Clinical Epidemiology最新文献

{"title":"Extracting Systemic Anticancer Treatment Lines from the Danish National Patient Registry for Solid Tumour Patients Treated in the North Denmark Region Between 2009 and 2019","authors":"Charles Vesteghem, Martin Bøgsted, Deirdre Cronin-Fenton, Laurids Østergaard Poulsen","doi":"10.2147/clep.s442591","DOIUrl":"https://doi.org/10.2147/clep.s442591","url":null,"abstract":"<strong>Background:</strong> Reconstructing patient treatment trajectories is important to generate real-world evidence for epidemiological studies. The Danish National Patient Registry (DNPR) contains information about drug prescriptions and could therefore be used to reconstruct treatment trajectories. We aimed to evaluate and enhance two existing methods to reconstruct systemic anticancer treatment trajectories.<br/><strong>Methods:</strong> This study was based on data from 8738 consecutive patients with solid tumors treated in the North Denmark Region between 2009 and 2019. Two approaches found in the literature as well as two new approaches were applied to the DNPR data. All methods relied on time intervals between two consecutive drug administrations to determine if they belonged to the same treatment line. MedOnc, a local dataset from the Department of Oncology, Aalborg University Hospital was used as a reference. To evaluate the performance of each method, F1-scores were calculated after matching the lines identified in both datasets. We used three different matching strategies: stringent matching, loose matching, and matching based on line numbers, controlling for overfitting.<br/><strong>Results:</strong> Overall, the two new approaches outperformed the simpler and best performing of the two existing methods, with F1-scores of 0.47 and 0.45 vs 0.44 for stringent matching and 0.84 and 0.83 vs 0.82 for loose matching. Nevertheless, only one of the new methods outperformed the existing simpler method when matching on the number of lines (0.73 vs 0.72). Large differences were seen by cancer site, especially for the stringent and line number matchings. Performances were relatively stable by calendar year.<br/><strong>Conclusion:</strong> The high F1-scores for the new methods confirm that they should be generally preferred to reconstruct systemic anticancer treatment trajectories using the DNPR.<br/><br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"27 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140044183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Copenhagen Primary Care Laboratory (CopLab) Database","authors":"Margit Kriegbaum, Bent Struer Lind, Mia Klinten Grand, Christen Lykkegaard Andersen","doi":"10.2147/clep.s437123","DOIUrl":"https://doi.org/10.2147/clep.s437123","url":null,"abstract":"<strong>Background:</strong> The Copenhagen General Practice Laboratory (CGPL) was founded in 1922 to provide paraclinical analyses to the primary health-care sector in Copenhagen. At the end of 2015, CGPL was closed and the CopLab database was established to make CGPL data available for research.<br/><strong>Methods:</strong> We isolated tests performed at the CGPL with clinically relevant test results. The database was linked to national registers containing health, social, and demographic information. Results are presented with descriptive statistics showing counts, percentages, medians, and interquartile ranges (IQR).<br/><strong>Results:</strong> The CopLab database includes 1,373,643 unique individuals from primary care with test results from laboratory analyses of blood/urine/semen as well as cardiac and lung function tests collected by CGPL from greater Copenhagen from 2000 to 2015. The CopLab database holds nearly all test results requested by general practitioners throughout years 2000 to 2015 for residents in the greater Copenhagen area. The median age of the individuals was 51 years and 59.7% were females. Each individual has a median of 4 requisitions. More than 1 million participants are currently alive and living in Denmark and may be followed in national registries such as the Danish National Patient Registry, Laboratory Database, National Prescription Database etc.<br/><br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"13 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140002054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Lipid-Lowering Drugs Reduce the Risk of Cholelithiasis? A Mendelian Randomization Study","authors":"Hao Dong, Rong Chen, Fang Xu, Fang Cheng","doi":"10.2147/clep.s439642","DOIUrl":"https://doi.org/10.2147/clep.s439642","url":null,"abstract":"<strong>Background and Aims:</strong> Cholelithiasis etiology intricately involves lipid metabolism. We sought to investigate the plausible causal link between genetically proxied lipid-lowering medications—specifically HMGCR inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors—and cholelithiasis risk.