International comparisons of the consultation prevalence of musculoskeletal conditions using population-based healthcare data from England and Sweden

Background: Huntington’s disease (HD) is a rare, genetic, neurodegenerative disease. Obtaining population-level data on epidemiology and disease management is challenging. Objective: To investigate the epidemiology, clinical manifestations, treatment, and healthcare utilization of patients with HD in Israel. Methods: Retrospective population-based cohort study, including 20 years of routinely collected data from Maccabi Healthcare Services, an insurer and healthcare provider for one-quarter of the Israeli population. Results: The study cohort included 109 adult patients (aged ≥18 years) diagnosed with HD, with mean age of 49.9 years and 56%females. The most common HD-related conditions were anxiety (40%), behavioral problems (34%), sleep disorders (21%), and falls (13%). Annual incidence rates for HD ranged from 0.17 to 1.34 per 100,000 from 2000 to 2018; the 2018 crude prevalence in adults was 4.36 per 100,000. Median survival from diagnosis was approximately 12 years (95%CI: 10.4–15.3). The most frequent symptomatic treatments were antidepressants (69%), antipsychotics (63%), and tetrabenazine (63%), the only drug approved for the treatment of HD chorea in Israel during the examined period. Patterns of healthcare utilization changed as disease duration increased, reflected by increased frequency of emergency department visits and home visits. Conclusion: This retrospective population-based study provides insights into the prevalence, incidence, clinical profile, survival, and resource utilization of patients with HD in ethnically diverse Israel. The findings in this study are generally consistent with the international literature and demonstrate the value of routinely collected healthcare data as a complementary resource in HD research.

Download Full-text

Maternal smoking behaviour across the first two pregnancies and small for gestational age birth: Analysis of the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the South of England

PLoS ONE ◽

10.1371/journal.pone.0260134 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260134

Author(s):

Elizabeth J. Taylor ◽

Pia Doh ◽

Nida Ziauddeen ◽

Keith M. Godfrey ◽

Ann Berrington ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Maternal Smoking ◽

Population Based ◽

Smoking Behaviour ◽

Adverse Birth Outcomes ◽

Full Sample ◽

Healthcare Data ◽

Increased Risk ◽

Never Smokers

Maternal smoking is established to cause adverse birth outcomes, but evidence considering maternal smoking change across successive pregnancies is sparse. We examined the association between self-reported maternal smoking during and between the first two pregnancies with the odds of small for gestational age (SGA) birth (<10th percentile) in the second infant. Records for the first two pregnancies for 16791 women within the SLOPE (Studying Lifecourse Obesity PrEdictors) study were analysed. This is a population-based cohort of prospectively collected anonymised antenatal and birth healthcare data (2003–2018) in Hampshire, UK. Logistic regression was used to relate maternal smoking change to the odds of SGA birth in the second infant. In the full sample, compared to never smokers, mothers smoking at the start of the first pregnancy had higher odds of SGA birth in the second pregnancy even where they stopped smoking before the first antenatal appointment for the second pregnancy (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.10, 2.03]). If a mother was not a smoker at the first antenatal appointment for either her first or her second pregnancy, but smoked later in her first pregnancy or between pregnancies, there was no evidence of increased risk of SGA birth in the second pregnancy compared to never smokers. A mother who smoked ten or more cigarettes a day at the start of both of her first two pregnancies had the highest odds of SGA birth (3.54 [2.55, 4.92]). Women who were not smoking at the start of the first pregnancy but who subsequently resumed/began smoking and smoked at the start of their second pregnancy, also had higher odds (2.11 [1.51, 2.95]) than never smokers. Smoking in the first pregnancy was associated with SGA birth in the second pregnancy, even if the mother quit by the confirmation of her second pregnancy.

