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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].
      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].
      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].
      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].