<br/><strong>Methods:</strong> Our study utilized two genetic instruments for exposure to lipid-lowering drugs. These instruments encompassed genetic variants linked to low-density lipoprotein (LDL) cholesterol within or in proximity to drug target genes, along with loci governing gene expression traits of these targets. Effect estimates were derived through Inverse-variance-weighted MR (IVW-MR) and summary-data-based MR (SMR) methods.<br/><strong>Results:</strong> Higher HMGCR-mediated LDL cholesterol levels (IVW-MR, OR = 2.15, 95% CI = 1.58– 2.94; <em>P</em> = 0.000) and increased HMGCR expression (SMR, OR = 1.19, 95% CI = 1.04– 1.37; <em>P</em> = 0.014) are linked to elevated cholelithiasis risk, suggesting potential benefits of HMGCR inhibition. In contrast, higher PCSK9-mediated LDL cholesterol levels (IVW-MR, OR = 0.72, 95% CI = 0.56– 0.94; <em>P</em> = 0.015) and increased PCSK9 expression (SMR, OR = 0.90, 95% CI = 0.82– 0.99; <em>P</em> = 0.035) both correlate with lower cholelithiasis risk, indicating that PCSK9 inhibition may elevate this risk. Nevertheless, no substantial link emerged between NPC1L1-mediated LDL cholesterol or NPC1L1 expression and cholelithiasis in both IVW-MR and SMR analyses.<br/><strong>Conclusion:</strong> This MR investigation affirms the causal link between the utilization of HMGCR inhibitors and a diminished risk of cholelithiasis. Additionally, it indicates a causal link between PCSK9 inhibitors use and increased cholelithiasis risk. However, no significant correlation was found between NPC1L1 inhibitors use and cholelithiasis risk.<br/><br/><strong>Keywords:</strong> cholelithiasis, lipid-lowering drugs, Mendelian randomization analysis, HMGCR inhibitors, PCSK9 inhibitors, NPC1L1 inhibitors<br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"27 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139923753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Validity of Chronic Kidney Disease in Health Claims Data Over Time: Results from a Cohort of Community-Dwelling Older Adults in Germany","authors":"Tim Bothe, Anne-Katrin Fietz, Elke Schaeffner, Antonios Douros, Anna Pöhlmann, Nina Mielke, Cédric Villain, Muhammad Helmi Barghouth, Volker Wenning, Natalie Ebert","doi":"10.2147/clep.s438096","DOIUrl":"https://doi.org/10.2147/clep.s438096","url":null,"abstract":"<strong>Purpose:</strong> The validity of ICD-10 diagnostic codes for chronic kidney disease (CKD) in health claims data has not been sufficiently studied in the general population and over time.<br/><strong>Patients and Methods:</strong> We used data from the Berlin Initiative Study (BIS), a prospective longitudinal cohort of community-dwelling individuals aged ≥ 70 years in Berlin, Germany. With estimated glomerular filtration rate (eGFR) as reference, we assessed the diagnostic validity (sensitivity, specificity, positive [PPV], and negative predictive values [NPV]) of different claims-based ICD-10 codes for CKD stages G3-5 (eGFR &lt; 60mL/min/1.73m²: ICD-10 N18.x-N19), G3 (eGFR 30–&lt; 60mL/min/1.73m²: N18.3), and G4-5 (eGFR &lt; 30mL/min/1.73m²: N18.4– 5). We analysed trends over five study visits (2009– 2019).<br/><strong>Results:</strong> We included data of 2068 participants at baseline (2009– 2011) and 870 at follow-up 4 (2018– 2019), of whom 784 (38.9%) and 440 (50.6%) had CKD G3-5, respectively. At baseline, sensitivity for CKD in claims data ranged from 0.25 (95%-confidence interval [CI] 0.22– 0.28) to 0.51 (95%-CI 0.48– 0.55) for G3-5, depending on the included ICD-10 codes, 0.20 (95%-CI 0.18– 0.24) for G3, and 0.36 (95%-CI 0.25– 0.49) for G4-5. Over the course of 10 years, sensitivity increased by 0.17 to 0.29 in all groups. Specificity, PPVs, and NPVs remained mostly stable over time and ranged from 0.82– 0.99, 0.47– 0.89, and 0.66– 0.98 across all study visits, respectively.<br/><strong>Conclusion:</strong> German claims data showed overall agreeable performance in identifying older adults with CKD, while differentiation between stages was limited. Our results suggest increasing sensitivity over time possibly attributable to improved CKD diagnosis and awareness.