Harkness Project Title: Analysis of the Implications of National CVD Prevention Policies in Five Countries
Mentors: David Bates, M.D., and Thomas H. Lee, M.D.
Placement: Brigham and Women's Hospital
Biography at time of Harkness Fellowship: Tom P. Marshall, a 2003-04 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is a is a lecturer in public health in the department of public health and epidemiology of the University of Birmingham. His responsibilities include undergraduate (medical student) teaching and postgraduate education, and research. Marshall’s research interests include prevention of cardiovascular disease in primary care, communication of risks to patients and quality monitoring and improvement. He currently holds a Medical Research Council grant to investigate patient preferences for treatments to prevent CHD. Marshall holds degrees in medicine and public health from the University of Edinburgh and London School of Hygiene and Tropical Medicine and is accredited in general practice and public health. He is in the process of completing his Ph.D. at the University of Birmingham.
Project: Marshall’s project estimated the resource costs and health consequences of applying differing national cardiovascular disease (CVD) prevention policies on a standard population, using the same standard assumptions about costs and benefits of assessment and treatment. He considered three treatments – aspirin, antihypertensive treatment, and statins – and guidelines from Australia, Canada, New Zealand, the U.K., and the U.S. The numbers of persons eligible for treatment, total costs (assessment and treatment), and benefits (CVD events prevented) were determined over a five-year timeframe.
Career activity since Fellowship:
Current Position: .Reader in Primary Care, Public Health and Epidemiology, University of Birmingham (Updated August 2010)
Nirantharakumar K, Hemming K, Narendran P, Marshall T, Coleman JJ. A prediction model for adverse outcome in hospitalized patients with diabetes Diabetes Care 2013.
Wu J, Yao GL, Zhu S, Mohammed MA. Marshall T. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study PLoS One 2013; 8(7): e67611.
Mohammed MA, Marshall T, Nirantharakumar K, Stevens A, Fitzmaurice D. Patterns of warfarin use in subgroups of patients with atrial fibrillation: a cross-sectional analysis of 430 general practices in the United Kingdom PLoS One 2013; May 2;8(5):e61979.
Marshall T, Caley M, Hemming K, Gill P, Gale N, Jolly K. Mixed methods evaluation of targeted case finding for cardiovascular disease prevention using a stepped wedged cluster RCT BMC Public Health 2012; 12:908.
Mohammed MA, Marshall T, Gill P. The Effect of Chance Variability in Blood Pressure Readings on the Decision Making of General Practitioners: An Internet-Based Case Vignette Study. PLoS ONE 2012; 7(11): e46556.
Mohammed M.A., El Sayed C., Marshall T. Patient and other factors influencing the prescribing of cardiovascular prevention therapy in the general practice setting with and without nurse assessment. Medical Decision Making 2012 May-Jun;32(3):498-506.
Gale N, Greenfield S, Gill P, Gutridge K, Marshall T. Patient and general practitioner attitudes to taking medication to prevent cardiovascular disease after receiving detailed information on risks and benefits of treatment: a qualitative study BMC Family Practice 2011, 12:59
Marshall T, Lancashire R, Sharp D, Peters TJ, Cheng KK, Hamilton W. The diagnostic performance of scoring systems to identify symptomatic colorectal cancer compared to current referral guidance Gut 2011 Sep;60(9):1242-8.
Marshall T, Westerby P, Chen J, Fairfield M, Harding J, Westerby R, Ahmad R, Middleton J “The Sandwell Project: a controlled evaluation of a programme of targeted screening for prevention of cardiovascular disease in primary care.” BMC Public Health 2008, 8:73.
Marshall T. “Identification of patients for clinical risk assessment by prediction of cardiovascular risk using default risk factor values.” BMC Public Health 2008, 8:25.
Marshall T. “The value of information: modelling the efficiency of strategies for identifying high-risk patients for primary prevention of cardiovascular disease.” Informatics in Primary Care 2006; 14:85-92
Marshall T. “The use of cardiovascular risk factor information in practice databases: making the best of patient data.” British Journal of General Practice 2006; 8:600-605.
Marshall T. “The Value of Information: Modelling the Efficiency of Strategies for Identifying High-Risk Patients for Primary Prevention of Cardiovascular Disease,” Informatics in Primary Care 2006; 14:85-92
Marshall T. “Misleading Measurements: Modelling the Effects of Blood Pressure Misclassification in a United States Population,” Medical Decision Making 2006; 26:624-632
Marshall T. “Evaluating National Guidelines for Prevention of Cardiovascular Disease in Primary Care,” Journal of Evaluation in Clinical Practice 2005; 11(5):452-61
Mohammed MA, Raftery J, Leatherbarrow M, Harley M, Marshall T. “Counting In-Hospital Deaths in England: A Comparison of Hospital Computer Systems and Mortuary Registers,” Journal of Health Services Research & Policy 2004; 2: 100-3.
Marshall T, Mohammed MA, Rouse A. “A Randomised Controlled Trial of League Tables and Control Charts as Aids to Health Service Decision-Making,” International Journal for Quality in Health Care 2004; 16(4): 1-7.
Marshall T. “When Measurements are Misleading: Modeling the Effects of Blood Pressure Misclassification in the English Population,” British Medical Journal 2004; 328: 933.
Marshall T. “Heart Attacks,” interview for BBC Radio 4 Casenotes May 4, 2004. [Transcript available at http://www.bbc.co.uk/radio4/science/casenotes_tr_20040504.shtml]
Marshall T. “Coronary Heart Disease Prevention: Insights from Modeling Incremental Cost-Effectiveness,” British Medical Journal 2003; 327: 1264-7.
Marshall T. “Blood pressure Variability: The Challenge of Variation,” American Journal of Hypertension, 2008 January; 21(1):3-4.