Table 1 An overview of the studies included in the review
From: Is real world evidence influencing practice? A systematic review of CPRD research in NICE guidances
Guideline or Guidance and year of publication | Title | Type | Broad Disease Area | CPRD studies cited | Use of evidence from CPRD data |
|---|---|---|---|---|---|
Guideline 2007 | Guidelines for osteoporosis in inflammatory bowel disease and coeliac disease | Clinical | Gastro–intestinal system | 3 | Increased risk of osteoporotic fracture in patients with Inflammatory Bowel Disease (Crohn’s disease and ulcerative colitis) who use steroids; severity of disease (after adjusting for corticosteroid use) also predicted fracture [21]. |
Increased fracture rates in Inflammatory Bowel Disease (Crohn’s disease and ulcerative colitis) patients with age; increased risk of osteoporotic fracture with steroid use [22]. | |||||
Small increase in fracture risk in patients with coeliac disease [23]. | |||||
Guideline 2009 | British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout | Clinical | Musculoskeletal and joint diseases | 1 | Prevalence of gout [24]. |
Guideline 2009 | Evidence-based guidelines for treating bipolar disorder: revised second edition - recommendations from the British Association for Psychopharmacology | Clinical | Central nervous system | 1 | Slightly greater risk of mortality from CHD and stroke in patients prescribed a higher dose of antipsychotics [25]. |
Guideline 2009 | Guidelines (2008) for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the United Kingdom | Clinical | Infections | 1 | Incidence of community-acquired MRSA infections in the UK; association between the use of quinolone or macrolide in the year previous to community-acquired MRSA [26]. |
Guideline 2009 | BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP | Clinical | Central nervous system | 1 | No substantive relationship between varenicline and possible adverse events (including depressed mood, agitation and suicidal thoughts) [27]. |
Guidance 2009 | Progestogen-only Pills | Prescribing | Obstetrics, gynaecology and urinary–tract disorders | 1 | No effect on risk of Venous thromboembolism (VTE) with progestogens used for contraception, and not in higher doses, for the treatment of gynaecological disorders [28]. |
Guideline 2009 | British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009 | Prescribing | Skin | 1 | Increased risk of herpes zoster with biologic therapy (infliximab, etanercept and anakinra) compared with DMARDs in patients with rheumatoid arthritis (RA) [29]. |
Guideline 2010 | Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care | Clinical | Cardiovascular system | 1 | Post-trial mortality estimates in heart failure patients [30]. |
Guideline 2011 | Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology | Clinical | Central nervous system | 1 | Metabolic derangements are risk factors for stroke and myocardial infarction [25]. |
Guidance 2012 | Smoking cessation | Clinical Knowledge Summary | Central nervous system | 1 | No clear association between varenicline and an increased risk of fatal or non- fatal self-harm. [27] |
Guideline 2012 | Psoriasis | Clinical | Skin | 3 | Higher risk of mortality from cardiovascular disease or cerebrovascular disease in severe psoriasis patients compared to an unexposed cohort. [31] |
Higher risk of mortality from diabetes in psoriasis patients compared to an unexposed cohort; the risk of mortality from liver disease was not significantly higher [32]. | |||||
Incidence of major adverse cardiac events was higher in psoriasis patients [33]. | |||||
Guidance 2012 | Sore throat - acute | Clinical Knowledge Summary | Ear, nose and oropharynx | 2 | Low benefit of using antibiotics to prevent complications from acute sore throat [34]. |
Incidence of quinsy was low but develops very quickly; low doses of antibiotics less likely to protect against quinsy [35]. | |||||
Guideline 2012 | Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation | Technology appraisals | Cardiovascular system | 2 | Prevalence of atrial fibrillation (AF) in people aged 55–64 in the UK [36]. |
Event rates according to baseline level of stroke risk and the distribution of patients with different CHADS2 scores [37]. | |||||
Guidance 2012 | Medications in recovery: re-orientating drug dependence treatment | Prescribing | Central nervous system | 1 | Increased risk of mortality in the first few weeks of prescribing opioid substitution Therapy (OST); overall mortality ratio was lower in those prescribed OST than in opioid users [38]. |
Guidance 2012 | Osteoporosis: assessing the risk of fragility fracture | Clinical | Endocrine system | 2 | Included in systematic review for the ‘history of falls’ as a prognostic factor for the risk of fragility of falls in Osteoporosis [39]. |
