Frank Doyle | Royal College of Surgeons in Ireland (original) (raw)

Papers by Frank Doyle

Acta Ophthalmologica, Sep 28, 2016

Evidence-based Mental Health, Oct 28, 2010

Receive free email alerts when new articles cite this article. Sign up in the Notes articles must... more Receive free email alerts when new articles cite this article. Sign up in the Notes articles must include the digital object identifier (DOIs) and date of initial publication.

Oxford University Press eBooks, Jul 1, 2018

Being diagnosed with coronary artery disease can have a major psychological impact on patients, a... more Being diagnosed with coronary artery disease can have a major psychological impact on patients, and individual and condition-specific differences have been reported in the literature. What is clear overall is that psychological disorders are more prevalent among patients with coronary artery disease than equivalent general population samples without chronic conditions. Coronary artery disease severity does not seem to completely account for this higher prevalence. Depressive and anxiety disorders are the most common to impact patients with coronary artery disease, and will be the main focus of this chapter.

Journal of Psychosomatic Research, Apr 1, 2022

BACKGROUND A substantial proportion of individuals with coronary artery disease experience modera... more BACKGROUND A substantial proportion of individuals with coronary artery disease experience moderate or severe acute depression that requires treatment. We assessed the cost-effectiveness of four interventions for depression in individuals with coronary artery disease. METHODS We assessed effectiveness of pharmacotherapy, psychotherapy, collaborative care and exercise as remission rate after 8 and 26 weeks using estimates from a recent network meta-analysis. The cost assessment included standard doses of antidepressants, contact frequency, and staff time per contact. Unit costs were calculated as health services' purchase price for pharmaceuticals and mid-point staff salaries obtained from the Irish Health Service Executive and validated by clinical staff. Incremental cost-effectiveness ratios were calculated as the incremental costs over incremental remissions compared to usual care. High- and low-cost scenarios and sensitivity analysis were performed with changed contact frequencies, and assuming individual vs. group psychotherapy or exercise. RESULTS After 8 weeks, the estimated incremental cost-effectiveness ratio was lowest for group exercise (€526 per remission), followed by pharmacotherapy (€589), individual psychotherapy (€3117) and collaborative care (€4964). After 26 weeks, pharmacotherapy was more cost-effective (€591) than collaborative care (€7203) and individual psychotherapy (€9387); no 26-week assessment for exercise was possible. Sensitivity analysis showed that group psychotherapy could be most cost-effective after 8 weeks (€519) and cost-effective after 26 weeks (€1565); however no group psychotherapy trials were available investigating its effectiveness. DISCUSSION Large variation in incremental cost-effectiveness ratios was seen. With the current assumptions, the most cost-effective depression intervention for individuals with coronary artery disease after 8 weeks was group exercise.

European Journal of Cardiovascular Nursing, Jun 1, 2007

European journal of cardiovascular prevention & rehabilitation, Aug 1, 2005

The Journal of Urology, Sep 1, 2015

Introduction: Transarterial embolization (TAE) is increasingly used in the management of renal an... more Introduction: Transarterial embolization (TAE) is increasingly used in the management of renal angiomyolipoma (AML). The level of evidence establishing the safety and efficacy of TAE has not increased in parallel. Materials and Methods: Using the MOOSE criteria, a systematic review of transarterial embolization of angiomyolipoma was performed to establish procedural safety and efficacy. MEDLINE PubMed search revealed 1739 publications, of which 31 studies met eligibility criteria. Results: 524 cases of TAE of AML were included. Self-limiting post-embolization syndrome occurred following 35.9%. Further morbidity occurred in 6.9%. No procedural mortality was reported. At a mean follow-up period of 39 months, mean size reduction was 3.4 cm (-38.3% of AML diameter). Unplanned repeat embolization or surgery was required in 20.9% during this period. The most frequent indications for repeat procedures include angiomyolipoma revascularization (30.0%), unchanged or increasing size (22.6%), refractory or recurring symptoms (16.7%), and representation with acute retroperitoneal hemorrhage (14.3%). A combination of two or more embolic agents was used in 46.8%, ethanol monotherapy in 41.7%, coil monotherapy in 6.2%, and foam or microparticle monotherapy in 5.2%. Conclusions: Transarterial embolization of angiomyolipoma demonstrates low rates of mortality and serious complications. Retreatment rates and size reduction at a mean follow-up duration of 39 months are presented. Longitudinal data assessing long-term size reduction and retreatment rates are lacking, recommendations guiding the indications for transarterial embolization and clear follow-up require further longitudinal data.

