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Author F D Richard Hobbs

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Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: a cross-sectional study.

Simon de Lusignan, Jienchi Dorward, Ana Correa, Nicholas Jones, Oluwafunmi Akinyemi, Gayatri Amirthalingam, Nick Andrews, Rachel Byford, Gavin Dabrera, Alex Elliot, Joanna Ellis, Filipa Ferreira, Jamie Lopez Bernal, Cecilia Okusi, Mary Ramsay, Julian Sherlock, Gillian Smith, John Williams, Gary Howsam, Maria Zambon, Mark Joy, F D Richard Hobbs,

BACKGROUND:There are few primary care studies of the COVID-19 pandemic. We aimed to identify demographic and clinical risk factors for testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre primary care network. METHODS:We analysed routinely collected, ... Read more >>

Lancet Infect Dis (The Lancet. Infectious diseases)
[2020, :]

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Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial.

James P Sheppard, Jenni Burt, Mark Lown, Eleanor Temple, Rebecca Lowe, Rosalyn Fraser, Julie Allen, Gary A Ford, Carl Heneghan, F D Richard Hobbs, Sue Jowett, Shahela Kodabuckus, Paul Little, Jonathan Mant, Jill Mollison, Rupert A Payne, Marney Williams, Ly-Mee Yu, Richard J McManus, ,

Importance:Deprescribing of antihypertensive medications is recommended for some older patients with polypharmacy and multimorbidity when the benefits of continued treatment may not outweigh the harms. Objective:This study aimed to establish whether antihypertensive medication reduction is possible without significant changes in systolic blood pressure control or adverse events during 12-week follow-up. ... Read more >>

JAMA (JAMA)
[2020, 323(20):2039-2051]

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The association between unexpected weight loss and cancer diagnosis in primary care: a matched cohort analysis of 65,000 presentations.

Brian D Nicholson, Willie Hamilton, Constantinos Koshiaris, Jason L Oke, F D Richard Hobbs, Paul Aveyard,

BACKGROUND:We aimed to understand the time period of cancer diagnosis and the cancer types detected in primary care patients with unexpected weight loss (UWL) to inform cancer guidelines. METHODS:This retrospective matched cohort study used cancer registry linked electronic health records from the UK's Clinical Practice Research Datalink from between 2000 ... Read more >>

Br. J. Cancer (British journal of cancer)
[2020, :]

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Development of an international standard set of outcome measures for patients with atrial fibrillation: a report of the International Consortium for Health Outcomes Measurement (ICHOM) atrial fibrillation working group.

William H Seligman, Zofia Das-Gupta, Adedayo O Jobi-Odeneye, Elena Arbelo, Amitava Banerjee, Andreas Bollmann, Bridget Caffrey-Armstrong, Daniel A Cehic, Ramon Corbalan, Michael Collins, Gopi Dandamudi, Prabhakaran Dorairaj, Matthew Fay, Isabelle C Van Gelder, Shinya Goto, Christopher B Granger, Bathory Gyorgy, Jeff S Healey, Jeroen M Hendriks, Mellanie True Hills, F D Richard Hobbs, Menno V Huisman, Kate E Koplan, Deirdre A Lane, William R Lewis, Trudie Lobban, Benjamin A Steinberg, Christopher J McLeod, Spencer Moseley, Adam Timmis, Guo Yutao, A John Camm,

AIMS:As health systems around the world increasingly look to measure and improve the value of care that they provide to patients, being able to measure the outcomes that matter most to patients is vital. To support the shift towards value-based health care in atrial fibrillation (AF), the International Consortium for ... Read more >>

Eur. Heart J. (European heart journal)
[2020, 41(10):1132-1140]

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Screening for atrial fibrillation: a call for evidence.

Nicholas R Jones, Clare J Taylor, F D Richard Hobbs, Louise Bowman, Barbara Casadei,

Atrial fibrillation (AF) is the most common cardiac arrhythmia and prevalence is predicted to double over the next 30 years due to changing demographics and the rise in prevalence of risk factors such as hypertension and diabetes. Atrial fibrillation is associated with a five-fold increased stroke risk, but anticoagulation in ... Read more >>

Eur. Heart J. (European heart journal)
[2020, 41(10):1075-1085]

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Survival rates in elderly patients with heart failure: reply.

Nicholas R Jones, Andrea K Roalfe, Ibiye Adoki, Clare J Taylor, F D Richard Hobbs,

Eur. J. Heart Fail. (European journal of heart failure)
[2020, 22(3):566-567]

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Impact of Changes to National Hypertension Guidelines on Hypertension Management and Outcomes in the United Kingdom.

