Clinicians and epidemiologists have become increasingly interested in access to patient records f... more Clinicians and epidemiologists have become increasingly interested in access to patient records for clinical audit and medical research. This article describes the historical background of the Office of Population Censuses and Surveys (OPCS), and the ways in which its records can be used to support such research. It also discusses how confidentiality is safeguarded, whilst at the same time access for those with approved studies has been improved.
The health of our children, the second in OPCS's latest series of decennial supplements, brin... more The health of our children, the second in OPCS's latest series of decennial supplements, brings together data from a wide variety of sources to paint a picture of the lifestyle and health of British children in the 1970s and 1980s. This review presents the main findings from the volume.
... 1989;34:1-166. Report on Confidential Enquiries into Maternal Deaths in England and Wales 198... more ... 1989;34:1-166. Report on Confidential Enquiries into Maternal Deaths in England and Wales 1982-1984. Turnbull A, Tindall VR, Beard RW, Robson G, Dawson IM, Cloake EP, Ashley JS,Botting B. PMID: 2641172 [PubMed - indexed for MEDLINE]. MeSH Terms. ...
A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was... more A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on the certificate, not just as the underlying cause. The results suggest there is presently no need to extend the use of the new stillbirth and neonatal death certificates, introduced in 1986, to the postneonatal period. Periodic multicause analysis of the old style death certificate should be sufficient to reveal the detail of conditions incriminated in postneonatal deaths.
... Adrian Worrall Research officer Nicolas Rea General practitioner Kentish Town Health Centre, ... more ... Adrian Worrall Research officer Nicolas Rea General practitioner Kentish Town Health Centre, London NW5 2AJ Yoav Ben-Shlomo Senior lecturer in ... Rate of diagnosis of cytological abnormalities is best end point Editor—Frank Buntinx and Marleen Brou-wers report a meta ...
To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death ... more To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used to determine ethnic group. Postneonatal mortality was highest in infants of mothers born in Pakistan (6.4/1000 live births) followed by infants of mothers born in the Caribbean (4.5) and the United Kingdom and Republic of Ireland (4.1). Crude rates were lower in infants of mothers born in India (3.9/1000), east and west Africa (3.0), and Bangladesh (2.8) than in infants of mothers born in the United Kingdom despite less favourable birth weights. Mortality ratios standardised separately for maternal age, parity, and social class were significantly higher in infants of mothers born in Pakistan and lower in those of mothers born in Bangladesh. The ratio for infants of Caribbean mothers was significantly higher when adjusted for maternal age. Ratios for infants of Indian and east African mothers did not show significant differences after standardisation. An important finding was a low incidence of sudden infant death in infants of Asian origin. This was paralleled by lower mortality from respiratory causes. During 1975-85 postneonatal mortality in all immigrant groups except Pakistanis fell to a similar or lower rate than that in the United Kingdom group; Pakistanis showed a persistent excess. During 1984-5 several immigrant groups (from the Republic of Ireland, India, west Africa, and the Caribbean) recorded an increase in postneonatal mortality. Surveillance of postneonatal mortality among ethnic communities should be continued, and research is needed to identify the causes underlying the differences.
Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights r... more Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighed under 1500 g at birth have been calculated in 100 g groups, separately for single and multiple births. By 1987 singleton live births in England and Wales who weighed between 700 and 799 g had a 43% chance of surviving to 1 year compared with a 32% chance five years earlier; those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute number of survivors weighing between 500 and 999 g at birth increased by nearly 50% between 1983 and 1987, and there was a 30% increase overall in survivors weighing less than 1500 g.
We examined like and unlike sex twinning rates in Great Britain by social class over the period 1... more We examined like and unlike sex twinning rates in Great Britain by social class over the period 1974-85. Although twinning rates are believed to have changed over that period, we found no evidence of differential change by social class, suggesting that any factors affecting twinning are widespread in the population.
Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 ... more Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained after standardising for maternal age and social class. The highest overall mortality was in infants of mothers born in Pakistan (standardised mortality ratio 237), followed by infants of mothers born in India (standardised mortality ratio 134), East Africa (standardised mortality ratio 126), and Bangladesh (standardised mortality ratio 118). Caribbean and West African mothers showed an overall deficit. Mortality was inversely related to social class in all groups except the Afro-Caribbean. Infants of mothers born in Pakistan had the highest mortality in every social class except I, and for most anomalies investigated. Their ratios were particularly high for limb and musculoskeletal anomalies (standardised mortality ratio 362), genitourinary anomalies (standardised mortality ratio 268), and central nervous system anomalies (standardised mortality ratio 239). Our findings highlight the need for further research to identify the causes underlying these differences.
