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Dr RALPH AKYEA's Outputs (49)

Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care (2022)
Journal Article
Jones, M., Akyea, R. K., Payne, K., Humphries, S. E., Abdul-Hamid, H., Weng, S., & Qureshi, N. (2022). Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care. Journal of Personalized Medicine, 12(3), Article 330. https://doi.org/10.3390/jpm12030330

Although familial hypercholesterolemia (FH) screening within primary care is considered cost-effective, which screening approach is cost-effective has not been established. This study determines the cost-effectiveness of six case-finding strategies f... Read More about Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care.

Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’ (2022)
Journal Article
Perkins, P., Parkinson, A., Hebdon, R., & Akyea, R. K. (2022). Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’. Journal of Pain and Symptom Management, 63(6), e691-697. https://doi.org/10.1016/j.jpainsymman.2022.01.018

Context: Some patients take their strong opioid painkillers as unmeasured sips. Objectives: To investigate how and why patients take their medication in this way. Methods: Patient receiving specialist palliative care who take their strong opioid pain... Read More about Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’.

Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study (2022)
Journal Article
Iyen, B., Vinogradova, Y., Akyea, R. K., Weng, S., Qureshi, N., & Kai, J. (2022). Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study. Journal of Endocrinological Investigation, 45(5), 1011-1020. https://doi.org/10.1007/s40618-021-01736-9

Purpose: Ethnic variation in risk of type 2 diabetes is well established, but its impact on mortality is less well understood. This study investigated the risk of all-cause and cardiovascular mortality associated with newly diagnosed type 2 diabetes... Read More about Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study.

Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis (2021)
Journal Article
Qureshi, S., Latif, A., Condon, L., Akyea, R. K., Kai, J., & Qureshi, N. (2022). Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis. Pharmacogenomics, 23(2), 135-154. https://doi.org/10.2217/pgs-2021-0131

Introduction: Pharmacogenomic testing can indicate which drugs may have limited therapeutic action or lead to adverse effects, hence guiding rational and safe prescribing. However, in the UK and other countries, there are still significant barriers t... Read More about Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis.

Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease (2021)
Journal Article
Weng, S. F., Akyea, R. K., Man, K. K., Lau, W. C. Y., Iyen, B., Blais, J. E., Chan, E. W., Siu, C. W., Qureshi, N., Wong, I. C. K., & Kai, J. (2021). Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease. PLoS ONE, 16(12), Article e0260839. https://doi.org/10.1371/journal.pone.0260839

Background: Variability in low-density lipoprotein cholesterol (LDL-C) response to statins is underappreciated. We characterised patients by their statin response (SR), baseline risk of cardiovascular disease (CVD) and 10-year CVD outcomes.

Method... Read More about Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease.

Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care (2021)
Journal Article
Iyen, B., Akyea, R. K., Weng, S., Kai, J., & Qureshi, N. (2021). Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care. Open Heart, 8(2), Article e001817. https://doi.org/10.1136/openhrt-2021-001817

Objectives: Guidance recommends statin treatment in Familial Hypercholesterolaemia (FH) achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). We assessed statin prescribing rates and LDL-cholesterol treatment goal attainmen... Read More about Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care.

Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care (2021)
Journal Article
Qureshi, N., Akyea, R. K., Dutton, B., Leonardi-Bee, J., Humphries, S. E., Weng, S., & Kai, J. (2021). Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care. Open Heart, 8(2), Article e001752. https://doi.org/10.1136/openhrt-2021-001752

Objective Familial hypercholesterolaemia (FH) is a common inherited disorder causing premature coronary heart disease (CHD) and death. We have developed the novel Familial Hypercholesterolaemia Case Ascertainment Tool (FAMCAT 1) case-finding algorith... Read More about Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care.

Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study (2021)
Journal Article
Akyea, R. K., Doehner, W., Iyen, B., Weng, S. F., Qureshi, N., & Ntaios, G. (2021). Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study. Journal of Cachexia, Sarcopenia and Muscle, 12(6), 2111-2121. https://doi.org/10.1002/jcsm.12818

Background: The association between obesity, major adverse cardiovascular events (MACE), and mortality in patients with incident stroke is not well established. We assessed the relationship between body mass index (BMI) and MACE in patients with inci... Read More about Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study.

Case-finding and genetic testing for familial hypercholesterolaemia in primary care (2021)
Journal Article
Qureshi, N., Akyea, R. K., Dutton, B., Leonardi-Bee, J., Humphries, S. E., Weng, S., & Kai, J. (2021). Case-finding and genetic testing for familial hypercholesterolaemia in primary care. Heart, 107(24), 1956-1961. https://doi.org/10.1136/heartjnl-2021-319742

Objective: Familial Hypercholesterolaemia (FH) is a common inherited disorder causing premature heart disease and death. We have developed novel case-finding algorithms (FAMCAT version 1 & 2) for application in primary care, to improve detection of... Read More about Case-finding and genetic testing for familial hypercholesterolaemia in primary care.

