Data Resource Profile: Expansion of the Rochester Epidemiology Project medical records-linkage system (E-REP)

SYNOPSISNumerous studies have estimated the frequency of bulimia nervosa among high school girls and college women, but population-based trends in incidence in a community have not been reported.In this study we determined the incidence of bulimia nervosa by identifying persons residing in the community of Rochester, Minnesota, who had the disorder initially diagnosed during the 11-year period from 1980 to 1990. Using our comprehensive population-based data resource (the Rochester Epidemiology Project), we identified cases by screening 777 medical records with diagnoses of bulimia; feeding disturbance; rumination syndrome; adverse effects of cathartics, emetics, or diuretics; polyphagia; sialosis; or vomiting.We identified 103 Rochester residents (100 female and 3 male) who fulfilled DSM-III-R diagnostic criteria for bulimia nervosa during the 11-year study period. Mean ± S.D. age for females at the time of diagnosis was 23·0 ± 6·1 years (range, 14·4 to 40·2 years). Yearly incidence in females rose sharply from 7·4 per 100000 population in 1980 to 49·7 in 1983, and then remained relatively constant around 30 per 100000 population. The annual age-adjusted incidence rates were 26·5 per 100000 population for females and 0·8 per 100000 population for males. The overall age-and sex-adjusted annual incidence was 13·5 per 100000 population.Bulimia nervosa is a common disorder in adolescent girls and young women from 15 to 24 years of age. Histories of alcohol or drug abuse, depression, or anorexia nervosa were higher than expected in the general population.

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Data Resource Profile: The Rochester Epidemiology Project (REP) medical records-linkage system

International Journal of Epidemiology ◽

10.1093/ije/dys195 ◽

2012 ◽

Vol 41 (6) ◽

pp. 1614-1624 ◽

Cited By ~ 295

Author(s):

J. L. St Sauver ◽

B. R. Grossardt ◽

B. P. Yawn ◽

L. J. Melton ◽

J. J. Pankratz ◽

...

Keyword(s):

Medical Records ◽

Data Resource ◽

Rochester Epidemiology Project

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History of the Rochester Epidemiology Project: Half a Century of Medical Records Linkage in a US Population

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2012.08.012 ◽

2012 ◽

Vol 87 (12) ◽

pp. 1202-1213 ◽

Cited By ~ 425

Author(s):

Walter A. Rocca ◽

Barbara P. Yawn ◽

Jennifer L. St. Sauver ◽

Brandon R. Grossardt ◽

L. Joseph Melton

Keyword(s):

Medical Records ◽

Rochester Epidemiology Project ◽

History Of

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Use of a Medical Records Linkage System to Enumerate a Dynamic Population Over Time: The Rochester Epidemiology Project

American Journal of Epidemiology ◽

10.1093/aje/kwq482 ◽

2011 ◽

Vol 173 (9) ◽

pp. 1059-1068 ◽

Cited By ~ 355

Author(s):

Jennifer L. St. Sauver ◽

Brandon R. Grossardt ◽

Barbara P. Yawn ◽

L. Joseph Melton ◽

Walter A. Rocca

Keyword(s):

Medical Records ◽

Rochester Epidemiology Project ◽

Dynamic Population ◽

Over Time

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The Effect of Patient Age and Calendar Year on the Incidence of Idiopathic vs. Secondary Venous Thromboembolism (VTE): A Population-Based Cohort Study.

Blood ◽

10.1182/blood.v104.11.3516.3516 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3516-3516

Author(s):

Catie E. Kobbervig ◽

John A. Heit ◽

Tanya M. Petterson ◽

Teresa J. Christianson ◽

Kent R. Bailey ◽

...

Keyword(s):