<br/><br/><strong>Keywords:</strong> CKD, diagnostic validity, health claims data, sensitivity, specificity<br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"1 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139923687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Obstetric Diagnosis and Procedure Codes in the Danish National Patient Registry in 2017","authors":"Kamille Herskind, Peter Bjødstrup Jensen, Christina Anne Vinter, Lone Krebs, Lene Friis Eskildsen, Anne Broe, Anton Pottegård, Mette Bliddal","doi":"10.2147/clep.s441123","DOIUrl":"https://doi.org/10.2147/clep.s441123","url":null,"abstract":"&lt;strong&gt;Purpose:&lt;/strong&gt; This study aimed to systematically evaluate the validity of variables related to pregnancy, delivery, and key characteristics of the infant in the Danish National Patient Register using maternal medical records as the reference standard.&lt;br/&gt;&lt;strong&gt;Patients and Methods:&lt;/strong&gt; We reviewed medical records of 1264 women giving birth in the Region of Southern Denmark during 2017. We calculated positive (PPV) and negative (NPV) predictive values, sensitivity, and specificity to estimate the validity of 49 selected variables.&lt;br/&gt;&lt;strong&gt;Results:&lt;/strong&gt; The PPV was ≥ 0.90 on most pregnancy-related variables including parity, pre-gestational BMI, diabetes disorders, and previous cesarean section, while it was lower for hypertensive disorders, especially mild to moderate preeclampsia (0.49, 95% CI 0.32– 0.66). Sensitivity ranged from 0.80 to 1.00 on all pregnancy-related variables, except hypertensive disorders (sensitivity 0.38– 0.71, lowest for severe preeclampsia). On most delivery-related variables including obstetric surgical procedures (eg cesarean section and induction of labor), pharmacological pain-relief, and gestational age at delivery, PPV’s ranged from 0.98 to 1.00 and the corresponding sensitivities from 0.87 to 1.00. Regarding infant-related variables, both the APGAR score registered five minutes after delivery and birthweight yielded a PPV of 1.00.&lt;br/&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Obstetric coding in the Danish National Patient Register shows very high validity and completeness making it a valuable source for epidemiologic research.&lt;br/&gt;&lt;br/&gt;&lt;strong&gt;Plain Language Summary:&lt;/strong&gt; Danish register data are often used for epidemiological research in reproduction. The registers are based on coded information to the registers based on information from medical records. The quality of the register data is highly dependent of the validity of the codes. Yet there is a lack in our knowledge of the validity of data related to pregnancy, childbirth, and the characteristics of the newborn baby. We therefore aimed to validate the Danish National Patient Registry data related to pregnancy and childbirth by comparing the registered code with information from the medical records.&lt;br/&gt;We scrutinized medical records from 1264 women giving birth in the Region of Southern Denmark during 2017. We compared the registration in the medical record with the registered code in the Danish National Patient Registry by calculating how accurate the register data are according to 49 different variables.&lt;br/&gt;Results showed that registered codes in the Patient Registry for pregnancy- and childbirth-related conditions and key infant characteristics were to a high degree in agreement with the data from the medical report with few exceptions.&lt;br/&gt;In conclusion, the study revealed that the Danish National Patient Register provides highly accurate and comprehensive data for most pregnancy, delivery, and infant-related variables. This underscore","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"183 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139923703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Self-Rated Health and Mortality in the Norwegian Women and Cancer (NOWAC) Study","authors":"Ida Løken Killie, Tonje Braaten, Geir Fagerjord Lorem, Kristin Benjaminsen Borch","doi":"10.2147/clep.s433965","DOIUrl":"https://doi.org/10.2147/clep.s433965","url":null,"abstract":"<strong>Purpose:</strong> We investigated the association between self-rated health (SRH) and cancer incidence and SRH and all-cause mortality among Norwegian women.<br/><strong>Population and Methods:</strong> We used data from 110,104 women in the Norwegian Women and Cancer (NOWAC) cohort aged 41– 70 years at baseline. We used flexible parametric survival analysis with restricted cubic splines to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between SRH and mortality in the entire cohort. We employed the same method in a multistate design to assess associations between baseline SRH and 1) cancer incidence, and 2) all-cause mortality in subgroups of women who did and did not receive a cancer diagnosis during follow-up.