Sarah L Lay-Flurrie, James P Sheppard, Richard J Stevens, Christian Mallen, Carl Heneghan, F D Richard Hobbs, Bryan Williams, Jonathan Mant, Richard J McManus,

In recent years, national and international guidelines have recommended the use of out-of-office blood pressure monitoring for diagnosing hypertension. Despite evidence of cost-effectiveness, critics expressed concerns this would increase cardiovascular morbidity. We assessed the impact of these changes on the incidence of hypertension, out-of-office monitoring and cardiovascular morbidity using routine ... Read more >>

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2020, 75(2):356-364]

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Searching for Atrial Fibrillation Poststroke: A White Paper of the AF-SCREEN International Collaboration.

Renate B Schnabel, Karl Georg Haeusler, Jeffrey S Healey, Ben Freedman, Giuseppe Boriani, Johannes Brachmann, Axel Brandes, Alejandro Bustamante, Barbara Casadei, Harry J G M Crijns, Wolfram Doehner, Gunnar Engström, Laurent Fauchier, Leif Friberg, David J Gladstone, Taya V Glotzer, Shinya Goto, Graeme J Hankey, Joseph A Harbison, F D Richard Hobbs, Linda S B Johnson, Hooman Kamel, Paulus Kirchhof, Eleni Korompoki, Derk W Krieger, Gregory Y H Lip, Maja-Lisa Løchen, Georges H Mairesse, Joan Montaner, Lis Neubeck, George Ntaios, Jonathan P Piccini, Tatjana S Potpara, Terence J Quinn, James A Reiffel, Antonio Luiz Pinho Ribeiro, Michiel Rienstra, Mårten Rosenqvist, Sakis Themistoclakis, Moritz F Sinner, Jesper Hastrup Svendsen, Isabelle C Van Gelder, Rolf Wachter, Tissa Wijeratne, Bernard Yan,

Cardiac thromboembolism attributed to atrial fibrillation (AF) is responsible for up to one-third of ischemic strokes. Stroke may be the first manifestation of previously undetected AF. Given the efficacy of oral anticoagulants in preventing AF-related ischemic strokes, strategies of searching for AF after a stroke using ECG monitoring followed by ... Read more >>

Circulation (Circulation)
[2019, 140(22):1834-1850]

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Estimated stroke risk, yield, and number needed to screen for atrial fibrillation detected through single time screening: a multicountry patient-level meta-analysis of 141,220 screened individuals.

Nicole Lowres, Jake Olivier, Tze-Fan Chao, Shih-Ann Chen, Yi Chen, Axel Diederichsen, David A Fitzmaurice, Juan Jose Gomez-Doblas, Joseph Harbison, Jeff S Healey, F D Richard Hobbs, Femke Kaasenbrood, William Keen, Vivian W Lee, Jes S Lindholt, Gregory Y H Lip, Georges H Mairesse, Jonathan Mant, Julie W Martin, Enrique Martín-Rioboó, David D McManus, Javier Muñiz, Thomas Münzel, Juliet Nakamya, Lis Neubeck, Jessica J Orchard, Luis Ángel Pérula de Torres, Marco Proietti, F Russell Quinn, Andrea K Roalfe, Roopinder K Sandhu, Renate B Schnabel, Breda Smyth, Apurv Soni, Robert Tieleman, Jiguang Wang, Philipp S Wild, Bryan P Yan, Ben Freedman,

BACKGROUND:The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation (AF) is not known. Therefore, it is not possible to determine the number needed to screen (NNS) to identify one treatable new AF case (NNS-Rx) (i.e., Class-1 oral anticoagulation [OAC] treatment recommendation) in each age stratum. If the ... Read more >>

PLoS Med. (PLoS medicine)
[2019, 16(9):e1002903]

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When should unexpected weight loss warrant further investigation to exclude cancer?

Brian D Nicholson, Paul Aveyard, Willie Hamilton, F D Richard Hobbs,

BMJ (BMJ (Clinical research ed.))
[2019, 366:l5271]

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Survival of patients with chronic heart failure in the community: a systematic review and meta-analysis.

Nicholas R Jones, Andrea K Roalfe, Ibiye Adoki, F D Richard Hobbs, Clare J Taylor,

AIM:To provide reliable survival estimates for people with chronic heart failure and explain variation in survival by key factors including age at diagnosis, left ventricular ejection fraction, decade of diagnosis, and study setting. METHODS AND RESULTS:We searched in relevant databases from inception to August 2018 for non-interventional studies reporting survival ... Read more >>

Eur. J. Heart Fail. (European journal of heart failure)
[2019, 21(11):1306-1325]

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Antibiotic Review Kit for Hospitals (ARK-Hospital): study protocol for a stepped-wedge cluster-randomised controlled trial.