Download Full-text

A66 GEOGRAPHIC VARIATION AND INCREASED INVOLVEMENT OF INTERVENTIONAL RADIOLOGISTS IN THE MANAGEMENT OF REFRACTORY ASCITES: A POPULATION BASED STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.065 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 79-80

Author(s):

D Motomura ◽

M Djerboua ◽

J Flemming

Keyword(s):

Cost Effective ◽

Standard Of Care ◽

Population Based ◽

Incidence Rates ◽

Case Definition ◽

Refractory Ascites ◽

Local Health ◽

Provider Type ◽

Healthcare Data ◽

Research Award

Abstract Background The disease burden from cirrhosis is increasing worldwide. Refractory ascites (RA) is a complication of cirrhosis associated with poor prognosis if liver transplant is not an option. Serial large volume paracentesis (LVP) is the standard of care in the management of refractory ascites (RA) and outpatient LVP has been shown to be safe and cost effective. Epidemiologic data is lacking regarding the incidence of RA, or how patients with RA are managed in routine clinical practice. Aims To describe secular trends in the incidence of RA in Ontario from 2000–2017, and to describe physician provider types performing LVPs in the RA population in Ontario. Methods This retrospective, population-based cohort study uses routinely collected healthcare data from Ontario, Canada, housed at ICES. From January 1, 2000 to Dec 31, 2017 all adult patients with cirrhosis were identified using a validated case definition, and those with RA were identified based on the need for serial LVP. All LVP procedures were described based on patient demographics, local health integration network (LHIN), physician type (Gastroenterology [GI], Internal Medicine [IM], Interventional Radiology [IR], Emergency Medicine [ER], other) and albumin administration. Annual incidence rates (IR) of RA in patients with cirrhosis were calculated and compared using Poisson regression to calculate incident rate ratios (IRRs). Annual LVP volume by provider type and LHIN were calculated and differences were compared using chi-squared analysis. Results The overall incidence of RA in patients with cirrhosis remained relatively stable over the study period (IRR 1.01, 95% CI 1.00–1.02 P<.001). The highest incidence of RA was in those with viral hepatitis and alcohol-related cirrhosis. A total of 90,126 LVPs were identified (median age 61 years [IQR 53–70], 69% male, median LVP per patient 24 [IQR 11–48], 15.8% received albumin infusion). The absolute numbers of LVPs more than tripled over the study period (12,047 in 1997–2002 vs. 37,437 in 2013–2017). GI performed the majority of LVPs (40.1%) followed by IR (22.4%), and IM (8.4%), but there was substantial variation based on location (Fig 1). Overall, the proportion performed by IR increased during the study (7.8% in 1997–2002 vs 30.8% in 2013–2017, P <.001) while the proportion performed by GI decreased (50% 1997–2002 vs 33.1% 2013–2017, P<.001). Conclusions The number of LVPs performed for RA have increased dramatically in Ontario over the past two decades, with the proportion being performed by GI physicians decreasing, while IR is increasing. Substantial variability exists across LHINs on the use of LVP, which may reflect differences in access to resources for LVP, or physician practice. Appropriate albumin use with LVP remains an area for potential quality improvement initiatives in the future. Funding Agencies AASLD Foundation Clinical Translational and Outcomes Research Award in Liver Disease (for supervisor JF)

Download Full-text

Anthropometric changes and risk of diabetes: are there sex differences? A longitudinal study of Alberta’s Tomorrow Project

BMJ Open ◽

10.1136/bmjopen-2018-023829 ◽

2019 ◽

Vol 9 (7) ◽

pp. e023829

Author(s):

Ming Ye ◽

Paula J Robson ◽

Dean T Eurich ◽

Jennifer E Vena ◽

Jian-Yi Xu ◽

...

