Research
Published Papers
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OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19
Working on behalf of NHS England, this study used the OpenSAFELY platform to describe the volume and variation of coded clinical activity in general practice between January 2019 and September 2020, taking respiratory disease and laboratory procedures as examples.
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Trends and clinical characteristics of COVID-19 vaccine recipients: a federated analysis of 57.9 million patients’ primary care records in situ using OpenSAFELY
Working on behalf of NHS England this study analysed 57.9 million patient records in situ and in near-real-time within the infrastructure of the Electronic Health Record (EHR) software vendors EMIS and TPP using OpenSAFELY. The paper describes vaccine coverage and time trends across a range of demographic and fine-grained clinical subgroups in eight Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts.
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Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform
Working on behalf of NHS England, this paper used the OpenSAFELY platform to quantify ethnic differences in SARS-CoV-2 infection and COVID-19 outcomes during the first and second waves of the COVID-19 pandemic in England.
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Identifying Care Home Residents in Electronic Health Records - An OpenSAFELY Short Data Report
This short data report describes the partial overlap between three methods for identifying care home residents in EHR, and provides detailed instructions for how to implement these in OpenSAFELY-TPP to support research into the impact of the COVID-19 pandemic on care home residents.
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Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February
Working on behalf of NHS England, this paper uses the OpenSAFELY platform to estimate the risk of death following confirmation of SARS-CoV-2 infection in England, comparing infection with VOC to non-VOC, after accounting for demographic factors and comorbidities
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OpenSAFELY: Risks of COVID-19 hospital admission and death for people with learning disabilities - a cohort study
Working on behalf of NHS England, this paper used the OpenSAFELY platform to assess the association between learning disability and risk of hospitalisation and mortality from COVID-19 in England among adults and children.
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Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic.
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HIV Infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform
Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the association between HIV infection and COVID-19 mortality.
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Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts
Working on behalf of NHS England, this paper used the OpenSAFELY platform to assess the association between routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and deaths from COVID-19.
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Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform
Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the effectiveness of hydroxychloroquine for prevention, as opposed to treatment, of COVID-19 mortality. We found no evidence of benefit or harm after adjusting for important differences between people with the same health conditions prescribed hydroxychloroquine or not.
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Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform
Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the association between ICS and COVID-19-related death among people with COPD or asthma using linked electronic health records (EHRs) in England, UK.
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OpenSAFELY: Factors associated with COVID-19 death in 17 million patients
Working on behalf of NHS England, this paper used the OpenSAFELY platform to quantify a range of clinical risk factors for COVID-19-related death in the largest cohort study conducted by any country to date.
Read more about OpenSAFELY: Factors associated with COVID-19 death in 17 million patients →
Pre-Prints
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Impact of First UK COVID-19 Lockdown on Hospital Admissions: Interrupted Time Series Study of 32 Million People
This study used OpenSAFELY (on behalf of NHS England), EAVEII (Scotland) and SAIL Databank (Wales) to investigate the weekly hospital admission rates for cancer, cardiovascular and respiratory conditions (excluding COVID-19) broken down by disease, sex, socioeconomic group and ethnicity group in a federated analysis across England, Scotland and Wales.
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Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY
Working on behalf of NHS England, this paper used the OpenSAFELY platform to measure the proportion of people with a recorded code for long COVID, overall and by demographic factors, electronic health record software system, and week.
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Association between oral anticoagulants and COVID-19 related outcomes: two cohort studies
Working on behalf of NHS England, this study used the OpenSAFELY platform to investigate the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes, comparing current OAC use versus non-use in Study 1; and warfarin versus direct oral anticoagulants (DOACs) in Study 2.
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Rates of serious clinical outcomes in survivors of hospitalisation with COVID-19: a descriptive cohort study within the OpenSAFELY platform
Patients with COVID-19 are thought to be at higher risk of cardiometabolic and pulmonary complications, but quantification of that risk is limited. Working on behalf of NHS England, this study aimed to describe the overall burden of these complications in survivors of severe COVID-19 using OpenSAFELY.
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Predicting COVID-19 related death using the OpenSAFELY platform
Working on behalf of NHS England, this study used the OpenSAFELY platform to compare approaches for obtaining relative and absolute estimates of risk of 28-day COVID-19 mortality for adults in the general population of England in the context of changing levels of circulating infection.
Read more about Predicting COVID-19 related death using the OpenSAFELY platform →
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Changes in the rate of cardiometabolic and pulmonary events during the COVID-19 pandemic
Working on behalf of NHS England, this study used the OpenSAFELY platform to describe the overall rate of various key clinical events over time, and their relationship with COVID-19.
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Trends, regional variation, and clinical characteristics of COVID-19 vaccine recipients: a retrospective cohort study in 23.4 million patients using OpenSAFELY
Working on behalf of NHS England, this study used the OpenSAFELY platform to develop a framework for detailed near-real-time monitoring of COVID-19 vaccine roll-out; to describe trends and variation in coverage by geographic area, and between key clinical and demographic patient groups.
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Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform
Working on behalf of NHS England, this study investigates how specific factors are differentially associated with COVID-19 mortality as compared to mortality from other causes.
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OpenSAFELY: impact of national guidance on switching from warfarin to direct oral anticoagulants (DOACs) in early phase of COVID-19 pandemic in England
Working on behalf of NHS England, this study investigates which people were switched from warfarin to DOACs following national guidance during the first wave of the COVID-19 pandemic; seeks to identify potentially unsafe co-prescribing of anticoagulants; and assesses whether abnormal clotting results have become more frequent during the pandemic.
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Association between living with children and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England
Working on behalf of NHS England, this study investigates whether risk of infection with SARs-CoV-2 and severe outcomes differed between adults living with and without children.
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Study protocol: Comparison of different risk prediction modelling approaches for COVID-19 related death using the OpenSAFELY platform
This protocol reports details of a planned study to explore the extent to which incorporating time-varying measures of infection burden over time improves the quality of risk prediction models for COVID-19 death in a large population of adult patients in England.
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Ethnic differences in COVID-19 infection, hospitalisation, and mortality: an OpenSAFELY analysis of 17 million adults in England
Working on behalf of NHS England, the aim of this study was to identify ethnic differences in the risk of COVID-19 infection, hospitalisation and mortality using a large general population cohort in England.
Supplemental Research
Post-publications supplement to Williamson, E.J., Walker, A.J., Bhaskaran, K. et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature (2020). https://doi.org/10.1038/s41586-020-2521-4
August 2020. In the above paper, working on behalf of NHS England, we estimated associations between a wide range of individual-level factors including demographics and comorbidities, and risk of COVID-19 death, but we did not explore interactions between variables. It is plausible that associations may depend on age, and evaluating this would inform more accurate risk prediction. The purpose of this supplement is therefore to present associations between individual-level factors and COVID-19 death,stratified by age group.
Download the supplement here.