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  • Journal article
    Palmer WL, Bottle A, Davie C, Vincent CA, Aylin Pet al., 2012,

    Dying for the Weekend <i>A Retrospective Cohort Study on the Association Between Day of Hospital Presentation and the Quality and Safety of Stroke Care</i>

    , ARCHIVES OF NEUROLOGY, Vol: 69, Pages: 1296-1302, ISSN: 0003-9942
  • Journal article
    Mamidanna R, Eid-Arimoku L, Almoudaris AM, Burns EM, Bottle A, Aylin P, Hanna GB, Faiz Oet al., 2012,

    Poor 1-Year Survival in Elderly Patients Undergoing Nonelective Colorectal Resection

    , DISEASES OF THE COLON & RECTUM, Vol: 55, Pages: 788-796, ISSN: 0012-3706
  • Journal article
    Sanders RD, Bottle A, Jameson SS, Mozid A, Aylin P, Edger L, Ma D, Reed MR, Walters M, Lees KR, Maze Met al., 2012,

    Independent Preoperative Predictors of Outcomes in Orthopedic and Vascular Surgery The Influence of Time Interval Between an Acute Coronary Syndrome or Stroke and the Operation

    , ANNALS OF SURGERY, Vol: 255, Pages: 901-907, ISSN: 0003-4932
  • Journal article
    Everitt AR, Clare S, Pertel T, John SP, Wash RS, Smith SE, Chin CR, Feeley EM, Sims JS, Adams DJ, Wise HM, Kane L, Goulding D, Digard P, Anttila V, Baillie JK, Walsh TS, Hume DA, Palotie A, Xue Y, Colonna V, Tyler-Smith C, Dunning J, Gordon SB, GenISIS Investigators, MOSAIC Investigators, Smyth RL, Openshaw PJ, Dougan G, Brass AL, Kellam P, Everitt AR, Clare S, Pertel T, John SP, Wash RS, Smith SE, Chin CR, Feeley EM, Sims JS, Adams DJ, Wise HM, Kane L, Goulding D, Digard P, Anttila V, Baillie JK, Walsh TS, Hume DA, Palotie A, Xue Y, Colonna V, Tyler-Smith C, Dunning J, Gordon SB, The GenISIS Investigators, The MOSAIC Investigators, Smyth RL, Openshaw PJ, Dougan G, Brass AL, Kellam P, Everitt AR, Clare S, Pertel T, John SP, Wash RS, Smith SE, Chin CR, Feeley EM, Sims JS, Adams DJ, Wise HM, Kane L, Goulding D, Digard P, Anttila V, Baillie JK, Walsh TS, Hume DA, Palotie A, Xue Y, Colonna V, Tyler-Smith C, Dunning J, Gordon SB, Everingham K, Dawson H, Hope D, Ramsay P, Campbell A, Kerr S, Harrison D, Rowan K, Addison J, Donald N, Galt S, Noble D, Taylor J, Webster LL, Taylor Local LI, Aldridge LL, Dornan R, Richard C, Gilmour D, Simmons LL, White LL, Jardine C, Williams LL, Booth LL, Quasim T, Watson V, Henry P, Munro F, Bell L, Ruddy LL, Cole LL, Southward J, Allcoat P, Gray S, McDougall LL, Matheson J, Whiteside LL, Alcorn D, Rooney LL, Sundaram R, Imrie LL, Bruce J, McGuigan K, Moultrie LL, Cairns LL, Grant J, Hughes M, Murdoch LL, Davidson LL, Harris G, Paterson R, Wallis LL, Binning LL, Pollock M, Antonelli J, Duncan A, Gibson J, McCulloch C, Murphy L, Haley C, Faulkner G, Freeman T, Hume DA, Baillie JK, Chaussabel D, Adamson WE, Carman WF, Thompson C, Zambon MC, Aylin P, Ashby D, Barclay WS, Brett SJ, Cookson WO, Drumright LN, Dunning J, Elderfield RA, Garcia-Alvarez L, Gazzard BG, Griffiths MJ, Habibi MS, Hansel TT, Herberg JA, Holmes AH, Hussell T, Johnston SL, Kon OM, Levin M, Moffatt MF, Nadel S, Openshaw PJ, Warner JO, Aston SJ, Gordon SB, Hay A, McCauleet al., 2012,

    IFITM3 restricts the morbidity and mortality associated with influenza.

    , Nature, Vol: 484, Pages: 519-523

    The 2009 H1N1 influenza pandemic showed the speed with which a novel respiratory virus can spread and the ability of a generally mild infection to induce severe morbidity and mortality in a subset of the population. Recent in vitro studies show that the interferon-inducible transmembrane (IFITM) protein family members potently restrict the replication of multiple pathogenic viruses1, 2, 3, 4, 5, 6, 7. Both the magnitude and breadth of the IFITM proteins’ in vitro effects suggest that they are critical for intrinsic resistance to such viruses, including influenza viruses. Using a knockout mouse model8, we now test this hypothesis directly and find that IFITM3 is essential for defending the host against influenza A virus in vivo. Mice lacking Ifitm3 display fulminant viral pneumonia when challenged with a normally low-pathogenicity influenza virus, mirroring the destruction inflicted by the highly pathogenic 1918 ‘Spanish’ influenza9, 10. Similar increased viral replication is seen in vitro, with protection rescued by the re-introduction of Ifitm3. To test the role of IFITM3 in human influenza virus infection, we assessed the IFITM3 alleles of individuals hospitalized with seasonal or pandemic influenza H1N1/09 viruses. We find that a statistically significant number of hospitalized subjects show enrichment for a minor IFITM3 allele (SNP rs12252-C) that alters a splice acceptor site, and functional assays show the minor CC genotype IFITM3 has reduced influenza virus restriction in vitro. Together these data reveal that the action of a single intrinsic immune effector, IFITM3, profoundly alters the course of influenza virus infection in mouse and humans.
  • Journal article
    Langford KM, Bottle A, Aylin PP, Ward Het al., 2012,

