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Clinical Epidemiology

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https://www.readbyqxmd.com/read/28579835/transmission-of-health-care-associated-infections-from-roommates-and-prior-room-occupants-a-systematic-review
#1
REVIEW
Bevin Cohen, Catherine Crawford Cohen, Borghild Løyland, Elaine L Larson
Pathogens that cause health care-associated infections (HAIs) are known to survive on surfaces and equipment in health care environments despite routine cleaning. As a result, the infection status of prior room occupants and roommates may play a role in HAI transmission. We performed a systematic review of the literature evaluating the association between patients' exposure to infected/colonized hospital roommates or prior room occupants and their risk of infection/colonization with the same organism. A PubMed search for English articles published in 1990-2014 yielded 330 studies, which were screened by three reviewers...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28579834/hypoglycemia-a-review-of-definitions-used-in-clinical-trials-evaluating-antihyperglycemic-drugs-for-diabetes
#2
REVIEW
Chakrapani Balijepalli, Eric Druyts, Gaye Siliman, Michel Joffres, Kristian Thorlund, Edward J Mills
OBJECTIVE: To understand the severity and potential impact of heterogeneity in definitions of hypoglycemia used in diabetes research, we aimed to review the hypoglycemia definitions adopted in randomized controlled trials (RCTs). METHODS: We reviewed 109 RCTs included in the Canadian Agency for Drugs and Technologies in Health reports for the second- and third-line therapy for the patients with type 2 diabetes (T2D). RESULTS: Nearly 60% (n=66) of the studies reviewed presented the definitions for overall hypoglycemia, and another 20% (n=22) of the studies reported the results for hypoglycemia but did not report a definition...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28546772/the-impact-of-socioeconomic-status-and-multimorbidity-on-mortality-a-population-based-cohort-study
#3
Nikoline Lund Jensen, Henrik Søndergaard Pedersen, Mogens Vestergaard, Stewart W Mercer, Charlotte Glümer, Anders Prior
OBJECTIVE: Multimorbidity (MM) is more prevalent among people of lower socioeconomic status (SES), and both MM and SES are associated with higher mortality rates. However, little is known about the relationship between SES, MM, and mortality. This study investigates the association between educational level and mortality, and to what extent MM modifies this association. METHODS: We followed 239,547 individuals invited to participate in the Danish National Health Survey 2010 (mean follow-up time: 3...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28533698/use-of-the-medicare-database-in-epidemiologic-and-health-services-research-a-valuable-source-of-real-world-evidence-on-the-older-and-disabled-populations-in-the-us
#4
REVIEW
Katherine E Mues, Alexander Liede, Jiannong Liu, James B Wetmore, Rebecca Zaha, Brian D Bradbury, Allan J Collins, David T Gilbertson
Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries' encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28503076/positive-predictive-value-of-peptic-ulcer-diagnosis-codes-in-the-danish-national-patient-registry
#5
Søren Viborg, Kirstine Kobberøe Søgaard, Peter Jepsen
BACKGROUND: Diagnoses of peptic ulcer are registered in the Danish National Patient Registry (DNPR) for administrative as well as research purposes, but it is unknown whether the coding validity depends on the location of the ulcer. OBJECTIVE: To validate the International Classification of Diseases, 10(th) revision diagnosis codes of peptic ulcer in the DNPR by estimating positive predictive values (PPVs) for gastric and duodenal ulcer diagnoses. METHODS: We identified all patients registered with a hospital discharge diagnosis of peptic ulcer from Aarhus University Hospital, Denmark, in 1995-2006...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28496365/prevalence-and-prognosis-of-stress-disorders-a-review-of-the-epidemiologic-literature
#6
REVIEW
Jaimie L Gradus
Given the ubiquity of traumatic events, it is not surprising that posttraumatic stress disorder (PTSD) - a common diagnosis following one of these experiences - is characterized as conferring a large burden for individuals and society. Although there is recognition of the importance of PTSD diagnoses throughout psychiatry, the literature on other diagnoses one may receive following a stressful or traumatic event is scant. This review summarizes the literature on stress disorders (classified according to the International Classification of Diseases, 10th Edition [ICD-10]), including acute stress reaction, PTSD, adjustment disorder and unspecified stress reactions...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28490904/clinical-epidemiology-in-the-era-of-big-data-new-opportunities-familiar-challenges
#7
Vera Ehrenstein, Henrik Nielsen, Alma B Pedersen, Søren P Johnsen, Lars Pedersen