To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the ... more To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the United Kingdom (UK), particularly in the large immigrant and ethnic minority communities. Unlinked anonymous neonatal seroprevalence survey with electronic record linkage of data from child health computers (maternal age and ethnic status) and birth registration (parent's country of birth). Of a total 137456 samples collected in 1997-1998, 188 (0.14%) were anti-HIV-1 seropositive. Seroprevalence was highest in women born in East Africa (2.3%) and Central Africa (1.9%). 76.4% of seropositive newborns were delivered to mothers born in sub-Saharan Africa; a further 6.0% had fathers from sub-Saharan Africa. However, there was little evidence of HIV in women born in Southern Asia [prevalence 0.0081%; 95% confidence interval (CI) 0-0.04], and none within UK-born Asian communities. Prevalence among the UK-born Black African community was low (0.14%; 95% CI 0-0.6). Among infants with both parents known to be born in the UK, seroprevalence was 0.023% (95% CI 0.01-0.04) in London, and zero (95% CI 0-0.007) in non-Metropolitan areas. Irrespective of mother's region of birth, seroprevalence was 4.2 times higher (95% CI 3.0-5.8) in newborns whose father's details were not recorded at birth registration, a marker for single unsupported mothers. The risk of HIV among pregnant women from sub-Saharan Africa has been recognized. However, in southern England, HIV is very rare in women from Southern Asia and in UK-born women in ethnic minority communities, in spite of cultural and travel ties to high-prevalence countries. Data linkage in anonymous surveys assists in monitoring the impact of the worldwide epidemic on prevalence and incidence locally.
The International journal of risk & safety in medicine, 1991
Statistical methods for surveillance are reviewed for use with both hospital-based systems and ce... more Statistical methods for surveillance are reviewed for use with both hospital-based systems and central registries. In the hospital-based system the surveillance methods are applied as each new case occurs and the methods focus on the number of unaffected births between each case. In centralized systems, it is usually more convenient to observe the number of cases in time intervals of fixed length. Methods for calculating exact confidence limits about the number of cases, the proportion of malformed cases and the observed-to-expected ratio are reviewed, as are methods allowing evidence to accumulate over several time periods. Examples are given to illustrate the use of the different methods.
Journal of Epidemiology and Community Health, 1997
STUDY OBJECTIVE: To evaluate the completeness of notification of deaths by the National Health Se... more STUDY OBJECTIVE: To evaluate the completeness of notification of deaths by the National Health Service Central Register (NHSCR) for England and Wales. DESIGN: Deaths for a birth cohort were ascertained through scanning the relevant volumes of NHSCR. Attempts were made to confirm these deaths and additional deaths were ascertained through searching local records. Logistic regression was used to investigate how
Clinicians and epidemiologists have become increasingly interested in access to patient records f... more Clinicians and epidemiologists have become increasingly interested in access to patient records for clinical audit and medical research. This article describes the historical background of the Office of Population Censuses and Surveys (OPCS), and the ways in which its records can be used to support such research. It also discusses how confidentiality is safeguarded, whilst at the same time access for those with approved studies has been improved.
The health of our children, the second in OPCS's latest series of decennial supplements, brin... more The health of our children, the second in OPCS's latest series of decennial supplements, brings together data from a wide variety of sources to paint a picture of the lifestyle and health of British children in the 1970s and 1980s. This review presents the main findings from the volume.
... 1989;34:1-166. Report on Confidential Enquiries into Maternal Deaths in England and Wales 198... more ... 1989;34:1-166. Report on Confidential Enquiries into Maternal Deaths in England and Wales 1982-1984. Turnbull A, Tindall VR, Beard RW, Robson G, Dawson IM, Cloake EP, Ashley JS,Botting B. PMID: 2641172 [PubMed - indexed for MEDLINE]. MeSH Terms. ...
A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was... more A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on the certificate, not just as the underlying cause. The results suggest there is presently no need to extend the use of the new stillbirth and neonatal death certificates, introduced in 1986, to the postneonatal period. Periodic multicause analysis of the old style death certificate should be sufficient to reveal the detail of conditions incriminated in postneonatal deaths.
... Adrian Worrall Research officer Nicolas Rea General practitioner Kentish Town Health Centre, ... more ... Adrian Worrall Research officer Nicolas Rea General practitioner Kentish Town Health Centre, London NW5 2AJ Yoav Ben-Shlomo Senior lecturer in ... Rate of diagnosis of cytological abnormalities is best end point Editor—Frank Buntinx and Marleen Brou-wers report a meta ...
