to hell is paved with good intentions: the experience of applying for national data for linkage and suggestions for improvement.

Julie A Taylor, Sonya Crowe, Ferran Espuny Pujol, Rodney C Franklin, Richard G Feltbower, Lee J Norman, James Doidge, Doug William Gould, Christina Pagel,

<h4>Background</h4>We can improve healthcare services by better understanding current provision. One way to understand this is by linking data sets from clinical and national audits, national registries and other National Health Service (NHS) encounter data. However, getting to the point of having linked national data sets is challenging.<h4>Objective</h4>We describe our ... Read more >>

BMJ Open (BMJ open)
[2021, 11(8):e047575]

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Mass infection is not an option: we must do more to protect our young.

Deepti Gurdasani, John Drury, Trisha Greenhalgh, Stephen Griffin, Zubaida Haque, Zoë Hyde, Aris Katzourakis, Martin McKee, Susan Michie, Christina Pagel, Stephen Reicher, Alice Roberts, Robert West, Christian Yates, Hisham Ziauddeen,

Lancet (Lancet (London, England))
[2021, 398(10297):297-298]

Cited: 3 times

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Development of a parent experience measure for paediatric critical care transport teams.

Ruth E C Evans, Victoria Barber, Sarah Seaton, Elizabeth S Draper, Fatemah Rajah, Christina Pagel, Eithne Polke, Padmanabhan Ramnarayan, Jo Wray, ,

<h4>Background</h4>A third of children admitted to paediatric intensive care units (PICUs) in the United Kingdom (UK) are transported by paediatric critical care transport services (PCCTs). Parents have described the transfer journey as particularly stressful. Critical care nurses have a key role in mitigating the impact of the journey on parents. ... Read more >>

Nurs Crit Care (Nursing in critical care)
[2021, :]

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There is a real danger that covid-19 will become entrenched as a disease of poverty.

Christina Pagel,

BMJ (BMJ (Clinical research ed.))
[2021, 373:n986]

Cited: 1 time

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The effect of care provided by paediatric critical care transport teams on mortality of children transported to paediatric intensive care units in England and Wales: a retrospective cohort study.

Sarah E Seaton, Elizabeth S Draper, Christina Pagel, Fatemah Rajah, Jo Wray, Padmanabhan Ramnarayan, ,

<h4>Background</h4>Centralisation of paediatric intensive care units (PICUs) has the increased the need for specialist paediatric critical care transport teams (PCCT) to transport critically ill children to PICU. We investigated the impact of care provided by PCCTs for children on mortality and other clinically important outcomes.<h4>Methods</h4>We analysed linked national data from ... Read more >>

BMC Pediatr (BMC pediatrics)
[2021, 21(1):217]

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"We are setting ourselves on fire to keep everyone else warm"-what does the recovery look like for NHS staff?

Christina Pagel, Edward Palmer,

BMJ (BMJ (Clinical research ed.))
[2021, 372:n569]

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Delaying the second dose of covid-19 vaccines.

Dominic Pimenta, Christian Yates, Christina Pagel, Deepti Gurdasani,

BMJ (BMJ (Clinical research ed.))
[2021, 372:n710]

Cited: 9 times

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The World Health Network: a global citizens' initiative

Yaneer Bar-Yam, Deepti Gurdasani, Michael G Baker, Gabriel Scally, Simone George, Amanda Kvalsvig, Sinéad Ní Fhaoláin, Shu-Ti Chiou, John Drury, Stephen Duckett, Eric L Ding, Carlos Gershenson, Christine Gibson, Trisha Greenhalgh, Adam Hamdy, Zoë Hyde, Tiffany James, Jose L Jimenez, Martin McKee, Susan Michie, Christina Pagel, Cecile Philippe, Kim Prather, Sunil K Raina, Walter Ricciardi, Meir Rubin, Tomás Ryan, Matthias F Schneider, Anthony Staines, Robert West, Hisham Ziauddeen,

Lancet (Lancet (London, England))
[2021, 398(10311):1567-1568]

Cited: 0 times

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The impact of the first wave of COVID-19 on those with lifelong conditions: a case study of congenital heart disease

Jo Wray, Christina Pagel, Adrian Chester, Fiona Kennedy, Sonya Crowe,

<h4>Objectives</h4> Globally, health care systems have been stretched to the limit by the COVID-19 pandemic. Significant changes have had to be made to the way in which non-COVID-19 related care has been delivered. Our objective was to understand, from the perspective of patients with a chronic, life-long condition (congenital heart ... Read more >>

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A national retrospective cohort study of mechanical ventilator availability and its association with mortality risk in intensive care patients with COVID-19

Harrison Wilde, Thomas Mellan, Iwona Hawryluk, John Dennis, Spiros Denaxas, Christina Pagel, Andrew Duncan, Samir Bhatt, Seth Flaxman, Bilal Mateen, Sebastian Vollmer,

<h4>Objectives: </h4> To determine if there is an association between survival rates in intensive care units (ICU) and occupancy of the unit on the day of admission. <h4>Design:</h4> National retrospective observational cohort study during the COVID-19 pandemic. <h4>Setting:</h4> 90 English hospital trusts (i.e. groups of hospitals functioning as single operational ... Read more >>

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Morbidities After Cardiac Surgery: Impact on Children's Quality of Life and Parents' Mental Health.