Keyword(s):

Longitudinal Study ◽

Sex Difference ◽

Cox Regression ◽

Positive Association ◽

Population Based ◽

Total Risk ◽

Specific Difference ◽

Healthcare Data ◽

The Difference ◽

Set Up

ObjectivesTo characterise the sex-specific difference in the association between anthropometric changes and risk of diabetes in the general population in Canada.Setting and participantsFrom 2000 to 2008, Alberta’s Tomorrow Project (ATP) invited Alberta’s residents aged 35–69 years to a prospective cohort study. A total of 19 655 diabetes-free ATP participants having anthropometrics measured at the baseline and follow-ups were included.Design and outcome measuresA longitudinal study design was used to examine the association between anthropometric changes and risk of diabetes and the sex difference in this association. Changes in weight, body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) were calculated as the difference between baseline and follow-up measures. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm with administrative healthcare data (2000–2015) linked to the ATP cohort. The sex-specific association between anthropometric changes and incidence of diabetes were examined by multivariable Cox regression models.ResultsChanges in weight, BMI, WC and WHR over time were positively associated with incidence of diabetes in both men and women. The sex difference in risk of diabetes associated with 1 standard deviation (SD) increase in anthropometrics was 0.07 (95% CI −0.02 to 0.14) for weight, 0.08 (95% CI −0.03 to 0.17) for BMI, 0.07 (95% CI −0.02 to 0.15) for WC and 0.09 (95% CI 0.03 to 0.13) for WHR. Similar results were found in sex difference in the associations with changes per 5% and changes per categories (5% loss, ±5%, 5% gain).ConclusionsThe positive association between anthropometric changes and risk of diabetes was generally stronger in men than in women. However, this sex-specific difference of approximately 10% of the total risk associated with anthropometric changes had limited significance. For population-based public health programmes aiming to control obesity and incidence of diabetes, it may not be necessary to set up sex-specific goals for anthropometric reduction.

Download Full-text

Population’s health study as a factor of resource saving

E3S Web of Conferences ◽

10.1051/e3sconf/201911002099 ◽

2019 ◽

Vol 110 ◽

pp. 02099

Author(s):

Natalia Astafieva ◽

Natalia Ivanova ◽

Elena Dorozhkina ◽

Ruslan Minnullin

Keyword(s):

Management System ◽

International Comparisons ◽

Policy Instruments ◽

Population Based ◽

Health Study ◽

Resource Saving ◽

Resources Management ◽

Methodical Approach ◽

Working Age ◽

Labor Resources

The article presents an approach to factor monitoring of health status of the population, based on a system of indicators used in international comparisons and in the labor and energy resources management system. This methodical approach is supplemented by indicators, taking into account specifics of the issue being studied (mortality at working age and incidence of socially-related diseases). Integrated health index of the population is calculated, the degree of its dependence on the constituent components is revealed, an assessment of the effectiveness of social policy instruments for saving labor resources in health care has been carried out when implementing the concept of innovative development of the country and the energy management system.

Download Full-text

Lessons learned from the Canadian cancer registry experience

Healthcare Management Forum ◽

10.1177/0840470417733008 ◽

2017 ◽

Vol 31 (1) ◽

pp. 9-12 ◽

Cited By ~ 1

Author(s):

Maureen MacIntyre ◽

Cathy MacKay

Keyword(s):

Data Collection ◽

Health System ◽

Patient Outcomes ◽

Cancer Registry ◽

Care Delivery ◽

Population Based ◽

Lessons Learned ◽

Opportunities To Learn ◽

Healthcare Data ◽

Canadian Health

Health leaders and caregivers are focused on evidence-based data to drive care delivery and practice. Ensuring the health system is functioning effectively and efficiently and that patient outcomes are reaching expected targets are topics that permeate conversations at the local, provincial, and national levels. However, as many leaders have come to understand in recent years, healthcare data collection and producing meaningful, high-quality metrics is a complex set of tasks, requiring its own level of attention and dedicated resources. In the healthcare data realm, there are opportunities to learn from experience. One of these opportunities is the population-based cancer registry, which is one of the oldest examples of standardized data collection in the Canadian health system.