To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death ... more To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used to determine ethnic group. Postneonatal mortality was highest in infants of mothers born in Pakistan (6.4/1000 live births) followed by infants of mothers born in the Caribbean (4.5) and the United Kingdom and Republic of Ireland (4.1). Crude rates were lower in infants of mothers born in India (3.9/1000), east and west Africa (3.0), and Bangladesh (2.8) than in infants of mothers born in the United Kingdom despite less favourable birth weights. Mortality ratios standardised separately for maternal age, parity, and social class were significantly higher in infants of mothers born in Pakistan and lower in those of mothers born in Bangladesh. The ratio for infants of Caribbean mothers was significantly higher when adjusted for maternal age. Ratios for infants of Indian and east African mothers did not show significant differences after standardisation. An important finding was a low incidence of sudden infant death in infants of Asian origin. This was paralleled by lower mortality from respiratory causes. During 1975-85 postneonatal mortality in all immigrant groups except Pakistanis fell to a similar or lower rate than that in the United Kingdom group; Pakistanis showed a persistent excess. During 1984-5 several immigrant groups (from the Republic of Ireland, India, west Africa, and the Caribbean) recorded an increase in postneonatal mortality. Surveillance of postneonatal mortality among ethnic communities should be continued, and research is needed to identify the causes underlying the differences.
Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights r... more Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighed under 1500 g at birth have been calculated in 100 g groups, separately for single and multiple births. By 1987 singleton live births in England and Wales who weighed between 700 and 799 g had a 43% chance of surviving to 1 year compared with a 32% chance five years earlier; those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute number of survivors weighing between 500 and 999 g at birth increased by nearly 50% between 1983 and 1987, and there was a 30% increase overall in survivors weighing less than 1500 g.
We examined like and unlike sex twinning rates in Great Britain by social class over the period 1... more We examined like and unlike sex twinning rates in Great Britain by social class over the period 1974-85. Although twinning rates are believed to have changed over that period, we found no evidence of differential change by social class, suggesting that any factors affecting twinning are widespread in the population.
Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 ... more Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained after standardising for maternal age and social class. The highest overall mortality was in infants of mothers born in Pakistan (standardised mortality ratio 237), followed by infants of mothers born in India (standardised mortality ratio 134), East Africa (standardised mortality ratio 126), and Bangladesh (standardised mortality ratio 118). Caribbean and West African mothers showed an overall deficit. Mortality was inversely related to social class in all groups except the Afro-Caribbean. Infants of mothers born in Pakistan had the highest mortality in every social class except I, and for most anomalies investigated. Their ratios were particularly high for limb and musculoskeletal anomalies (standardised mortality ratio 362), genitourinary anomalies (standardised mortality ratio 268), and central nervous system anomalies (standardised mortality ratio 239). Our findings highlight the need for further research to identify the causes underlying these differences.
To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the ... more To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the United Kingdom (UK), particularly in the large immigrant and ethnic minority communities. Unlinked anonymous neonatal seroprevalence survey with electronic record linkage of data from child health computers (maternal age and ethnic status) and birth registration (parent's country of birth). Of a total 137456 samples collected in 1997-1998, 188 (0.14%) were anti-HIV-1 seropositive. Seroprevalence was highest in women born in East Africa (2.3%) and Central Africa (1.9%). 76.4% of seropositive newborns were delivered to mothers born in sub-Saharan Africa; a further 6.0% had fathers from sub-Saharan Africa. However, there was little evidence of HIV in women born in Southern Asia [prevalence 0.0081%; 95% confidence interval (CI) 0-0.04], and none within UK-born Asian communities. Prevalence among the UK-born Black African community was low (0.14%; 95% CI 0-0.6). Among infants with both parents known to be born in the UK, seroprevalence was 0.023% (95% CI 0.01-0.04) in London, and zero (95% CI 0-0.007) in non-Metropolitan areas. Irrespective of mother's region of birth, seroprevalence was 4.2 times higher (95% CI 3.0-5.8) in newborns whose father's details were not recorded at birth registration, a marker for single unsupported mothers. The risk of HIV among pregnant women from sub-Saharan Africa has been recognized. However, in southern England, HIV is very rare in women from Southern Asia and in UK-born women in ethnic minority communities, in spite of cultural and travel ties to high-prevalence countries. Data linkage in anonymous surveys assists in monitoring the impact of the worldwide epidemic on prevalence and incidence locally.
The International journal of risk & safety in medicine, 1991
Statistical methods for surveillance are reviewed for use with both hospital-based systems and ce... more Statistical methods for surveillance are reviewed for use with both hospital-based systems and central registries. In the hospital-based system the surveillance methods are applied as each new case occurs and the methods focus on the number of unaffected births between each case. In centralized systems, it is usually more convenient to observe the number of cases in time intervals of fixed length. Methods for calculating exact confidence limits about the number of cases, the proportion of malformed cases and the observed-to-expected ratio are reviewed, as are methods allowing evidence to accumulate over several time periods. Examples are given to illustrate the use of the different methods.
Journal of Epidemiology and Community Health, 1997
STUDY OBJECTIVE: To evaluate the completeness of notification of deaths by the National Health Se... more STUDY OBJECTIVE: To evaluate the completeness of notification of deaths by the National Health Service Central Register (NHSCR) for England and Wales. DESIGN: Deaths for a birth cohort were ascertained through scanning the relevant volumes of NHSCR. Attempts were made to confirm these deaths and additional deaths were ascertained through searching local records. Logistic regression was used to investigate how
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Papers by B. Botting