<br/><strong>Results:</strong> With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HR_{good SRH} 1.19, 95% CI 1.12– 1.26) and HR_{poor SRH} 1.81, 95% CI 1.66– 1.97). Lower SRH at baseline was associated with cancer incidence (HR_{good SRH} 1.14, 95% CI 1.08– 1.20 and HR_{poor SRH} 1.44, 95% CI: 1.32– 1.58). Poor baseline SRH was associated with increased mortality for women who received a cancer diagnosis (HR_{poor SRH} 1.20, 95% CI 1.04– 1.39), and SRH showed a strong association with increased mortality for women who stayed cancer free (HR_{good SRH} 1.59, 95% CI 1.44– 1.77 and HR_{poor SRH} 3.34, 95% CI 2.91– 3.84).<br/><strong>Conclusion:</strong> Lower SRH at baseline predicted increased cancer risk and all-cause mortality in middle-aged to older women. Poor SRH at baseline predicted all-cause mortality in women who later received a cancer diagnosis. Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free, and the association was stronger for these women compared to both the entire cohort and to women who were subsequently diagnosed with cancer.<br/><br/><strong>Keywords:</strong> self-rated health, cohort study, multistate, cancer, mortality, women<br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"20 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139910127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in the Care of Children with Inflammatory Bowel Disease Within and Across Canadian Provinces: A Multi-Province Population-Based Cohort Study","authors":"M Ellen Kuenzig, Therese A Stukel, Matthew W Carroll, Gilaad G Kaplan, Anthony R Otley, Harminder Singh, Alain Bitton, Stephen G Fung, Sarah Spruin, Stephanie Coward, Yunsong Cui, Zoann Nugent, Anne M Griffiths, David R Mack, Kevan Jacobson, Geoffrey C Nguyen, Laura E Targownik, Wael El-Matary, Charles N Bernstein, Trevor J B Dummer, Jennifer L Jones, Lisa M Lix, Sanjay K Murthy, Juan Nicolás Peña-Sánchez, Soheila Nasiri, Eric I Benchimol","doi":"10.2147/clep.s449183","DOIUrl":"https://doi.org/10.2147/clep.s449183","url":null,"abstract":"&lt;strong&gt;Purpose:&lt;/strong&gt; The incidence of childhood-onset inflammatory bowel disease (IBD) is rising. We described variation in health services utilization and need for surgery among children with IBD between six and 60 months following IBD diagnosis across Canadian pediatric centers and evaluated the associations between care provided at diagnosis at each center and the variation in these outcomes.&lt;br/&gt;&lt;strong&gt;Patients and Methods:&lt;/strong&gt; Using population-based deterministically-linked health administrative data from four Canadian provinces (Alberta, Manitoba, Nova Scotia, Ontario) we identified children diagnosed with IBD &lt; 16 years of age using validated algorithms. Children were assigned to a pediatric center of care using a hierarchical approach based on where they received their initial care. Outcomes included IBD-related hospitalizations, emergency department (ED) visits, and IBD-related abdominal surgery occurring between 6 and sixty months after diagnosis. Mixed-effects meta-analysis was used to pool results and examine the association between center-level care provision and outcomes.&lt;br/&gt;&lt;strong&gt;Results:&lt;/strong&gt; We identified 3784 incident cases of pediatric IBD, of whom 2937 (77.6%) were treated at pediatric centers. Almost a third (31.4%) of children had ≥ 1 IBD-related hospitalization and there were 0.66 hospitalizations per person during follow-up. More than half (55.8%) of children had ≥ 1 ED visit and there were 1.64 ED visits per person. Between-center heterogeneity was high for both outcomes; centers where more children visited the ED at diagnosis had more IBD-related hospitalizations and more ED visits during follow-up. Between-center heterogeneity was high for intestinal resection in Crohn’s disease but not colectomy in ulcerative colitis.&lt;br/&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; There is variation in health services utilization among children with IBD and risk of undergoing intestinal resection in those with Crohn’s disease, but not colectomy among children with ulcerative colitis, across Canadian pediatric tertiary-care centers. Improvements in clinical care pathways are needed to ensure all children have equitable and timely access to high quality care.