Using Routinely Collected Electronic Healthcare Record Data to Investigate Fibrotic Multimorbidity in England.

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.2147/CLEP.S463499

Georgie M Massen, Hannah R Whittaker, Sarah Cook, Gisli Jenkins, Richard J Allen, Louise V Wain, Iain Stewart, Jennifer K Quint

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引用次数: 0

Abstract

Background: Electronic healthcare records (EHRs) are used to document diagnoses, symptoms, tests, and prescriptions. Though not primarily collected for research purposes, owing to the size of the data as well as the depth of information collected, they have been used extensively to conduct epidemiological research. The Clinical Practice Research Datalink (CPRD) is an EHR database containing representative data of the UK population with regard to age, sex, race, and social deprivation measures. Fibrotic conditions are characterised by excessive scarring, contributing towards organ dysfunction and eventual organ failure. Fibrosis is associated with ageing as well as many other factors, it is hypothesised that fibrotic conditions are caused by the same underlying pathological mechanism. We calculated the prevalence of fibrotic conditions (as defined in a previous Delphi survey of clinicians) as well as the prevalence of fibrotic multimorbidity (the proportion of people with multiple fibrotic conditions).

Methods: We included a random sample of 993,370 UK adults, alive, and enrolled at a UK general practice, providing data to the CPRD Aurum database as of 1st of January 2015. Individuals had to be eligible for linkage to hospital episode statistics (HES) and ONS death registration. We calculated the point prevalence of fibrotic conditions and multi-morbid fibrosis on the 1st of January 2015. Using death records of those who died in 2015, we investigated the prevalence of fibrosis associated death. We explored the most commonly co-occurring fibrotic conditions and determined the settings in which diagnoses were commonly made (primary care, secondary care or after death).

Results: The point prevalence of any fibrotic condition was 21.46%. In total, 6.00% of people had fibrotic multimorbidity. Of the people who died in 2015, 34.82% had a recording of a fibrotic condition listed on their death certificate.

Conclusion: The key finding was that fibrotic multimorbidity affects approximately 1 in 16 people.

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利用常规收集的电子医疗记录数据调查英格兰的纤维化多发病。

背景：电子医疗记录（EHR）用于记录诊断、症状、检查和处方。尽管电子病历并非主要为研究目的而收集，但由于其数据量大、收集信息的深度高，已被广泛用于开展流行病学研究。临床实践研究数据链（CPRD）是一个电子病历数据库，包含英国人口在年龄、性别、种族和社会贫困程度方面的代表性数据。纤维化病症的特点是瘢痕过多，导致器官功能障碍和最终器官衰竭。纤维化与老龄化以及许多其他因素有关，因此假设纤维化病症是由相同的潜在病理机制引起的。我们计算了纤维化病症的患病率（根据之前对临床医生进行的德尔菲调查的定义）以及纤维化多病症的患病率（患有多种纤维化病症的人数比例）：我们随机抽取了 993,370 名在英国全科诊所注册的英国成年人，他们在 2015 年 1 月 1 日前向 CPRD Aurum 数据库提供了数据。受试者必须符合医院病例统计（HES）和英国国家统计局（ONS）死亡登记的链接条件。我们计算了 2015 年 1 月 1 日纤维化病症和多病纤维化的点流行率。利用 2015 年死亡人员的死亡记录，我们调查了纤维化相关死亡的患病率。我们探讨了最常并发的纤维化病症，并确定了常见的诊断环境（初级保健、二级保健或死后）：结果：任何纤维化病症的发病率为 21.46%。共有6.00%的人患有多种纤维化疾病。在2015年去世的人中，34.82%的人的死亡证明上有纤维化病症记录：主要发现是，每16人中约有1人患有纤维化多病症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.