    Using routine data to monitor inequalities in an acute trust: a retrospective study

    , BMC Health Services Research, Vol: 12
  • Journal article
    Jen M-H, Saxena S, Bottle A, Pollok R, Holmes A, Aylin Pet al., 2012,

    Assessment of administrative data for evaluating the shifting acquisition of <i>Clostridium difficile</i> infection in England

    , JOURNAL OF HOSPITAL INFECTION, Vol: 80, Pages: 229-237, ISSN: 0195-6701
  • Journal article
    Alexandrescu R, Bottle A, Jarman B, Aylin Pet al., 2012,

    Impact of transfer for angioplasty and distance on AMI in-hospital mortality.

    , Acute Card Care, Vol: 14, Pages: 5-12

    BACKGROUND: The aim of the study was to evaluate the impact of transfer status and distance on in-hospital mortality for acute myocardial infarction (AMI) patients undergoing angioplasty on the same or next day of hospital admission. METHODS: Retrospective analysis of English hospital administrative data using logistic regression modelling. RESULTS: After risk adjustment for the patient baseline characteristics, transferred patients had a higher in-hospital mortality rate than those admitted directly to hospital for angioplasty performed on the same or next day: OR=1.25 (95% confidence interval: 1.02-1.52), P=0.029. There was no statistically significant increased risk of in-hospital mortality with increasing distance between home and angioplasty centre (OR=0.98 (0.84-1.16), P=0.842 for 6-15 km and 1.03 (0.87-1.22), P=0.768 for >15 km when compared with <6 km) or with increasing inter-hospital transfer distance for angioplasty (OR=0.84 (0.55-1.29), P=0.435 for 16-34 km and 0.88 (0.58-1.35), for >34 km when compared with <16 km). CONCLUSIONS: Transfer status is associated with in-hospital mortality rate for AMI patients undergoing angioplasty on the same or next day of hospital admission. No relation between in-hospital mortality and the distance from home to angioplasty centre or inter-hospital transfer distance for angioplasty was found in these patients.
  • Journal article
    Almoudaris AM, Burns E, Bottle A, Aylin P, Darzi A, Vincent Cet al., 2012,

    Single measures of performance do not reflect overall institutional quality in colorectal cancer surgery

    , Gut

    Objective To evaluate overall performance of English colorectal cancer surgical units identified as outliers for a single quality measure—30 day inhospital mortality.Design 144 542 patients that underwent primary major colorectal cancer resection between 2000/2001 and 2007/2008 in 149 English National Health Service units were included from hospital episodes statistics. Casemix adjusted funnel plots were constructed for 30 day inhospital mortality, length of stay, unplanned readmission within 28 days, reoperation, failure to rescue-surgical (FTR-S) and abdominoperineal excision (APE) rates. Institutional performance was evaluated across all other domains for institutions deemed outliers for 30 day mortality. Outliers were those that lay on or breached 3 SD control limits. ‘Acceptable’ performance was defined if units appeared under the upper 2 SD limit.Results 5 high mortality outlier (HMO) units and 15 low mortality outlier (LMO) units were identified. Of the five HMO units, two were substandard performance outliers (ie, above 3 SD) on another metric (both on high reoperation rates). A further two HMO institutions exceeded the second but not the third SD limits for substandard performance on other outcome metrics. One of the 15 LMO units exceeded 3 SD for substandard performance (APE rate). One LMO institution exceeded the second but not the third SD control limits for high reoperation rates. Institutional mortality correlated with FTR-S and reoperations (R=0.445, p<0.001 and R=0.191, p<0.020 respectively).Conclusions Performance appraisal in colorectal surgery is complex and dependent on stakeholder perspective. Benchmarking units solely on a single performance measure is over simplistic and potentially hazardous. A global appraisal of institutional outcome is required to contextualise performance.
  • Journal article
    Tsang C, Majeed A, Aylin P, 2012,

    Routinely recorded patient safety events in primary care: a literature review

    , FAMILY PRACTICE, Vol: 29, Pages: 8-15, ISSN: 0263-2136
  • Journal article
    Mamidanna R, Bottle A, Aylin P, Faiz O, Hanna GBet al., 2012,

    Short-Term Outcomes Following Open Versus Minimally Invasive Esophagectomy for Cancer in England <i>A Population</i>-<i>Based National Study</i>

    , ANNALS OF SURGERY, Vol: 255, Pages: 197-203, ISSN: 0003-4932

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by Paul Aylin and Alex Bottle

Statistical Methods for Healthcare Performance Monitoring
A book for those measuring, monitoring, comparing and improving healthcare performance