Routinely recorded health data have evolved from mere by-products of health care delivery or billing into a powerful research tool for studying and improving patient care through clinical epidemiologic research. Big data in the context of epidemiologic research means large interlinkable data sets within a single country or networks of multinational databases. Several Nordic, European, and other multinational collaborations are now well established. Advantages of big data for clinical epidemiology include improved precision of estimates, which is especially important for reassuring ("null") findings; ability to conduct meaningful analyses in subgroup of patients; and rapid detection of safety signals...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28490903/cardiovascular-risks-in-smokers-treated-with-nicotine-replacement-therapy-a-historical-cohort-study
#8
Jens Dollerup, Jørgen Vestbo, Tarita Murray-Thomas, Alan Kaplan, Richard J Martin, Emilio Pizzichini, Marcia M M Pizzichini, Anne Burden, Jessica Martin, David B Price
BACKGROUND: Previous research suggests exposure to nicotine replacement therapy (NRT) may be associated with an increased risk of cardiovascular disease (CVD). METHODS: Using data from the United Kingdom's Clinical Practice Research Datalink, this study aimed to evaluate CVD events and survival among individuals who attempted smoking cessation with the support of NRT compared with those aided by smoking cessation advice only. We studied CVD outcomes over 4 and 52 weeks in 50,214 smokers attempting to quit - 33,476 supported by smoking cessation advice and 16,738 with the support of NRT prescribed by their primary care physician...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28442934/effect-of-glomerular-filtration-rate-at-dialysis-initiation-on-survival-in-patients-with-advanced-chronic-kidney-disease-what-is-the-effect-of-lead-time-bias
#9
Cynthia J Janmaat, Merel van Diepen, Raymond T Krediet, Marc H Hemmelder, Friedo W Dekker
PURPOSE: Current clinical guidelines recommend to initiate dialysis in the presence of symptoms or signs attributable to kidney failure, often with a glomerular filtration rate (GFR) of 5-10 mL/min/1.73 m(2). Little evidence exists about the optimal kidney function to start dialysis. Thus far, most observational studies have been limited by lead-time bias. Only a few studies have accounted for lead-time bias, and showed contradictory results. We examined the effect of GFR at dialysis initiation on survival in chronic kidney disease patients, and the role of lead-time bias therein...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28435326/the-association-between-thyroid-disorders-and-incident-gout-population-based-case-control-study
#10
Saskia G Bruderer, Christoph R Meier, Susan S Jick, Michael Bodmer
CONTEXT: Thyroid hormones influence kidney function and thereby might alter serum urate levels, a major risk factor for gouty arthritis. OBJECTIVE: To assess the risk of developing incident gout in association with hypothyroidism or hyperthyroidism. DESIGN: Retrospective population-based case-control analysis. SETTING: UK-based Clinical Practice Research Datalink, a primary care research database. PATIENTS: We identified adult patients with a diagnosis of incident gout between 1990 and 2014...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28408854/control-of-confounding-in-the-analysis-phase-an-overview-for-clinicians
#11
Johnny Kahlert, Sigrid Bjerge Gribsholt, Henrik Gammelager, Olaf M Dekkers, George Luta
In observational studies, control of confounding can be done in the design and analysis phases. Using examples from large health care database studies, this article provides the clinicians with an overview of standard methods in the analysis phase, such as stratification, standardization, multivariable regression analysis and propensity score (PS) methods, together with the more advanced high-dimensional propensity score (HD-PS) method. We describe the progression from simple stratification confined to the inclusion of a few potential confounders to complex modeling procedures such as the HD-PS approach by which hundreds of potential confounders are extracted from large health care databases...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28405173/confounding-in-observational-studies-based-on-large-health-care-databases-problems-and-potential-solutions-a-primer-for-the-clinician
#12
Mette Nørgaard, Vera Ehrenstein, Jan P Vandenbroucke
Population-based health care databases are a valuable tool for observational studies as they reflect daily medical practice for large and representative populations. A constant challenge in observational designs is, however, to rule out confounding, and the value of these databases for a given study question accordingly depends on completeness and validity of the information on confounding factors. In this article, we describe the types of potential confounding factors typically lacking in large health care databases and suggest strategies for confounding control when data on important confounders are unavailable...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28392715/positive-predictive-values-of-international-classification-of-diseases-10th-revision-codes-for-dermatologic-events-and-hypersensitivity-leading-to-hospitalization-or-emergency-room-visit-among-women-with-postmenopausal-osteoporosis-in-the-danish-and-swedish
#13
Kasper Adelborg, Lotte Brix Christensen, Troels Munch, Johnny Kahlert, Ylva Trolle Lagerros, Grethe S Tell, Ellen M Apalset, Fei Xue, Vera Ehrenstein
BACKGROUND: Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs) of International Classification of Diseases, 10th revision (ICD-10) codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO)...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28356772/chinese-health-care-system-and-clinical-epidemiology