Sex disparity in subsequent outcomes in survivors of coronary heart disease (2021)
Journal Article
Akyea, R. K., Kontopantelis, E., Kai, J., Weng, S. F., Patel, R. S., Asselbergs, F. W., & Qureshi, N. (2022). Sex disparity in subsequent outcomes in survivors of coronary heart disease. Heart, 108(1), 37-45. https://doi.org/10.1136/heartjnl-2021-319566

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 (M... Read More about Sex disparity in subsequent outcomes in survivors of coronary heart disease.

Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK (2021)
Journal Article
Iyen, B., Weng, S., Vinogradova, Y., Akyea, R. K., Qureshi, N., & Kai, J. (2021). Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK. BMC Public Health, 21, Article 576. https://doi.org/10.1186/s12889-021-10606-1

Background: Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantifi... Read More about Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK.

Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes (2021)
Journal Article
Akyea, R. K., Vinogradova, Y., Qureshi, N., Patel, R. S., Kontopantelis, E., Ntaios, G., Asselbergs, F. W., Kai, J., & Weng, S. F. (2021). Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes. Stroke, 52(2), 396-405. https://doi.org/10.1161/strokeaha.120.031659

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 de... Read More about Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes.

Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol (2020)
Journal Article
Blais, J. E., Akyea, R. K., Coetzee, A., Chan, A. H., Lau, W. C., Man, K. K., Harrison, J., Chan, E. W., Beyene, K. A., Wong, I. C., & Weng, S. (2021). Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol. BJGP Open, 5(1), 1-9. https://doi.org/10.3399/bjgpopen20X101127

Background: Clinical guidelines recommend specific targets for low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) for primary prevention of cardiovascular disease (CVD). Furthermore, individual variab... Read More about Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol.

Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study (2020)
Journal Article
Akyea, R. K., Qureshi, N., Kai, J., de Lusignan, S., Sherlock, J., McGee, C., & Weng, S. (2020). Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study. BJGP Open, 4(5), 1-10. https://doi.org/10.3399/bjgpopen20X101114

Background: Familial hypercholesterolaemia (FH) is an inherited lipid disorder causing premature heart disease, which is severely underdiagnosed. Improving the identification of people with FH in primary care settings would help to reduce avoidable h... Read More about Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study.

Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care (2020)
Journal Article
Akyea, R. K., Qureshi, N., Kai, J., & Weng, S. F. (2020). Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care. npj Digital Medicine, 3(1), Article 142. https://doi.org/10.1038/s41746-020-00349-5

Familial hypercholesterolaemia (FH) is a common inherited disorder, causing lifelong elevated low-density lipoprotein cholesterol (LDL-C). Most individuals with FH remain undiagnosed, precluding opportunities to prevent premature heart disease and de... Read More about Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care.

Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial (2020)
Journal Article
Perkins, P., Parkinson, A., Parker, R., Blaken, A., & Akyea, R. K. (2020). Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial. BMJ Supportive and Palliative Care, 12, 58-63. https://doi.org/10.1136/bmjspcare-2020-002434

Introduction: Nausea and vomiting are common symptoms for patients with advanced cancer. While there is evidence for acupuncture point stimulation for treatment of these symptoms for patients having anticancer treatment, there is little for when they... Read More about Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial.

Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source (2020)
Journal Article
Ntaios, G., Weng, S. F., Perlepe, K., Akyea, R., Condon, L., Lambrou, D., Sirimarco, G., Strambo, D., Eskandari, A., Karagkiozi, E., Vemmou, A., Korompoki, E., Manios, E., Makaritsis, K., Vemmos, K., & Michel, P. (2021). Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source. European Journal of Neurology, 28(1), 192-201. https://doi.org/10.1111/ene.14524

Background: Hierarchical clustering, a common “unsupervised” machine‐learning algorithm, is advantageous for exploring potential underlying aetiology in particularly heterogeneous diseases. We investigated potential embolic sources in ESUS using a da... Read More about Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source.

Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models (2020)
Journal Article
Akyea, R. K., Leonardi-Bee, J., Asselbergs, F. W., Patel, R. S., Durrington, P., Wierzbicki, A. S., Ibiwoye, O. H., Kai, J., Qureshi, N., & Weng, S. F. (2020). Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models. BMJ Open, 10(7), Article e034564. https://doi.org/10.1136/bmjopen-2019-034564

Introduction: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. With advances in early diagnosis and treatment of CVD and increasing life expectancy, more people are surviving initial CVD events. However, models t... Read More about Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models.

Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying (2020)
Journal Article
Perkins, P., Parkinson, A., Akyea, R. K., & Husbands, E. (2020). Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying. BMJ Supportive and Palliative Care, 10(3), 300-303. https://doi.org/10.1136/bmjspcare-2019-002029

Introduction: Many patients want to stay at home to die. They invariably become unable to take oral medication during their terminal phase. Symptoms are usually controlled by subcutaneous medications. There have been no studies on nasal fentanyl (NF)... Read More about Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying.