Evidence map›Paper›PMID 32979305›Full record

ArticleThe Lancet. Public health2020

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study.

Richard Williams, David A Jenkins, Darren M Ashcroft, Ben Brown, Stephen Campbell, Matthew J Carr, Sudeh Cheraghi-Sohi, Navneet Kapur, Owain Thomas, Roger T Webb and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 138 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
138citing papers in PubMed, 3 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

138 citing papers in PubMed, 3 syntheses or guidelines pooled it, 269 citations in OpenAlex.

  1. Utilization of mental health services during the first year of the COVID-19 pandemic - a systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2026
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78 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Richard WilliamsThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK. Electronic address: richard.williams@manchester.ac.uk.
David A JenkinsThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK.
Darren M AshcroftThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Pharmacy and Optometry, University of Manchester, Manchester, UK.
Ben BrownThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK; Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK; Langworthy Medical Practice, Salford, UK.
Stephen CampbellThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
Matthew J CarrThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
Sudeh Cheraghi-SohiThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
Navneet KapurThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
Owain ThomasLangworthy Medical Practice, Salford, UK.
Roger T WebbThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
Niels PeekThe National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK.
National Institute for Health Research · GBUniversity of Manchester · GBManchester Academic Health Science Centre · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo date, research on the indirect impact of the COVID-19 pandemic on the health of the population and the health-care system is scarce. We aimed to investigate the indirect effect of the COVID-19 pandemic on general practice health-care usage, and the subsequent diagnoses of common physical and mental health conditions in a deprived UK population.

methodsWe did a retrospective cohort study using routinely collected primary care data that was recorded in the Salford Integrated Record between Jan 1, 2010, and May 31, 2020. We extracted the weekly number of clinical codes entered into patient records overall, and for six high-level categories: symptoms and observations, diagnoses, prescriptions, operations and procedures, laboratory tests, and other diagnostic procedures. Negative binomial regression models were applied to monthly counts of first diagnoses of common conditions (common mental health problems, cardiovascular and cerebrovascular disease, type 2 diabetes, and cancer), and corresponding first prescriptions of medications indicative of these conditions. We used these models to predict the expected numbers of first diagnoses and first prescriptions between March 1 and May 31, 2020, which were then compared with the observed numbers for the same time period.

findingsBetween March 1 and May 31, 2020, 1073 first diagnoses of common mental health problems were reported compared with 2147 expected cases (95% CI 1821 to 2489) based on preceding years, representing a 50·0% reduction (95% CI 41·1 to 56·9). Compared with expected numbers, 456 fewer diagnoses of circulatory system diseases (43·3% reduction, 95% CI 29·6 to 53·5), and 135 fewer type 2 diabetes diagnoses (49·0% reduction, 23·8 to 63·1) were observed. The number of first prescriptions of associated medications was also lower than expected for the same time period. However, the gap between observed and expected cancer diagnoses (31 fewer; 16·0% reduction, -18·1 to 36·6) during this time period was not statistically significant.

interpretationIn this deprived urban population, diagnoses of common conditions decreased substantially between March and May 2020, suggesting a large number of patients have undiagnosed conditions. A rebound in future workload could be imminent as COVID-19 restrictions ease and patients with undiagnosed conditions or delayed diagnosis present to primary and secondary health-care services. Such services should prioritise the diagnosis and treatment of these patients to mitigate potential indirect harms to protect public health.

fundingNational Institute of Health Research.

Indexed as

DiagnosisPandemicsAdultCardiovascular DiseasesCerebrovascular DisordersCoronavirus InfectionsCOVID-19Diabetes Mellitus, Type 2FemaleGeneral PracticeHumansMaleMental DisordersMiddle AgedModels, StatisticalNeoplasms

Identifiers

PMID32979305
PMCPMC7511209
OpenAlexW3088602860

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.