Dose effect relationship between steroid use and fracture risk [40]. | |||||
Guideline 2012 | Infection: Prevention and control of healthcare-associated infections in primary and community care | Clinical | Infections | 1 | Probability of treatment failure in young women with urinary tract infections [41]. |
Guideline 2013 | Omalizumab for treating severe persistent allergic asthma (review of technology appraisal guidance 133 and 201) | Technology appraisals | Respiratory system | 1 | Mortality rate for severe persistent allergic asthma patients being treated with Omalizumab [42]. |
Guidance 2014 | Contraception - combined hormonal methods | Clinical Knowledge Summary | Obstetrics, gynaecology and urinary–tract disorders | 1 | Higher risk of venous thromboembolism (VTE) associated with Yasmin® than the risk of VTE with COCs containing levonorgestrel [43]. |
Guidance 2015 | Gout | Clinical Knowledge Summary | Musculoskeletal and joint diseases | 1 | Prevalence of Gout [24]. |
Guidance 2015 | Immunisations - seasonal influenza | Clinical Knowledge Summary | Immunological products and vaccines | 1 | No association between influenza vaccines and Guillain-Barré syndrome [44]. |
Guidance 2015 | Otitis externa | Clinical Knowledge Summary | Ear, nose and oropharynx | 1 | Prescribing patterns of oral antibiotics for otitis externa [45]. |
Guidance 2015 | Vortioxetine for treating major depressive episode | Technology appraisals | Central nervous system | 1 | Provided drug utilisation and healthcare resource data and comparative outcomes for diagnosed patients prescribed the specific product [46]. |
Guidance 2015 | Multiple sclerosis | Clinical Knowledge Summary | Central nervous system | 1 | Prevalence of Multiple sclerosis [47]. |
Guideline 2015 | British HIV Association guidelines on the use of vaccines in HIV-positive adults 2015 | Prescribing | Infections | 1 | Vaccinations protect against severe disease, complications such as bronchopneumonia, hospital admission, and mortality in the elderly and those with underlying conditions [48]. |
Guideline 2015 | Suspected Cancer: recognition and referral | Clinical | Malignant disease and immunosuppression | 15 | Provided the positive predictive values of symptoms for lung, oesophageal, stomach, colorectal, bladder and renal cancer to improve the diagnosis of such cancers [49]. |
| Â | Â | Â | Â | Â | Provided the positive predictive values of symptoms for pancreatic cancer to improve the diagnosis of this cancer [50]. |
Provided the positive predictive values of symptoms for oesophageal and stomach cancer to improve the diagnosis of these cancer [51]. | |||||
Provided the positive predictive values of symptoms for breast cancer to improve the diagnosis of this cancer [52]. | |||||
Provided the positive predictive values of symptoms for endometrial cancer to improve the diagnosis of this cancer [53]. | |||||
| Â | Â | Â | Â | Â | Provided the positive predictive values of symptoms for bladder cancer to improve the diagnosis of this cancer [54]. |
Provided the positive predictive values of symptoms for renal cancer to improve the diagnosis of this cancer [55]. | |||||
Provided the positive predictive values of symptoms for myeloma to improve the diagnosis of this cancer [56]. | |||||
Provided the positive predictive values of symptoms for bladder cancer to improve the diagnosis of this cancer [57]. | |||||
|  |  |  |  |  | Provided the positive predictive values of symptoms for urological cancer, brain cancer, CNS cancer, neuroblastoma, retinoblastoma and Wilms’ tumour in children to improve the diagnosis of these cancers [58]. |
Provided the positive predictive values of symptoms for urological cancer, brain cancer, CNS cancer, leukaemia/lymphoma, Non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, bone sarcoma, soft tissue sarcoma, abdominal cancer, neuroblastoma, retinoblastoma and Wilms’ tumour in children and young adults to improve the diagnosis of these cancers [59]. | |||||
Provided the positive predictive values of symptoms for brain cancer, CNS cancer, leukaemia, Non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, bone sarcoma, soft tissue sarcoma neuroblastoma, retinoblastoma and Wilms’ tumour in children, young adults and adults to improve the diagnosis of these cancers [60]. | |||||
| Â | Â | Â | Â | Â | Provided the positive predictive values of symptoms for brain and CNS cancer to improve the diagnosis of these cancer [61]. |
Provided the positive predictive values of symptoms for brain and CNS cancer in children and young adults to improve diagnosis of these cancers [62]. | |||||
Provided the positive predictive values of symptoms for brain, lung and CNS cancer to improve diagnosis of these cancers [63]. |