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Clinical Epidemiology

Isabelle Arnet, Melanie Greenland, Matthew W Knuiman, Jamie M Rankin, Joe Hung, Lee Nedkoff, Tom G Briffa, Frank M Sanfilippo
Background: Electronic health care data contain rich information on medicine use from which adherence can be estimated. Various measures developed with medication claims data called for transparency of the equations used, predominantly because they may overestimate adherence, and even more when used with multiple medications. We aimed to operationalize a novel calculation of adherence with polypharmacy, the daily polypharmacy possession ratio (DPPR), and validate it against the common measure of adherence, the medication possession ratio (MPR) and a modified version (MPRm )...
2018: Clinical Epidemiology
Elham Kharazmi, Masoud Babaei, Mahdi Fallah, Tianhui Chen, Kristina Sundquist, Kari Hemminki
Background: Familial clustering of upper gastrointestinal (UGI) cancers and the significance of family history has been addressed previously. We aimed to elucidate the familial risk based on the specified tumor location and histology. Method: In the Swedish Family-Cancer Database, we determined the familial risk of UGI cancer patients diagnosed (1958-2015) with esophageal and gastric cancer by tumor location using standardized incidence ratios (SIRs). Results: Risk of esophageal cancer in first-degree relatives (FDRs) of patients with esophageal cancer increased 2...
2018: Clinical Epidemiology
Laura McDonald, Cormac J Sammon, Mihail Samnaliev, Sreeram Ramagopalan
Background: Primary care databases represent a rich source of data for health care research; however, the quality of recording of secondary care events in these databases is uncertain. This study sought to investigate the completeness of recording of hospital admissions for bleeds in primary care records and explore the impact of incomplete recording on estimates of bleeding risk associated with antithrombotic treatment. Methods: The study population consisted of adults with non-valvular atrial fibrillation who had at least one bleed recorded in either the Clinical Practice Research Datalink (CPRD) or Hospital Episode Statistics (HES) while receiving prescriptions for an oral anticoagulant...
2018: Clinical Epidemiology
Chien Tai Hong, Han-Hwa Hu, Lung Chan, Chyi-Huey Bai
Background: People with Parkinson's disease (PwP) are speculated to be at a low risk of cerebrovascular and cardiovascular disease (CVD) because they have fewer vascular risk factors and lower smoking rate. However, emerging evidence suggests that PwP are at higher risk of CVD, which introduces controversy to the notion that there is no association between Parkinson's disease (PD) and CVD. Hence, we conducted a meta-analysis to analyze the risk of CVD in PwP. Methods: Electronic databases were searched using terms related to PD and CVD...
2018: Clinical Epidemiology
Zahid A Butt, Nabin Shrestha, Dionne Gesink, Michelle Murti, Jane A Buxton, Mark Gilbert, Robert F Balshaw, Stanley Wong, Margot Kuo, Jason Wong, Amanda Yu, Maria Alvarez, Hasina Samji, David Roth, Theodora Consolacion, Mark W Hull, Gina Ogilvie, Mark W Tyndall, Mel Krajden, Naveed Z Janjua
Background: Understanding differences in HIV incidence among people living with hepatitis C virus (HCV) can help inform strategies to prevent HIV infection. We estimated the time to HIV diagnosis among HCV-positive individuals and evaluated factors that could affect HIV-infection risk in this population. Patients and methods: The British Columbia Hepatitis Testers Cohort includes all BC residents (~1.5 million: about a third of all residents) tested for HCV and HIV from 1990 to 2013 and is linked to administrative health care and mortality data...
2018: Clinical Epidemiology
Janick Weberpals, Lina Jansen, Geert Silversmit, Julie Verbeeck, Lydia van der Geest, Pauline Aj Vissers, Vesna Zadnik, Hermann Brenner
Purpose: The Mantel-Byar method is the gold standard analytical approach to avoid immortal time bias, but requires information on the time between start of follow-up and exposure initiation. Alternatively, a modified landmark approach might be used to mitigate the amount of immortal time bias, which assumes exposure initiation at a predefined landmark time. In the context of an expected positive association between adjuvant chemotherapy (ACT) and overall survival among resected pancreatic cancer (PCa) patients, this study aims to empirically assess the performance of this approach relative to the Mantel-Byar method...