#14
REVIEW
Yuelian Sun, Hans Gregersen, Wei Yuan
China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28352203/missing-data-and-multiple-imputation-in-clinical-epidemiological-research
#15
Alma B Pedersen, Ellen M Mikkelsen, Deirdre Cronin-Fenton, Nickolaj R Kristensen, Tra My Pham, Lars Pedersen, Irene Petersen
Missing data are ubiquitous in clinical epidemiological research. Individuals with missing data may differ from those with no missing data in terms of the outcome of interest and prognosis in general. Missing data are often categorized into the following three types: missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR). In clinical epidemiological research, missing data are seldom MCAR. Missing data can constitute considerable challenges in the analyses and interpretation of results and can potentially weaken the validity of results and conclusions...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28293121/the-completeness-of-chest-x-ray-procedure-codes-in-the-danish-national-patient-registry
#16
Peter Hjertholm, Kaare Rud Flarup, Louise Mahncke Guldbrandt, Peter Vedsted
OBJECTIVE: The aim of this validation study was to assess the completeness of the registrations of chest X-rays (CXR) in two different versions of the Danish National Patient Registry (DNPR). MATERIAL AND METHODS: We included electronic record data on CXR performed on patients aged 40 to 99 years from nine radiology departments covering 20 Danish hospitals. From each department, we included data from three randomly selected weeks between 2004 and 2011 (reference standard)...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28280390/a-nationwide-population-based-cross-sectional-survey-of-health-related-quality-of-life-in-patients-with-myeloproliferative-neoplasms-in-denmark-mpnhealthsurvey-survey-design-and-characteristics-of-respondents-and-nonrespondents
#17
Nana Brochmann, Esben Meulengracht Flachs, Anne Illemann Christensen, Christen Lykkegaard Andersen, Knud Juel, Hans Carl Hasselbalch, Ann-Dorthe Zwisler
OBJECTIVE: The Department of Hematology, Zealand University Hospital, Denmark, and the National Institute of Public Health, University of Southern Denmark, created the first nationwide, population-based, and the most comprehensive cross-sectional health-related quality of life (HRQoL) survey of patients with myeloproliferative neoplasms (MPNs). In Denmark, all MPN patients are treated in public hospitals and treatments received are free of charge for these patients. Therefore, MPN patients receive the best available treatment to the extent of its suitability for them and if they wish to receive the treatment...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28275316/cohort-description-the-danish-study-of-functional-disorders
#18
Thomas Meinertz Dantoft, Jeanette Frost Ebstrup, Allan Linneberg, Sine Skovbjerg, Anja Lykke Madsen, Jesper Mehlsen, Louise Brinth, Lene Falgaard Eplov, Tina Wisbech Carstensen, Andreas Schroder, Per Klausen Fink, Erik Lykke Mortensen, Torben Hansen, Oluf Pedersen, Torben Jørgensen
The Danish study of Functional Disorders (DanFunD) cohort was initiated to outline the epidemiology of functional somatic syndromes (FSS) and is the first larger coordinated epidemiological study focusing exclusively on FSS. FSS are prevalent in all medical settings and can be defined as syndromes that, after appropriate medical assessment, cannot be explained in terms of a conventional medical or surgical disease. FSS are frequent and the clinical importance varies from vague symptoms to extreme disability...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28260946/the-clinical-impact-of-serrated-colorectal-polyps
#19
REVIEW
Brendon M O'Connell, Seth D Crockett
Serrated polyps (SPs) of the colorectum pose a novel challenge to practicing gastroenterologists. Previously thought benign and unimportant, there is now compelling evidence that SPs are responsible for a significant percentage of incident colorectal cancer worldwide. In contrast to conventional adenomas, which tend to be slow growing and polypoid, SPs have unique features that undermine current screening and surveillance practices. For example, sessile serrated polyps (SSPs) are flat, predominately right-sided, and thought to have the potential for rapid growth...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28255255/validity-of-data-in-the-danish-colorectal-cancer-screening-database
#20
Mette Kielsholm Thomsen, Sisse Helle Njor, Morten Rasmussen, Dorte Linnemann, Berit Andersen, Gunnar Baatrup, Lennart Jan Friis-Hansen, Jens Christian Riis Jørgensen, Ellen Margrethe Mikkelsen
BACKGROUND: In Denmark, a nationwide screening program for colorectal cancer was implemented in March 2014. Along with this, a clinical database for program monitoring and research purposes was established. OBJECTIVE: The aim of this study was to estimate the agreement and validity of diagnosis and procedure codes in the Danish Colorectal Cancer Screening Database (DCCSD). METHODS: All individuals with a positive immunochemical fecal occult blood test (iFOBT) result who were invited to screening in the first 3 months since program initiation were identified...
2017: Clinical Epidemiology
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