Ann Sarah Walker, Eric Budgell, Magda Laskawiec-Szkonter, Katy Sivyer, Sarah Wordsworth, Jack Quaddy, Marta Santillo, Adele Krusche, Laurence S J Roope, Nicole Bright, Fiona Mowbray, Nicola Jones, Kieran Hand, Najib Rahman, Melissa Dobson, Emma Hedley, Derrick Crook, Mike Sharland, Chris Roseveare, F D Richard Hobbs, Chris Butler, Louella Vaughan, Susan Hopkins, Lucy Yardley, Timothy E A Peto, Martin J Llewelyn, ,

BACKGROUND:To ensure patients continue to get early access to antibiotics at admission, while also safely reducing antibiotic use in hospitals, one needs to target the continued need for antibiotics as more diagnostic information becomes available. UK Department of Health guidance promotes an initiative called 'Start Smart then Focus': early effective ... Read more >>

Trials (Trials)
[2019, 20(1):421]

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Natriuretic peptide-guided treatment for heart failure: a systematic review and meta-analysis.

Julie McLellan, Clare R Bankhead, Jason L Oke, F D Richard Hobbs, Clare J Taylor, Rafael Perera,

BACKGROUND:GUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant. OBJECTIVE:This ... Read more >>

BMJ Evid Based Med (BMJ evidence-based medicine)
[2020, 25(1):33-37]

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Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4).

Mark Monahan, Sue Jowett, Alecia Nickless, Marloes Franssen, Sabrina Grant, Sheila Greenfield, F D Richard Hobbs, James Hodgkinson, Jonathan Mant, Richard J McManus,

The use of self-monitoring of blood pressure, with or without telemonitoring, to guide therapy decisions by physicians for patients with hypertension has been recently demonstrated to reduce blood pressure compared with using clinic monitoring (usual care). However, both the cost-effectiveness of these strategies compared with usual care, and whether the ... Read more >>

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2019, 73(6):1231-1239]

Cited: 1 time

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The role of informal carers in the diagnostic process of heart failure: a secondary qualitative analysis.

Frances Bell-Davies, Clare Goyder, Nicola Gale, F D Richard Hobbs, Clare J Taylor,

BACKGROUND:Heart failure (HF) is a common clinical syndrome, particularly in older people, and symptoms can develop gradually. The aim of this study was to explore the role of informal carers in the HF diagnostic process. METHODS:Secondary analysis of qualitative interviews with 16 participants with a new diagnosis of HF. Original ... Read more >>

BMC Cardiovasc Disord (BMC cardiovascular disorders)
[2019, 19(1):92]

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Diagnostic tests, drug prescriptions, and follow-up patterns after incident heart failure: A cohort study of 93,000 UK patients.

Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, F D Richard Hobbs, John G Cleland, John J V McMurray, Kazem Rahimi,

BACKGROUND:Effective management of heart failure is complex, and ensuring evidence-based practice presents a major challenge to health services worldwide. Over the past decade, the United Kingdom introduced a series of national initiatives to improve evidence-based heart failure management, including a landmark pay-for-performance scheme in primary care and a national audit ... Read more >>

PLoS Med. (PLoS medicine)
[2019, 16(5):e1002805]

Cited: 2 times

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Patient consultation rate and clinical and NHS outcomes: a cross-sectional analysis of English primary care data from 2.7 million patients in 238 practices.

Sarah Lay-Flurrie, Edouard Mathieu, Clare Bankhead, Brian D Nicholson, Rafael Perera-Salazar, Tim Holt, F D Richard Hobbs, Chris Salisbury, ,

BACKGROUND:Primary care workload is high and increasing in the United Kingdom. We sought to examine the association between rates of primary care consultation and outcomes in England. METHODS:Cross sectional observational study of routine electronic health care records in 283 practices from the Clinical Practice Research Datalink from April 2013 to ... Read more >>

BMC Health Serv Res (BMC health services research)
[2019, 19(1):219]

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Schedules for Self-monitoring Blood Pressure: A Systematic Review.

James A Hodgkinson, Richard Stevens, Sabrina Grant, Jonathan Mant, Emma P Bray, F D Richard Hobbs, Una Martin, Claire Schwartz, David McCartney, Rachel O'Mahony, Rafael Perera-Salazar, Nia Roberts, Sarah Stevens, Bryan Williams, Richard J McManus,

BACKGROUND:Self-monitoring of blood pressure better predicts prognosis than clinic measurement, is popular with patients, and endorsed in hypertension guidelines. However, there is uncertainty over the optimal self-monitoring schedule. We therefore aimed to determine the optimum schedule to predict future cardiovascular events and determine "true" underlying blood pressure. METHODS:Six electronic databases ... Read more >>

Am. J. Hypertens. (American journal of hypertension)
[2019, 32(4):350-364]

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Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study.