Pilot and Feasibility Studies, Jun 22, 2023

Prehospital and Disaster Medicine, May 1, 2023

Irish Journal of Medical Science, Aug 16, 2007

Background General practitioners (GPs) are often the first to assess mental health difficulties a... more Background General practitioners (GPs) are often the first to assess mental health difficulties after acute coronary syndrome (ACS). Aims To determine whether GPs observed an increase in mental health difficulties one year post-hospitalisation for ACS. Methods Postal survey. Results GPs rated patients (n=442) as having probable (GP assessed-10%) or definite (formally assessed-7%) mental health difficulties pre-hospitalisation. Post-hospitalisation the prevalence of probable cases increased significantly to 19% (OR=4.3, 95%CI 2.1-10.2, p<0.001). In multivariate analysis, only smoking at index hospitalisation was associated with being assessed as a new case of probable/formal mental health difficulties (RR=2.1, 95%CI 1.3-3.4, p=0.003). 47% of cases were prescribed some medication for this problem. Conclusions GPs recorded a significant increase in mental health difficulties in ACS patients 12 months after hospitalisation, with smoking used as an indicator of new cases.

Psychosomatic Medicine, Jun 1, 2021

Journal of Affective Disorders, Feb 1, 2016

Irish Journal of Medical Science, Apr 1, 2004

Health policy, Dec 1, 2017

Health Psychology Review, Sep 1, 2007

Current Cardiology Reports, Oct 19, 2015

Psychosomatic Medicine, Sep 1, 2012

Objective: Both depression and anxiety and been associated with poor prognosis in patients with a... more Objective: Both depression and anxiety and been associated with poor prognosis in patients with acute coronary syndrome (ACS). However, certain symptoms, and how they are measured, may be more important than others. We investigated 3 different scales to determine their predictive validity in a national sample. Methods: Patients with ACS (N=598) completed either the Hospital Anxiety and Depression Scales (HADS-A, HADS-D; N=316) or the Beck Depression Inventory-Fast Screen (BDI-FS; N=282). Their all-cause mortality status was assessed at 8 years. Results: During follow-up 20% (121/598) of participants died. Cox proportional hazards modelling showed that the HADS-D was predictive of mortality (Hazard Ratio [HR]=1.11, 95% CI 1.04-1.19), and this association remained significant after adjustment for major clinical/demographic factors. The HADS-A (HR=0.96, 95% CI 0.85-1.09), and the BDI-FS (HR=0.99, 95% CI 0.91-1.08) were not. The following depression items from the HADS-D predicted mortality: "I still enjoy the things I used to enjoy" (HR=1.38, 95% CI 1.05-1.82), "I can laugh and see the funny side of things" (HR=1.48, 95% CI 1.11-1.96), "I feel as if I am slowed down" (HR=1.66, 95% CI 1.24-2.22) and "I look forward with enjoyment to things" (HR=1.36, 95% CI 1.08-1.72). Conclusions: Depressive symptoms related to lack of enjoyment or pleasure and physical or cognitive slowing, as measured by the HADS-D, predicted all-cause mortality over 8 years in patients with ACS. Other depressive and anxiety symptoms did 2 not. Whether symptoms of distress predict prognosis in ACS seems to be dependent on the measures and items used.