2018: Clinical Epidemiology
Otília Menyhárt, János T Fekete, Balázs Győrffy
Background: Population aging is a common demographic pattern in developed countries, and aging increases the risk of cancer. The disproportionately high cancer burden, as a consequence, is especially pronounced in Central and Eastern European countries, including Hungary. Methods: We summarized current and projected future cancer incidences and mortalities utilizing data from the last two decades. Predictions are based on cancer incidence and mortality collected between 1996 and 2015 in Hungary...
2018: Clinical Epidemiology
Chi-Ho Chan, Shun-Fa Yang, Han-Wei Yeh, Ying-Tung Yeh, Yu-Hsun Wang, Ying-Hock Teng, Chao-Bin Yeh
Background: Burns are the main cause of accidental injury, and pneumonia is a common respiratory disease in humans. Aim: The purpose of this study was to investigate the relationship between burn injury and pneumonia. Patients and methods: A nationwide population-based cohort study was conducted using data from the National Health Insurance Research Database in Taiwan. We identified and enrolled 2,893 subjects with burn injury, who were individually matched to 2,893 subjects in the comparison group by using the propensity score...
2018: Clinical Epidemiology
Yael I Nillni, Amelia K Wesselink, Elizabeth E Hatch, Ellen M Mikkelsen, Jaimie L Gradus, Kenneth J Rothman, Lauren A Wise
Purpose: To examine the influence of depressive symptoms, perceived stress, and psychotropic medication use on prospectively assessed menstrual cycle regularity and length. Participants and methods: Data were obtained from Pregnancy Study Online, a prospective cohort study of pregnancy planners from North America. At baseline, women reported information on demographics, anthropometrics, lifestyle, and medical history, including their use of psychotropic medications...
2018: Clinical Epidemiology
Stine Bakkensen Bruun, Irene Petersen, Nickolaj Risbo Kristensen, Deirdre Cronin-Fenton, Alma Becic Pedersen
Purpose: To examine the association between selective serotonin reuptake inhibitor (SSRI) use and mortality, postoperative complications, and quality of in-hospital care in hip fracture patients. Patients and methods: The study was a nationwide cohort study based on individual-level linked, prospectively collected data from Danish population-based national registries covering all hospitals in Denmark. The health care system in Denmark is tax-funded, and all citizens have equal access to health care services...
2018: Clinical Epidemiology
Wen-Qin Guo, Lang Li, Qiang Su, Yu-Han Sun, Xian-Tao Wang, Wei-Ran Dai, Hong-Qing Li
Introduction: The optimal revascularization strategy for patients with ST-segment elevation myocardial infarction and multivessel disease is unclear. In this study, we performed a meta-analysis to determine the optimal revascularization strategy for treating these patients. Methods: Searches of PubMed, the Cochrane Library,, and the reference lists of relevant papers were performed covering the period between the year 2000 and March 20, 2017. A pairwise analysis and a Bayesian network meta-analysis were performed to compare the effectiveness of early complete revascularization (CR) during the index hospitalization, delayed CR, and culprit only revascularization (COR)...
2018: Clinical Epidemiology
Mette Tranberg, Bodil Hammer Bech, Jan Blaakær, Jørgen Skov Jensen, Hans Svanholm, Berit Andersen
Background: Participation in cervical cancer screening varies by socioeconomic status. The aims were to assess if offering human papilloma virus (HPV) self-sampling kits has an effect on screening participation among various socioeconomic groups and to determine if two invitation strategies for offering self-sampling influence the participation rate equally. Methods: The study was based on registry data that were applied to data from a randomized controlled trial (n=9,791) measuring how offering HPV self-sampling affected screening participation...
2018: Clinical Epidemiology
Morten Fenger-Grøn, Maiken Ina Siegismund Kjaersgaard, Erik Thorlund Parner, Mai-Britt Guldin, Peter Vedsted, Mogens Vestergaard
Purpose: Losing a loved one to death is a common and natural life-course experience. Still, bereavement has been associated with an increased risk of suicidal behavior and psychiatric hospitalization and little is known of how to counter these adverse events. We aimed to study the effect of early treatment in primary care with talk therapy (TT) or antidepressants (AD) in severely bereaved people. Methods: We conducted a population-based cohort study including 207,435 adult Danes who experienced a severe loss in 1996-2013...