&lt;br/&gt;&lt;br/&gt;&lt;strong&gt;Plain Language Summary:&lt;/strong&gt; Inflammatory bowel disease (IBD) is a chronic health condition of the gastrointestinal system, which is becoming more common in children. They require lifelong treatment and receiving high quality care is important for preventing complications. We determined if outcomes of children with IBD was different across Canada. We also tested if differences in care at diagnosis was related to outcomes. More than three-quarters of children with IBD were treated at pediatric hospitals. Children treated at some hospitals were more likely to be hospitalized and visit the emergency room when compared to children treated at other hospitals. Children with Crohn’s disease (one type of IBD) were more likely to have surgery at some hospitals whe","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"25 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139770504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Arterial and Venous Thrombotic Events Among Patients with COVID-19: A Multi-National Collaboration of Regulatory Agencies from Canada, Europe, and United States.","authors":"Vincent Lo Re Iii, Noelle M Cocoros, Rebecca A Hubbard, Sarah K Dutcher, Craig W Newcomb, John G Connolly, Silvia Perez-Vilar, Dena M Carbonari, Maria E Kempner, José J Hernández-Muñoz, Andrew B Petrone, Allyson M Pishko, Meighan E Rogers Driscoll, James T Brash, Sean Burnett, Catherine Cohet, Matthew Dahl, Terese A DeFor, Antonella Delmestri, Djeneba Audrey Djibo, Talita Duarte-Salles, Laura B Harrington, Melissa Kampman, Jennifer L Kuntz, Xavier Kurz, Núria Mercadé-Besora, Pamala A Pawloski, Peter R Rijnbeek, Sarah Seager, Claudia A Steiner, Katia Verhamme, Fangyun Wu, Yunping Zhou, Edward Burn, J Michael Paterson, Daniel Prieto-Alhambra","doi":"10.2147/CLEP.S448980","DOIUrl":"10.2147/CLEP.S448980","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have examined how the absolute risk of thromboembolism with COVID-19 has evolved over time across different countries. Researchers from the European Medicines Agency, Health Canada, and the United States (US) Food and Drug Administration established a collaboration to evaluate the absolute risk of arterial (ATE) and venous thromboembolism (VTE) in the 90 days after diagnosis of COVID-19 in the ambulatory (eg, outpatient, emergency department, nursing facility) setting from seven countries across North America (Canada, US) and Europe (England, Germany, Italy, Netherlands, and Spain) within periods before and during COVID-19 vaccine availability.</p><p><strong>Patients and methods: </strong>We conducted cohort studies of patients initially diagnosed with COVID-19 in the ambulatory setting from the seven specified countries. Patients were followed for 90 days after COVID-19 diagnosis. The primary outcomes were ATE and VTE over 90 days from diagnosis date. We measured country-level estimates of 90-day absolute risk (with 95% confidence intervals) of ATE and VTE.</p><p><strong>Results: </strong>The seven cohorts included 1,061,565 patients initially diagnosed with COVID-19 in the ambulatory setting before COVID-19 vaccines were available (through November 2020). The 90-day absolute risk of ATE during this period ranged from 0.11% (0.09-0.13%) in Canada to 1.01% (0.97-1.05%) in the US, and the 90-day absolute risk of VTE ranged from 0.23% (0.21-0.26%) in Canada to 0.84% (0.80-0.89%) in England. The seven cohorts included 3,544,062 patients with COVID-19 during vaccine availability (beginning December 2020). The 90-day absolute risk of ATE during this period ranged from 0.06% (0.06-0.07%) in England to 1.04% (1.01-1.06%) in the US, and the 90-day absolute risk of VTE ranged from 0.25% (0.24-0.26%) in England to 1.02% (0.99-1.04%) in the US.</p><p><strong>Conclusion: </strong>There was heterogeneity by country in 90-day absolute risk of ATE and VTE after ambulatory COVID-19 diagnosis both before and during COVID-19 vaccine availability.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"71-89"},"PeriodicalIF":3.4,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Trends in Male Breast Cancer Incidence, Mortality, and Survival in Austria (1983–2017)","authors":"Lazo Ilic, Judit Simon, Monika Hackl, Gerald Haidinger","doi":"10.2147/clep.s428824","DOIUrl":"https://doi.org/10.2147/clep.s428824","url":null,"abstract":"<strong>Background:</strong> Male breast cancer (MBC) comprises less than 1% of all breast cancer cases globally and remains understudied with persisting sex-specific survival disadvantages. We aim to contribute to better understanding of MBC with a comprehensive analysis of time-trends over several decades in Austria.