International Journal of Cardiology, Sep 1, 2013

Acta Ophthalmologica, Sep 28, 2016

Evidence-based Mental Health, Oct 28, 2010

Receive free email alerts when new articles cite this article. Sign up in the Notes articles must... more Receive free email alerts when new articles cite this article. Sign up in the Notes articles must include the digital object identifier (DOIs) and date of initial publication.

Oxford University Press eBooks, Jul 1, 2018

Being diagnosed with coronary artery disease can have a major psychological impact on patients, a... more Being diagnosed with coronary artery disease can have a major psychological impact on patients, and individual and condition-specific differences have been reported in the literature. What is clear overall is that psychological disorders are more prevalent among patients with coronary artery disease than equivalent general population samples without chronic conditions. Coronary artery disease severity does not seem to completely account for this higher prevalence. Depressive and anxiety disorders are the most common to impact patients with coronary artery disease, and will be the main focus of this chapter.

Journal of Psychosomatic Research, Apr 1, 2022

BACKGROUND A substantial proportion of individuals with coronary artery disease experience modera... more BACKGROUND A substantial proportion of individuals with coronary artery disease experience moderate or severe acute depression that requires treatment. We assessed the cost-effectiveness of four interventions for depression in individuals with coronary artery disease. METHODS We assessed effectiveness of pharmacotherapy, psychotherapy, collaborative care and exercise as remission rate after 8 and 26 weeks using estimates from a recent network meta-analysis. The cost assessment included standard doses of antidepressants, contact frequency, and staff time per contact. Unit costs were calculated as health services' purchase price for pharmaceuticals and mid-point staff salaries obtained from the Irish Health Service Executive and validated by clinical staff. Incremental cost-effectiveness ratios were calculated as the incremental costs over incremental remissions compared to usual care. High- and low-cost scenarios and sensitivity analysis were performed with changed contact frequencies, and assuming individual vs. group psychotherapy or exercise. RESULTS After 8 weeks, the estimated incremental cost-effectiveness ratio was lowest for group exercise (€526 per remission), followed by pharmacotherapy (€589), individual psychotherapy (€3117) and collaborative care (€4964). After 26 weeks, pharmacotherapy was more cost-effective (€591) than collaborative care (€7203) and individual psychotherapy (€9387); no 26-week assessment for exercise was possible. Sensitivity analysis showed that group psychotherapy could be most cost-effective after 8 weeks (€519) and cost-effective after 26 weeks (€1565); however no group psychotherapy trials were available investigating its effectiveness. DISCUSSION Large variation in incremental cost-effectiveness ratios was seen. With the current assumptions, the most cost-effective depression intervention for individuals with coronary artery disease after 8 weeks was group exercise.

European Journal of Cardiovascular Nursing, Jun 1, 2007

European journal of cardiovascular prevention & rehabilitation, Aug 1, 2005

The Journal of Urology, Sep 1, 2015

Introduction: Transarterial embolization (TAE) is increasingly used in the management of renal an... more Introduction: Transarterial embolization (TAE) is increasingly used in the management of renal angiomyolipoma (AML). The level of evidence establishing the safety and efficacy of TAE has not increased in parallel. Materials and Methods: Using the MOOSE criteria, a systematic review of transarterial embolization of angiomyolipoma was performed to establish procedural safety and efficacy. MEDLINE PubMed search revealed 1739 publications, of which 31 studies met eligibility criteria. Results: 524 cases of TAE of AML were included. Self-limiting post-embolization syndrome occurred following 35.9%. Further morbidity occurred in 6.9%. No procedural mortality was reported. At a mean follow-up period of 39 months, mean size reduction was 3.4 cm (-38.3% of AML diameter). Unplanned repeat embolization or surgery was required in 20.9% during this period. The most frequent indications for repeat procedures include angiomyolipoma revascularization (30.0%), unchanged or increasing size (22.6%), refractory or recurring symptoms (16.7%), and representation with acute retroperitoneal hemorrhage (14.3%). A combination of two or more embolic agents was used in 46.8%, ethanol monotherapy in 41.7%, coil monotherapy in 6.2%, and foam or microparticle monotherapy in 5.2%. Conclusions: Transarterial embolization of angiomyolipoma demonstrates low rates of mortality and serious complications. Retreatment rates and size reduction at a mean follow-up duration of 39 months are presented. Longitudinal data assessing long-term size reduction and retreatment rates are lacking, recommendations guiding the indications for transarterial embolization and clear follow-up require further longitudinal data.