Clare J Taylor, José M Ordóñez-Mena, Andrea K Roalfe, Sarah Lay-Flurrie, Nicholas R Jones, Tom Marshall, F D Richard Hobbs,

OBJECTIVES:To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group. DESIGN:Population based cohort study. SETTING:Primary care, United Kingdom. PARTICIPANTS:Primary care data for 55 959 patients aged ... Read more >>

BMJ (BMJ (Clinical research ed.))
[2019, 364:l223]

Cited: 7 times

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Practice variation in the use of tests in UK primary care: a retrospective analysis of 16 million tests performed over 3.3 million patient years in 2015/16.

Jack W O'Sullivan, Sarah Stevens, Jason Oke, F D Richard Hobbs, Chris Salisbury, Paul Little, Ben Goldacre, Clare Bankhead, Jeffrey K Aronson, Carl Heneghan, Rafael Perera,

BACKGROUND:The UK's National Health Service (NHS) is currently subject to unprecedented financial strain. The identification of unnecessary healthcare resource use has been suggested to reduce spending. However, there is little very research quantifying wasteful test use, despite the £3 billion annual expenditure. Geographical variation has been suggested as one metric ... Read more >>

BMC Med (BMC medicine)
[2018, 16(1):229]

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Benefits and Harms of Antihypertensive Treatment in Low-Risk Patients With Mild Hypertension.

James P Sheppard, Sarah Stevens, Richard Stevens, Una Martin, Jonathan Mant, F D Richard Hobbs, Richard J McManus,

Importance:Evidence to support initiation of pharmacologic treatment in low-risk patients with mild hypertension is inconclusive, with previous trials underpowered to demonstrate benefit. Clinical guidelines across the world are contradictory. Objective:To examine whether antihypertensive treatment is associated with a low risk of mortality and cardiovascular disease (CVD) in low-risk patients with ... Read more >>

JAMA Intern Med (JAMA internal medicine)
[2018, 178(12):1626-1634]

Cited: 4 times

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OPtimising Treatment for MIld Systolic hypertension in the Elderly (OPTiMISE): protocol for a randomised controlled non-inferiority trial.

James P Sheppard, Jenni Burt, Mark Lown, Eleanor Temple, John Benson, Gary A Ford, Carl Heneghan, F D Richard Hobbs, Sue Jowett, Paul Little, Jonathan Mant, Jill Mollison, Alecia Nickless, Emma Ogburn, Rupert Payne, Marney Williams, Ly-Mee Yu, Richard J McManus,

INTRODUCTION:Recent evidence suggests that larger blood pressure reductions and multiple antihypertensive drugs may be harmful in older people, particularly frail individuals with polypharmacy and multimorbidity. However, there is a lack of evidence to support deprescribing of antihypertensives, which limits the practice of medication reduction in routine clinical care. The aim ... Read more >>

BMJ Open (BMJ open)
[2018, 8(9):e022930]

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Reduced Salt Intake for Heart Failure: A Systematic Review.

Kamal R Mahtani, Carl Heneghan, Igho Onakpoya, Stephanie Tierney, Jeffrey K Aronson, Nia Roberts, F D Richard Hobbs, David Nunan,

Importance:Recent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to ... Read more >>

JAMA Intern Med (JAMA internal medicine)
[2018, 178(12):1693-1700]

Cited: 2 times

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Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests.

Jack W O'Sullivan, Sarah Stevens, F D Richard Hobbs, Chris Salisbury, Paul Little, Ben Goldacre, Clare Bankhead, Jeffrey K Aronson, Rafael Perera, Carl Heneghan,

OBJECTIVES:To assess the temporal change in test use in UK primary care and to identify tests with the greatest increase in use. DESIGN:Retrospective cohort study. SETTING:UK primary care. PARTICIPANTS:All patients registered to UK General Practices in the Clinical Practice Research Datalink, 2000/1 to 2015/16. MAIN OUTCOME MEASURES:Temporal trends in test ... Read more >>

BMJ (BMJ (Clinical research ed.))
[2018, 363:k4666]

Cited: 8 times

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Survival of patients with chronic heart failure in the community: a systematic review and meta-analysis protocol.

Nicholas R Jones, Andrea K Roalfe, Ibiye Adoki, F D Richard Hobbs, Clare J Taylor,

BACKGROUND:Heart failure (HF) is a common condition affecting more than 10% of those over 70 years of age. Reliable estimates of survival following a diagnosis of HF are important to guide management and facilitate advanced care planning. Most existing research has focused on survival rates for patients admitted to hospital with ... Read more >>

Syst Rev (Systematic reviews)
[2018, 7(1):151]

Cited: 1 time

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