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Stratified TreAtments Research (STAR)

We use information from large databases of electronic health records to better target preventative treatments at those patients with the most to gain

People are living for longer, with more long-term physical and mental conditions which worsen their health. One example is high blood pressure, which is associated with an increased risk of heart attack and stroke. This risk can be reduced by lowering blood pressure with treatment, and some people may take 3-4 different drugs to achieve this. However on average, for every 67 patients who take blood pressure lowering treatment over five years, only one will avoid having a stroke. This is because these drugs only reduce possibility of stroke, they do not remove it altogether. Some of these patients may be prone to side effects such as falls and kidney problems and the risk of these side effects can change over time.

Preventative medications, such as blood pressure lowering drugs, are often started when patient has a certain outlook and then continued for many years, with doctors reluctant to stop prescribing them despite changes in an individual’s risk/benefit profile. The Stratified TreAtments Research (STAR) group aims better understand the association between treatment and harms and develop tools which predict those patients who are most likely to benefit and those most likely to suffer harm from the medications they take. It is hoped that these clinical support tools will enable doctors and patients to balance the individual benefits and harms of treatments and make better informed decisions about starting or continuing preventative drugs. Our research focuses on the following areas:

  • Evidence synthesis of data from previous trials
  • Casual inference studies using data from electronic health records
  • Risk prediction modelling using data from electronic health records
  • Clinical trials of deprescribing medications in high risk patients

Studies

Risk Calculators

STAR team

Selected publications