<br/><strong>Methods:</strong> We used Austrian National Cancer Registry data on 1648 cases of MBC cases diagnosed between 1983 and 2017 in Austria. Overall incidence, mortality, and survival rates, as well as age-, stage-, and period-specific incidence and survival rates were calculated. Joinpoint regression was performed to assess trends.<br/><strong>Results:</strong> MBC incidence rates increased throughout the whole observation period (1983– 2017) with an annual percent change (APC) of 1.44% (95% confidence interval, CI: 0.77 to 2.11). During the same period, morality rates were stable (APC: – 0.25, 95% CI: – 0.53 to 0.60). Ten-year survival rates showed three phases of decreasing increases with an average APC of 2.45%, 1983– 2009 (95% CI: 2.1 to 2.74). Five-year survival rates improved until 2000 (APC: 2.31, 95% CI: 1.34 to 3.30) and remained stable thereafter (APC: 0.10, 95% CI: – 0.61 to 0.80). Stage-specific analyses showed a single trend of stable incidence rates of distant disease MBC (APC: – 0.03, 95% CI: – 1.67 to 1.65). Further, we observed increases in localised, regional, and unknown stage cancer incidence and increases in incidence rates across all age groups over the whole observation period. However, the estimates on these subgroup-specific trends (according to age- and stage) show wider 95% CIs and lower bounds closer to zero or negative in comparison to our findings on overall incidence, mortality, and survival.<br/><strong>Conclusion:</strong> Despite improvements in survival rates, MBC mortality rates remained largely stable between 1983 and 2017 in Austria, possibly resulting from a balance between increasing overall incidence and stable incidence rates of distant disease MBC.<br/><br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"38 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Survival Trends in Southeastern China, 2011–2021: A Population-Based Study","authors":"Yan Zhou, Yeying Wen, Zhisheng Xiang, Jingyu Ma, Yongtian Lin, Yongying Huang, Chuanben Chen","doi":"10.2147/clep.s442152","DOIUrl":"https://doi.org/10.2147/clep.s442152","url":null,"abstract":"<strong>Purpose:</strong> The 5-year cancer survival rate among Chinese patients is lower than that among patients in developed countries and varies widely across geographic regions. The aim of this study was to analyse the 5-year relative cancer survival rate in southeastern China, between 2011 and 2021.<br/><strong>Patients and Methods:</strong> We utilised population-based statistics from 12 cancer registries in Fujian, China. Study population data were up to date as of Dec 31, 2019, and survival outcome status was updated as of Dec 31, 2021. We used the ICD-10 and the ICD-O-3 to categorize all cancer cases. We analysed the 5-year relative survival for cancers combined and different cancer types stratified by sex, urban and rural areas, and age. Survival estimates were stratified according to calendar period (2011– 13, 2014– 15, 2016– 18 and 2019– 21).<br/><strong>Results:</strong> Ultimately, a total of 160,294 cancer patients were enrolled in the study. In 2011– 13, 2014– 15, 2016– 18 and 2019– 21, the age-standardised 5-year relative survival for cancers combined were 29.1% (95% CI: 28.6– 29.7), 31.5% (95% CI: 31.0– 32.0), 36.8% (95% CI: 36.4– 37.3) and 39.1% (95% CI: 38.7– 39.6), respectively. The age-standardised 5-year relative survival for lung, prostate, larynx, colon-rectum, kidney and bone cancers increased 4.3%, 4.0%, 3.8%, 3.4%, 3.4% and 2.70%, respectively. Cancers with high 5-year relative survival rates (&gt; 60%) in 2019– 21 included thyroid, testis, breast, bladder, cervix, prostate and uterus cancers. The 5-year survival rates in 2019– 2021 was higher for females than for males (47.8% vs 32.0%) and higher in urban areas than in rural areas (41.7% vs 37.1%). Relative survival rates decreased with increasing age.<br/><strong>Conclusion:</strong> The 5-year cancer survival in Fujian Province increased between 2011 and 2021 but remained at a low level. Building a strong primary public health system may be a key step in reducing the cancer burden in Fujian Province.<br/><br/><strong>Keywords:</strong> relative survival, cancer, population-based study, cancer registry<br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"11 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139647583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}