Jo Wray, Deborah Ridout, Alison Jones, Peter Davis, Paul Wellman, Warren Rodrigues, Emma Hudson, Victor Tsang, Christina Pagel, Katherine L Brown,

<h4>Background</h4>Most children now survive cardiac surgery, and the focus of quality improvement initiatives has shifted toward more complex outcome measures. The aim of this investigation was to study the impact of early postoperative morbidities on parent-reported patient quality of life and parental anxiety or depression over 6 months.<h4>Methods</h4>This prospective case-matched ... Read more >>

Ann Thorac Surg (The Annals of thoracic surgery)
[2020, :]

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Factors associated with unplanned reinterventions and their relation to early mortality after pediatric cardiac surgery.

Dan M Dorobantu, Deborah Ridout, Katherine L Brown, Warren Rodrigues, Mansour T A Sharabiani, Christina Pagel, David Anderson, Paul Wellman, Andrew McLean, Jane Cassidy, David J Barron, Victor T Tsang, Serban C Stoica,

<h4>Objective</h4>Unplanned reintervention (uRE) is used as an indicator of patient morbidity and quality of care in pediatric cardiac surgery. We investigated associated factors and early mortality after uREs.<h4>Methods</h4>Morbidity data were prospectively collected in 5 UK centers between 2015 and 2017; uRE included surgical cardiac, interventional transcatheter cardiac, permanent pacemaker, and ... Read more >>

J Thorac Cardiovasc Surg (The Journal of thoracic and cardiovascular surgery)
[2021, 161(3):1155-1166.e9]

Cited: 1 time

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The UK needs a sustainable strategy for COVID-19.

Deepti Gurdasani, Laura Bear, Debby Bogaert, Rochelle A Burgess, Reinhard Busse, Roberto Cacciola, Yves Charpak, Tim Colbourn, John Drury, Karl Friston, Valentina Gallo, Lynn R Goldman, Trisha Greenhalgh, Zoë Hyde, Krutika Kuppalli, Maimuna S Majumder, Jose M Martin-Moreno, Martin McKee, Susan Michie, Elias Mossialos, Ali Nouri, Christina Pagel, Dominic Pimenta, Saskia Popescu, Viola Priesemann, Angela L Rasmussen, Stephen Reicher, Walter Ricciardi, Ken Rice, Joshua Silver, Tara C Smith, Clare Wenham, Robert West, Gavin Yamey, Christian Yates, Hisham Ziauddeen,

Lancet (Lancet (London, England))
[2020, 396(10265):1800-1801]

Cited: 10 times

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Neurodevelopmental status and follow-up in preschool children with heart disease in London, UK.

Aparna Hoskote, Deborah Ridout, Victoria Banks, Suzan Kakat, Monica Lakhanpaul, Christina Pagel, Rodney Cg Franklin, Thomas Witter, Rhian Lakhani, Shane M Tibby, David Anderson, Victor Tsang, Jo Wray, Katherine Brown,

<h4>Objective</h4>To describe neurodevelopment and follow-up services in preschool children with heart disease (HD).<h4>Design</h4>Secondary analysis of a prospectively collected multicentre dataset.<h4>Setting</h4>Three London tertiary cardiac centres.<h4>Patients</h4>Preschool children<5 years of age: both inpatients and outpatients.<h4>Methods</h4>We analysed results of Mullen Scales of Early Learning (MSEL) and parental report of follow-up services in a representative ... Read more >>

Arch Dis Child (Archives of disease in childhood)
[2021, 106(3):263-271]

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Early morbidities following paediatric cardiac surgery: a mixed-methods study

Katherine L Brown, Christina Pagel, Deborah Ridout, Jo Wray, Victor T Tsang, David Anderson, Victoria Banks, David J Barron, Jane Cassidy, Linda Chigaru, Peter Davis, Rodney Franklin, Luca Grieco, Aparna Hoskote, Emma Hudson, Alison Jones, Suzan Kakat, Rhian Lakhani, Monica Lakhanpaul, Andrew McLean, Steve Morris, Veena Rajagopal, Warren Rodrigues, Karen Sheehan, Serban Stoica, Shane Tibby, Martin Utley, Thomas Witter,

<h4>Background</h4>Over 5000 paediatric cardiac surgeries are performed in the UK each year and early survival has improved to > 98%.<h4>Objectives</h4>We aimed to identify the surgical morbidities that present the greatest burden for patients and health services and to develop and pilot routine monitoring and feedback.<h4>Design and setting</h4>Our multidisciplinary mixed-methods study took ... Read more >>

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