2018: Clinical Epidemiology
Nai-Fang Chi, Yi-Chun Kuan, Yao-Hsien Huang, Lung Chan, Chaur-Jong Hu, Hung-Yi Liu, Hung-Yi Chiou, Li-Nien Chien
Objective: This study aimed to develop and validate a prognostic model for the 1-year risk of late poststroke epilepsy (PSE). Materials and methods: We included patients initially diagnosed with ischemic stroke between 2003 and 2014 in a National Health Insurance claims-based cohort in Taiwan. Patients were further divided into development and validation cohorts based on their year of stroke diagnosis. Multivariable Cox regression with backward elimination was used to analyze the association between 1-year PSE and risk factors before and on stroke admission...
2018: Clinical Epidemiology
Jonathan Montomoli, Rune Erichsen, Henrik Gammelager, Alma B Pedersen
Purpose: The aim of this study was to examine the prognostic impact of liver disease on mortality following hip fracture (HF). Patients and methods: This nationwide cohort study, based on prospectively collected data retrieved from Danish registries, included all patients diagnosed with incident HF in Denmark during 1996-2013. Patients were classified based on the coexisting liver disease at the time of HF, ie, no liver disease, noncirrhotic liver disease, and liver cirrhosis...
2018: Clinical Epidemiology
Rahmat Sediq, Jurjen van der Schans, Aafje Dotinga, Rolinde A Alingh, Bob Wilffert, Jens Hj Bos, Catharina Cm Schuiling-Veninga, Eelko Hak
Background: While self-reported data are commonly used as a source of medication use for pharmaco-epidemiological studies, such information is prone to forms of bias. Several previous studies showed that various factors like age, type of drug and data collection method may influence accuracy. We aimed to assess the concordance of the self-reported medication use that was documented at entry to the Lifelines Cohort Study, a three-generation follow-up study in the Netherlands that started in 2006 and included over 167,000 participants...
2018: Clinical Epidemiology
Per-Ola Sundin, Ruzan Udumyan, Katja Fall, Scott Montgomery
Background: Although acute onset kidney complications associated with severe infections including pneumonia are well characterized, little is known about possible subsequent delayed risk of chronic kidney disease (CKD). Patients and methods: Associations between hospital admission with pneumonia in adulthood and raised risks of subsequent CKD were evaluated in a cohort of all male residents in Sweden born from 1952 to 1956 (n=284,198) who attended mandatory military conscription examinations in late adolescence (n=264,951) and were followed up through 2009...
2018: Clinical Epidemiology
Julian Varghese, Michael Fujarski, Stefan Hegselmann, Philipp Neuhaus, Martin Dugas
Objective: Best-practice data models harmonize semantics and data structure of medical variables in clinical or epidemiological studies. While there exist several published data sets, it remains challenging to find and reuse published eligibility criteria or other data items that match specific needs of a newly planned study or registry. A novel Internet-based method for rapid comparison of published data models was implemented to enable reuse, customization, and harmonization of item catalogs for the early planning and development phase of research databases...
2018: Clinical Epidemiology
Tra My Pham, Irene Petersen, Kate Walters, Rosalind Raine, Jill Manthorpe, Naaheed Mukadam, Claudia Cooper
Objectives: We compared incidence of dementia diagnosis by white, black, and Asian ethnic groups and estimated the proportion of UK white and black people developing dementia in 2015 who had a diagnosis for the first time in a UK-wide study. Methods: We analyzed primary care electronic health records from The Health Improvement Network database between 2007 and 2015 and compared incidence of dementia diagnosis to dementia incidence from community cohort studies...
2018: Clinical Epidemiology
Stine Munk Hald, Christine Kring Sloth, Sabine Morris Hey, Charlotte Madsen, Nina Nguyen, Luis Alberto García Rodríguez, Rustam Al-Shahi Salman, Sören Möller, Frantz Rom Poulsen, Anton Pottegård, David Gaist
Purpose: The purpose of this study is to establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR). Patients and methods: We estimated the positive predictive value (PPV) of ICH diagnoses for a sample of 500 patients from the DSR (patients recorded under ICH diagnosis) and DNPR (International Classification of Diseases, version 10, code I61) during 2010-2015, using discharge summaries and brain imaging reports (minimal data)...
2018: Clinical Epidemiology
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