Pilot and Feasibility Studies, Jun 22, 2023

Prehospital and Disaster Medicine, May 1, 2023

Irish Journal of Medical Science, Aug 16, 2007

Background General practitioners (GPs) are often the first to assess mental health difficulties a... more Background General practitioners (GPs) are often the first to assess mental health difficulties after acute coronary syndrome (ACS). Aims To determine whether GPs observed an increase in mental health difficulties one year post-hospitalisation for ACS. Methods Postal survey. Results GPs rated patients (n=442) as having probable (GP assessed-10%) or definite (formally assessed-7%) mental health difficulties pre-hospitalisation. Post-hospitalisation the prevalence of probable cases increased significantly to 19% (OR=4.3, 95%CI 2.1-10.2, p<0.001). In multivariate analysis, only smoking at index hospitalisation was associated with being assessed as a new case of probable/formal mental health difficulties (RR=2.1, 95%CI 1.3-3.4, p=0.003). 47% of cases were prescribed some medication for this problem. Conclusions GPs recorded a significant increase in mental health difficulties in ACS patients 12 months after hospitalisation, with smoking used as an indicator of new cases.

Psychosomatic Medicine, Jun 1, 2021

Journal of Affective Disorders, Feb 1, 2016

Irish Journal of Medical Science, Apr 1, 2004

Health policy, Dec 1, 2017

Health Psychology Review, Sep 1, 2007

Current Cardiology Reports, Oct 19, 2015

Psychosomatic Medicine, Sep 1, 2012

Objective: Both depression and anxiety and been associated with poor prognosis in patients with a... more Objective: Both depression and anxiety and been associated with poor prognosis in patients with acute coronary syndrome (ACS). However, certain symptoms, and how they are measured, may be more important than others. We investigated 3 different scales to determine their predictive validity in a national sample. Methods: Patients with ACS (N=598) completed either the Hospital Anxiety and Depression Scales (HADS-A, HADS-D; N=316) or the Beck Depression Inventory-Fast Screen (BDI-FS; N=282). Their all-cause mortality status was assessed at 8 years. Results: During follow-up 20% (121/598) of participants died. Cox proportional hazards modelling showed that the HADS-D was predictive of mortality (Hazard Ratio [HR]=1.11, 95% CI 1.04-1.19), and this association remained significant after adjustment for major clinical/demographic factors. The HADS-A (HR=0.96, 95% CI 0.85-1.09), and the BDI-FS (HR=0.99, 95% CI 0.91-1.08) were not. The following depression items from the HADS-D predicted mortality: "I still enjoy the things I used to enjoy" (HR=1.38, 95% CI 1.05-1.82), "I can laugh and see the funny side of things" (HR=1.48, 95% CI 1.11-1.96), "I feel as if I am slowed down" (HR=1.66, 95% CI 1.24-2.22) and "I look forward with enjoyment to things" (HR=1.36, 95% CI 1.08-1.72). Conclusions: Depressive symptoms related to lack of enjoyment or pleasure and physical or cognitive slowing, as measured by the HADS-D, predicted all-cause mortality over 8 years in patients with ACS. Other depressive and anxiety symptoms did 2 not. Whether symptoms of distress predict prognosis in ACS seems to be dependent on the measures and items used.

International Journal of Cardiology, Sep 1, 2013