Risk Factors ◽

Medical Records ◽

Clinical Characteristics ◽

Population Based ◽

Incidence Rates ◽

Olmsted County ◽

Inception Cohort ◽

Rochester Epidemiology Project ◽

Biology Of Aging ◽

Adjusted Incidence

Abstract If the observed dramatic increase in VTE incidence with advancing age is due to increased VTE risk factor exposure (i.e., secondary VTE), the incidence of idiopathic VTE should not vary with age or calendar year. Objective: To estimate the incidence of idiopathic and secondary VTE by age and by calendar year. Methods: Using the resources of the Rochester Epidemiology Project, we identified the inception cohort of Olmsted County, MN, residents with a first lifetime VTE during the 30-year period, 1966–1995 (n=2761). For each case, we reviewed the complete medical records in the community for 48 baseline clinical characteristics that are commonly-accepted risk factors for VTE. We categorized VTE cases as idiopathic (n=305) if no such characteristics were present; the remaining cases were categorized as secondary. Age- and sex-specific incidence rates were calculated using idiopathic or secondary VTE cases as the numerator, and age-, sex- and calendar year-specific estimates of the population of Olmsted County as the denominator. Results: The incidence of both idiopathic and secondary VTE increased exponentially with age for both men and women (p<0.001). Over the 30-year study period, the age-adjusted incidence of idiopathic VTE was essentially constant among men (from 19.0 to 17.1 per 100,000 men-years for 1966–70 and 1990–95, respectively), but decreased markedly among women (from 18.5 to 3.6 per 100,000 woman-years for 1966–70 and 1990–95, respectively; p=0.005 for the interaction). Conclusions: The dramatic increase in VTE incidence with age likely reflects the biology of aging, although as yet unidentified VTE risk factors cannot be excluded. The reason for the decreased incidence of idiopathic VTE over the last 30 years among women is unclear.

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FTS-03-02: Half a century of medical records linkage in the rochester epidemiology project

Alzheimer s & Dementia ◽

10.1016/j.jalz.2015.07.125 ◽

2015 ◽

Vol 11 (7S_Part_4) ◽

pp. P170-P170

Author(s):

Walter Rocca

Keyword(s):

Medical Records ◽

Rochester Epidemiology Project

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Aquaporin-4 and MOG autoantibody discovery in idiopathic transverse myelitis epidemiology

Neurology ◽

10.1212/wnl.0000000000007828 ◽

2019 ◽

Vol 93 (4) ◽

pp. e414-e420 ◽

Cited By ~ 4

Author(s):

Elia Sechi ◽

Eslam Shosha ◽

Jonathan P. Williams ◽

Sean J. Pittock ◽

Brian G. Weinshenker ◽

...

Keyword(s):

Predominantly White ◽

Diagnostic Criteria ◽

Medical Records ◽

Transverse Myelitis ◽

Population Based ◽

Myelin Oligodendrocyte Glycoprotein ◽

Aquaporin 4 ◽

Olmsted County ◽

White Population ◽

Rochester Epidemiology Project

ObjectiveDiagnostic criteria from 2002 classify transverse myelitis (TM) as idiopathic or disease associated but predate the discovery of aquaporin-4 (AQP4)–immunoglobulin G (IgG) and myelin oligodendrocyte glycoprotein (MOG)-IgG, which associate with TM. Prior incidence estimates of idiopathic TM (ITM) range from 1 to 6.2 per 1 million. We sought to determine whether the population-based incidence and prevalence of ITM were reduced by testing patients with ITM for AQP4/MOG-IgG and reclassifying seropositive cases as having disease-associated TM.MethodsFor this observational study, we retrospectively identified all cases of incident (January 1, 2003–December 31, 2016) and prevalent (December 31, 2016) ITM in Olmsted County (85% white) by using the Rochester Epidemiology Project medical records linkage system. ITM was defined by the 2002 Transverse MyelitisConsortium Working Group diagnostic criteria. Available sera were tested for AQP4-IgG and MOG-IgG.ResultsTwenty-four patients (incident 22, prevalent 17) initially met 2002 ITM criteria (longitudinally extensive TM [LETM] 6). Sera were tested for AQP4-IgG in 22 of 24 (92%) and MOG-IgG in 21 of 24 (88%). Three seropositive cases (AQP4-IgG 2, MOG-IgG 1) were identified and reclassified as having disease-associated TM, accounting for 14% of total incident and 12% of total prevalent cases. AQP4-IgG and MOG-IgG seropositive cases represented 50% (3 of 6) of idiopathic LETM. After reclassification of seropositive patients, the final ITM incidence was 8.6 per 1,000,000 and prevalence was 7.9 per 100,000. Three cases of ITM (14%) subsequently fulfilled multiple sclerosis criteria within the study period.ConclusionsThe availability of AQP4-IgG and MOG-IgG modestly reduced ITM incidence and prevalence, which remained higher than previously reported in this predominantly white population. Incorporation of these biomarkers into future revisions of TM diagnostic criteria should be considered.

