Evangelos Kontopantelis

Evangelos Kontopantelis
The University of Manchester · Faculty of Biology, Medicine and Health

PhD in Computer Engineering

About

429
Publications
79,436
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Introduction
Data Scientist and Health Services Researcher I mainly work with large-scale primary care databases (PCDs) to investigate important health care issues: the effect of monetary incentives on quality of care, predictors of cancer, cancer screening utilisation, care for people with severe mental illnesses. From a methodological perspective I am mainly interested in computational statistics, meta-analysis, time series analysis and the validity issues around large databases in health care.
Additional affiliations
January 2006 - December 2010
The University of Manchester
February 2001 - February 2005
National Technical University of Athens
Position
  • PhD Student

Publications

Publications (429)
Article
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Background The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in...
Article
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Background Multiple imputation is frequently used to deal with missing data in healthcare research. Although it is known that the outcome should be included in the imputation model when imputing missing covariate values, it is not known whether it should be imputed. Similarly no clear recommendations exist on: the utility of incorporating a seconda...
Article
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To quantify the relationship between a national primary care pay-for-performance programme, the UK's Quality and Outcomes Framework (QOF), and all-cause and cause-specific premature mortality linked closely with conditions included in the framework. Longitudinal spatial study, at the level of the "lower layer super output area" (LSOA). 32482 LSOAs...
Article
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This article describes a new individual patient data (IPD) meta-analysis post-estimation command, ipdforest. The command produces a forest plot, following an one-stage meta-analysis with xtmixed or xtmelogit (renamed in Stata 13 to mixed and meqrlogit respectively; ipdforest is currently not compatible with the new names). The overall effect is obt...
Article
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Heterogeneity has a key role in meta-analysis methods and can greatly affect conclusions. However, true levels of heterogeneity are unknown and often researchers assume homogeneity. We aim to: a) investigate the prevalence of unobserved heterogeneity and the validity of the assumption of homogeneity; b) assess the performance of various meta-analys...
Article
BACKGROUND: Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, we aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. METHODS: In this cohort study, we used...
Article
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Background: Atrial fibrillation (AF) is an important risk factor for ischaemic stroke, and AF incidence is expected to increase. Guidelines recommend using oral anticoagulants (OACs) to prevent the development of stroke. However, studies have reported the frequent underuse of OACs in AF patients. The objective of this study is to describe nonvalvu...
Article
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Introduction Cardiovascular disease (CVD) remains one of the leading causes of preventable death in Europe, therefore any opportunity to intervene and improve care should be maximised. Known CVD risk factors are routinely collected in the emergency department (ED), yet they are often not acted on. If the risk factors have prognostic value and a pat...
Article
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Objective: To compare the efficacy of different statin therapies by intensity for prevention of cardiovascular disease (CVD) in people with diabetes according to non-high-density lipoprotein cholesterol (non-HDL-C). Design: Systematic review and network meta-analysis. Data Sources: Searches in MEDLINE, Cochrane Central Register of Controlled Tri...
Preprint
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In observational studies, researchers must select a method to control for confounding. Options include propensity score methods and regression. It remains unclear how dataset characteristics (size, overlap in propensity scores, exposure prevalence) influence the relative performance of the methods, making it difficult to select the best method for...
Article
Aims The Global Registry of Acute Coronary Events (GRACE) score was developed to evaluate risk in patients with the acute coronary syndrome with or without ST-segment elevation. Little is known about its performance at predicting in-hospital mortality for ethnic minority patients. Methods and results We identified 326 160 admissions with non-ST-se...
Article
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Background Deaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of excess mortality do not adequately account for varying age profiles of deaths b...
Article
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Purpose The adverse impact of hearing loss (HL) extends beyond auditory impairment and may affect the individuals' psychosocial wellbeing. We aimed to examine whether there exists a causal psychosocial pathway between HL and depression in later life, via socioeconomic factors and quality of life, and whether hearing aids usage alleviates depressive...
Article
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OBJECTIVES To assess associations between current use of sodium–glucose cotransporter 2 inhibitors (SGLT2is), glucagon-like peptide 1 receptor agonists (GLP-1RAs), and their combination and risk for major adverse cardiac and cerebrovascular events (MACCE) and heart failure (HF) in people with type 2 diabetes. RESEARCH DESIGN AND METHODS In three n...
Article
Objectives: This study examines the safety and feasibility of same-day discharge (SDD) in patients undergoing percutaneous coronary intervention (PCI) to coronary chronic total occlusions (CTOs) and explores independent associations of clinical and procedural characteristics with SDD. Background: While the recently published consensus statements...
Article
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Objective: We aimed to update the prevalence estimates of hearing loss in older adults in England using a nationally representative sample of adults aged 50 years old and older. Design: A comparative cross-sectional study design was implemented. Hearing loss was defined as ≥35 dB HL at 3.0 kHz, as measured via Hearcheck in the better-hearing ear...
Article
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Objectives: To determine the average treatment effect (ATE) of primary percutaneous coronary intervention (pPCI) versus medical treatment (MT) on in-hospital outcomes across the spectrum of frailty in patients with ST-elevation myocardial infarction (STEMI). Methods: Adult patients hospitalized for STEMI between October 2015 until December 2017...
