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Use of electronic patient records to examine COVID outcomes in people with dementia


   Norwich Medical School

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  Dr Y Loke  No more applications being accepted  Competition Funded PhD Project (UK Students Only)

About the Project

People living with dementia are among the worst hit by the SARS-CoV-2 pandemic globally, with an estimated quarter of deaths directly due to COVID-19 in England occurring in people with dementia (www.alzheimers.org.uk/worsthit). It is imperative to better understand health related contributors to severe outcomes here, as the pandemic continues with new variants, and for any future pandemics. 

Certain sedating medications that increase the risk and complications from pneumonia are thought to cause similar issues in COVID-19. This project will explore the risk of covid infection and subsequent severe outcomes in people with dementia prescribed higher compared to lower doses of these sedatives.  

This PhD project will involve the analysis of patient records from a large database of >62 million UK primary care patient records linked to hospital and death certificate data. These databases present huge opportunities for studying the effects of covid, but there are challenges to explore such as the recording and availability of covid data (www.cebm.net/covid-19/why-no-one-can-ever-recover-from-covid-19-in-england-a-statistical-anomaly/), additional infection risk within care homes and hospitals, selection biases and confounding.   

The PhD project will be jointly supervised by Dr Kathryn Richardson and Prof Yoon Loke from the Norwich Medical School, and include collaboration with UCL, the universities of Cambridge and Exeter, Newcastle University, and UBC (Canada).  

The PhD will be hosted by the Norwich Epidemiology Centre allowing exchange of ideas and experience with fellow researchers. Training will be provided in relevant research methodology, the handling and analysis of large health datasets, contemporary evaluation of sources of bias, and cutting-edge statistical techniques. Attendance at formal training courses and conferences will be encouraged. There is the potential to take the PhD in a more statistical (around missing data issues or joint modelling) or epidemiological direction depending on the candidate’s interests. 

Please contact Dr Kathryn Richardson ([Email Address Removed]) for further details. 


Funding Notes

This PhD project is a Faculty of Medicine and Health Sciences competition for funded studentships. The studentships are funded for 3 years and comprise UK tuition fees, an annual stipend of £15,609 (2021/22 rate) and £1,000 per annum to support research training. International applicants (including EU) may apply but are required to fund the difference between UK and International tuition fees (details of tuition fees can be found on our website https://www.uea.ac.uk/study/fees-and-funding/fees).

References

Richardson K, Loke YK, Fox C, et al. Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study. BMC Med 2020; 18:351. doi: 10.1186/s12916-020-01821-5
Richardson K, Fox C, Maidment I, et al. Anticholinergic medication and risk of dementia: case-control study. BMJ 2018;361:k1315 doi:10.1136/bmj.k1315
Richardson K, Mattishent K, Loke YK, et al. History of Benzodiazepine Prescriptions and Risk of Dementia: Possible Bias Due to Prevalent Users and Covariate Measurement Timing in a Nested Case-Control Study. Am J Epidemiol 2019; 188(7):1228-36
Sterne JA, Hernan MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355 :i4919 doi:10.1136/bmj.i4919
Howard R, Burns A, Schneider L. Antipsychotic prescribing to people with dementia during COVID-19. Lancet Neurol. 2020 Nov;19(11):892. doi: 10.1016/S1474-4422(20)30370-7.
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