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Incidence of progressive supranuclear palsy and multiple system atrophy in Olmsted County, Minnesota, 1976 to 1990

Neurology ◽

10.1212/wnl.49.5.1284 ◽

1997 ◽

Vol 49 (5) ◽

pp. 1284-1288 ◽

Cited By ~ 234

Author(s):

James H. Bower ◽

Demetrius M. Maraganore ◽

Shannon K. McDonnell ◽

Walter A. Rocca

Keyword(s):

Multiple System Atrophy ◽

Progressive Supranuclear Palsy ◽

Medical Records ◽

Census Data ◽

Incidence Rates ◽

Olmsted County ◽

Annual Incidence Rate ◽

Rochester Epidemiology Project ◽

Average Annual Incidence ◽

Incident Cases

Information on the incidence of progressive supranuclear palsy (PSP) is limited; incidence rates for multiple system atrophy (MSA) are not available. We studied the incidence of PSP and MSA in Olmsted County, Minnesota, for the years 1976 to 1990. This study was part of a larger investigation of all forms of parkinsonism. We used the medical records-linkage system of the Rochester Epidemiology Project to identify all subjects whose records contained documentation of any form of parkinsonism, related neurodegenerative diseases, or tremor of any type. A nurse abstractor screened the records and, when applicable, a neurologist reviewed them to determine the presence or absence of parkinsonism. Cases of parkinsonism were classified using specified diagnostic criteria. Population denominators were derived from census data and were corrected by removing prevalent cases of parkinsonism. Over the 15 years of the study, we found 16 incident cases of PSP and nine incident cases of MSA. No cases of PSP or MSA had onset before age 50 years. The average annual incidence rate (new cases per 100,000 person-years) for ages 50 to 99 years was 5.3 for PSP and 3.0 for MSA. The incidence of PSP increased steeply with age from 1.7 at 50 to 59 years to 14.7 at 80 to 99 years, and was consistently higher in men. Median survival time from symptom onset was 5.3 years for PSP and 8.5 years for MSA. The incidence of PSP increases with age and is consistently higher in men at all ages. PSP and MSA are more common than previously recognized.

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Population-based incidence of food allergies in Olmsted County over 17 years

Allergy and Asthma Proceedings ◽

10.2500/aap.2022.43.210088 ◽

2022 ◽

Vol 43 (1) ◽

pp. 44-49 ◽

Cited By ~ 1

Author(s):

Yahya Almodallal ◽

Amy L. Weaver ◽

Avni Y. Joshi

Keyword(s):

Food Allergy ◽

Medical Records ◽

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

Food Allergies ◽

Olmsted County ◽

Rochester Epidemiology Project ◽

Rising Incidence ◽

Male Patients

Background: There is growing concern about the rising incidence and prevalence of food allergy globally. We previously reported the incidence of food allergy in Olmsted County, Minnesota, between 2002 and 2011. We sought to update the incidence and temporal trends of food allergies in our region through 2018. Methods: By using the Rochester Epidemiology Project, all Olmsted County residents, with an incident diagnosis of food allergy between January 2, 2012, and December 31, 2018, were identified and their medical records were reviewed. These cases were combined with the previously collected incidence cases from January 2, 2002, and December 31, 2011, to understand longitudinal trends in food allergy incidence rates. Results: Over the 17-year study period, 1076 patients (58.0% male patients, 72.1% white) were diagnosed with an incident food allergy. The median (interquartile range) age at first diagnosis was 2.0 years (1.1-8.4 years). The overall annual incidence rate for all ages was 3.9 (95% confidence interval [CI], 3.6‐4.1) per 10,000 person-years and was significantly higher in male than in female patients (4.4 [95% CI, 4.0‐4.7] and 3.3 [95% CI, 3.0‐3.6], respectively; p < 0.001). The most common food allergen was egg in infancy (57.7%), peanuts in ages 1‐4 years (58.3%), tree nuts in ages 5‐18 years (57.4%), and seafood in adults (≥19 years) (45.3%). Conclusion: The incidence of food allergy in Olmsted County steadily increased from 2002 to 2008, then remained relatively stable between the years 2008 and 2013, and again presented a rising trend over the next 5 years until 2018. This warrants further investigations into the effects of changes in guidelines for early introductions of allergenic foods and other factors that affect causality.

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Impairment Tutorial: Spinal Cord Stimulation and Intraspinal Opioids:Impairment Rating Issues

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.sepoct04 ◽

2000 ◽

Vol 5 (5) ◽

pp. 4-5

Author(s):

James B. Talmage ◽

Leon H. Ensalada

Keyword(s):

Medical Records ◽

Evaluation Process ◽

Current Approach ◽

Satisfaction Survey ◽

Start Time ◽

Medical Evaluation ◽

Independent Medical Evaluation ◽

Other Information ◽

Physician Reviews ◽

Written Informed Consent

Abstract Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.

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