Conference Paper
Worldwide, it is forecasted that 131.5 million people will suffer from dementia by 2050, and the annual cost of care will increase from 818 billion USD in 2016 to 2 trillion USD by 2030, with burgeoning social consequences. Given a timely prediction of a dementia outcome in patients, appropriate mitigating interventions can be applied to reduce ris...
Article
Objective To investigate the utility of Charlson comorbidity index (CCI) as a measure of comorbidity burden to predict procedural outcomes after de novo cardiac implantable electronic device (CIED) implantation. Methods All de novo CIED implantations in the United States National Inpatient Sample between 2015 and 2018 were retrospectively analyzed...
Article
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Objective To describe the distribution of consultations at the practice level and examine whether increases are uniform or driven by people who consult more frequently. Design Retrospective cohort study. Setting UK general practice data from the Clinical Practice Research Datalink (CPRD) GOLD database. Participants 1 699 709 314 consultation eve...
Article
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Background The way we collect and use patient experience data is vital to optimise the quality and safety of health services. Yet, some patients and carers do not give feedback because of the limited ways data is collected, analysed and presented. In this study, we worked together with researchers, staff, patient and carer participants, and patient...
Article
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Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse. Aim: To identify characteristics, geographical patterns and drivers of GP locum use. Design and setting: Observational study of routine data from general practices in England. Method...
Article
Background The association between socioeconomic status (SES), sex, race/ethnicity and outcomes during hospitalization for heart failure (HF) has not previously been investigated. Methods We analyzed HF hospitalizations in the United States National Inpatient Sample between 2015-2017. Using a hierarchical, multivariable Poisson regression model to...
Article
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Background: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback. Objectives:...
Article
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Background Patients presenting with chest pain represent a large proportion of attendances to emergency departments. In these patients clinicians often consider the diagnosis of acute myocardial infarction (AMI), the timely recognition and treatment of which is clinically important. Clinical prediction models (CPMs) have been used to enhance early...
Article
Background There are limited data on the management strategies, temporal trends and clinical outcomes of patients who present with non–ST‐segment–elevation myocardial infarction and have a prior history of CABG. Methods and Results We identified 287 658 patients with non–ST‐segment–elevation myocardial infarction between 2010 and 2017 in the Unite...
Article
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Background Schizophrenia and bipolar disorder are severe mental illnesses which are highly prevalent worldwide. Risperidone and Paliperidone are treatments for either illnesses, but their efficacy compared to other antipsychotics and growing reports of hormonal imbalances continue to raise concerns . As existing evidence on both antipsychotics are...
Article
Objective Evidence on sex differences in outcomes after developing coronary heart disease (CHD) has focused on recurrent CHD, all-cause mortality or revascularisation. We assessed sex disparities in subsequent major adverse cardiovascular events (MACE) in adults surviving their first-time CHD. Methods Using a population-based cohort obtained from...
Article
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Objective To quantify general practitioners’ (GPs’) turnover in England between 2007 and 2019, describe trends over time, regional differences and associations with social deprivation or other practice characteristics. Design A retrospective study of annual cross-sectional data. Setting All general practices in England (8085 in 2007, 6598 in 2019...
Article
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Importance Wearable physical activity (PA) trackers, such as accelerometers, fitness trackers, and pedometers, are accessible technologies that may encourage increased PA levels in line with current recommendations. However, whether their use is associated with improvements in PA levels in participants who experience 1 or more cardiometabolic condi...
Article
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Background: The association between psoriasis and the risk of cancer has been investigated in numerous studies utilising electronic health records (EHRs), with conflicting results in the extent of the association. Objectives: To assess concordance and timing of cancer recording between primary care, hospital and death registration data for peopl...
Article
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Objective To develop evidence of work-related and personal predictors of COVID-19 transmission. Setting and respondents Data are drawn from a population survey of individuals in the USA and UK conducted in June 2020. Background methods Regression models are estimated for 1467 individuals in which reported evidence of infection depends on work-rel...
Preprint
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Background Deaths in the first year of the COVID-19 pandemic in England & Wales have been shown to be unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups....
Article
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Objective To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared...
Article
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Meta-analysis of clinical trials targeting rare events face particular challenges when the data lack adequate number of events and are susceptible to high levels of heterogeneity. The standard meta-analysis methods (DerSimonian Laird (DL) and Mantel–Haenszel (MH)) often lead to serious distortions because of such data sparsity. Applications of the...
Article
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Background Excess deaths during the COVID-19 pandemic compared with those expected from historical trends have been unequally distributed, both geographically and socioeconomically. Not all excess deaths have been directly related to COVID-19 infection. We investigated geographical and socioeconomic patterns in excess deaths for major groups of und...
Article
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Background The general health of children of parents with mental illness is overlooked. Aims To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI). Method This was a retrospective cohort study of children aged 0–17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Cl...
Article
Background Little is known about the association between admitting physician specialty and care quality and outcomes for non-ST-segment elevation myocardial infarction (NSTEMI). Methods & Results We identified 288,420 patients hospitalised with NSTEMI between 2010-2017 in the United Kingdom (UK) Myocardial Infarction National Audit Project (MINAP)...
Article
Background The mental health of the UK population declined at the onset of the COVID-19 pandemic. Convenience sample surveys indicate that recovery began soon after. Using a probability sample, we tracked mental health during the pandemic to characterise mental health trajectories and identify predictors of deterioration. Methods This study was...
Article
Background Aortic stenosis requires timely treatment with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). This study aimed to investigate the indirect impact of coronavirus disease 2019 (COVID-19) on national SAVR and TAVR activity and outcomes. Methods The UK TAVR Registry and the National Adult C...
Article
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Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. Methods: A systematic literature search was performed for studies reporting the impact of HPV...
Article
Background Little is known about ethnic disparities in care and clinical outcomes of patients admitted with non-ST-segment elevation myocardial infarction (NSTEMI) in national cohorts from universal healthcare systems derived from Europe. Methods & Results We identified 280,588 admissions with NSTEMI in the United Kingdom (UK) Myocardial Infarctio...
Article
To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effe...
Article
Full-text available
Severe coronavirus disease 2019 (COVID-19) is associated with increased risk of venous thromboembolism events (VTE). This study performed a systematic review in PubMed/EMBASE of studies reporting the prevalence of VTE in patients with COVID-19 who were totally screened/assessed for deep vein thrombosis (DVT) and/or for pulmonary embolism (PE). Amon...
Article
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Objective Most current cardiovascular disease (CVD) risk stratification tools are for people without CVD, but very few are for prevalent CVD. In this study, we developed and validated a CVD severity score in people with coronary heart disease (CHD) and evaluated the association between severity and adverse outcomes. Methods Primary and secondary c...
Article
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Background To estimate excess mortality for care home residents during the COVID-19 pandemic in England, exploring associations with care home characteristics. Methods Daily number of deaths in all residential and nursing homes in England notified to the Care Quality Commission (CQC) from 1 January 2017 to 7 August 2020. Care home-level data linke...
Article
Aims The post-discharge outcomes of patients with cancer who undergo PCI are not well understood. This study evaluates the rates of readmissions within 90 days for acute myocardial infarction (AMI) and bleeding among patients with cancer who undergo percutaneous coronary intervention (PCI). Methods and results Patients treated with PCI in the year...
Article
Background and purpose: Data about variations in stroke incidence and subsequent major adverse outcomes are essential to inform secondary prevention and prioritizing resources to those at the greatest risk of major adverse end points. We aimed to describe the age, sex, and socioeconomic differences in the rates of first nonfatal stroke and subsequ...
Article
Objective To describe the place and cause of death during the COVID-19 pandemic to assess its impact on excess mortality. Methods This national death registry included all adult (aged≥18 years) deaths in England and Wales between 1st January 2014 and 30th June 2020. Daily deaths during COVID-19 pandemic were compared against the expected daily dea...
Article
Full-text available
Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people’s quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to...
Article
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Background Hearing loss (HL) is a significant public health concern globally and is estimated to affect over nine million people in England. The aim of this research was to explore the regional patterns and trends of HL in a representative longitudinal prospective cohort study of the English population aged 50 and over. Methods We used the full da...
Article
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Background The increasing trends in opioid prescribing and opioid-related deaths in England are concerning. A greater understanding of the association of deprivation with opioid prescribing is needed to guide policy responses and interventions. Methods The 2018/2019 English national primary care prescribing data were analysed spatially. Prescribin...
Preprint
BACKGROUND Digital diabetes management systems have the potential to deliver cost-effective self-management support. DiabetesMyWay (DMW) is a platform for an open access website that includes a variety of multimedia resources including offering patients access to their clinical data in the form of an electronic personal health record. DMW aims to i...
Article
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Introduction Diabetes prevention programs (DPPs) are effective, in a pre-diabetic population, in reducing weight, lowering glycated hemoglobin and slowing the progression to diabetes. Little is known about the relationship between participation in DPPsand participant characteristics or service delivery. We investigated uptake and retention in Engla...
Article
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Background: To examine the association between the degree of risk factor control and cardiovascular disease (CVD) risk in type 2 diabetes and to assess if the presence of cardio-renal disease modifies these relationships. Methods: A retrospective cohort study using data from English practices from CPRD GOLD (Clinical Practice Research Datalink) an...
Preprint
Full-text available
Background: To estimate excess mortality for care home residents during the COVID-19 pandemic in England, exploring associations with care home characteristics. Methods: Daily number of deaths in all residential and nursing homes in England notified to the Care Quality Commission (CQC) from 1st January 2017 to 7th August 2020. Care home level data...
Article
Aims Primary percutaneous coronary intervention (pPCI) is the gold standard, guideline-recommended revascularization strategy in patients presenting with ST-elevation myocardial infarction (STEMI). However, there are limited data on its use and effectiveness among patients with active cancer presenting with STEMI. Methods and results All STEMI hos...