Download Full-text

Describing the Linkages of the Citizenship and Immigration Canada Permanent Resident Data and Vital Statistics—Death Registry to Ontario’s Administrative Health Database

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.36 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Astrid Guttmann ◽

Maria Chiu ◽

Michael Lebenbaum ◽

Kelvin Lam ◽

Nelson Chong ◽

...

Keyword(s):

Record Linkage ◽

Causes Of Death ◽

Population Based ◽

Vital Statistics ◽

Cross Sectional ◽

Healthcare Data ◽

Universal Healthcare ◽

Permanent Resident ◽

Linkage Methods ◽

Health Database

ABSTRACTObjectives Ontario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada (IRCC) Permanent Resident database and the Office of the Registrar General’s Vital Statistics-Death (VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files. Approach We used both deterministic and probabilistic linkage methods to link the IRCC database (1985-2012) and VSD registry (1990-2012) to the Ontario’s Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records. Results The overall linkage rates for the IRCC database and VSD registry were 86.4% and 96.2%, respectively. The majority (68.2%) of the record linkages in IRCC were achieved after the three deterministic passes with the remaining 18.2% being linked probabilistically. Similarly the majority (79.8%) of the record linkages in the ORGD were linked using deterministic record linkage and the remaining 16.3% were linked after probabilistic and manual review. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC and sex and most causes of death for VSD. However, lower linkage rates were observed among people born in East Asia (78%) in the IRCC database and certain causes of death in the VSD registry, namely perinatal conditions (61.3%) and congenital anomalies (81.3%). Conclusion The linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to be conducted. Analytic techniques to account for sub-optimal linkage rates may be required in studies of certain ethnic groups or certain causes of death among children and infants.

Download Full-text

Survival in Adult Italian Cancer Patients, 1978–1989

Tumori Journal ◽

10.1177/030089169708300109 ◽

1997 ◽

Vol 83 (1) ◽

pp. 39-425 ◽

Cited By ~ 23

Author(s):

Arduino Verdecchia ◽

Riccardo Capocaccia ◽

Roberta De Angelis ◽

Fulvia Valente ◽

...

Keyword(s):

Cancer Patient ◽

Cancer Patients ◽

Patient Survival ◽

National Level ◽

International Comparisons ◽

Relative Survival ◽

Cancer Registries ◽

Population Based ◽

Cancer Site ◽

Malignant Neoplasms

Aims To present a systematic analysis of population-based cancer patient survival in Italy. Methods Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level. Results Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also to give a basis for international comparisons with countries involved in the EUROCARE study. Conclusions For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.

Download Full-text

Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012–2014

BMJ Open ◽

10.1136/bmjopen-2018-021501 ◽

2018 ◽

Vol 8 (7) ◽

pp. e021501 ◽

Cited By ~ 4

Author(s):

Wan-Hua Hsieh ◽

Chien-Hsing Wang ◽

Tsung-Hsueh Lu

Keyword(s):

Outcome Measures ◽

International Comparisons ◽

Mortality Rates ◽

Oecd Countries ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Undetermined Intent ◽

Self Harm

ObjectiveTo compare the drowning mortality rates and proportion of deaths of each intent among all drowning deaths in Organisation for Economic Co-operation and Development (OECD) countries in 2012–2014.DesignA population-based cross-sectional study.Setting32 OECD countries.ParticipantsIndividuals in OECD countries who died from drowning.Main outcome measuresDrowning mortality rates (deaths per 100 000 population) and proportion (%) of deaths of each intent (ie, unintentional intent, intentional self-harm, assault, undetermined intent and all intents combined) among all drowning deaths.ResultsCountries with the highest drowning mortality rates (deaths per 100 000 population) were Estonia (3.53), Japan (3.49) and Greece (2.40) for unintentional intent; Ireland (0.96), Belgium (0.96) and Korea (0.89) for intentional self-harm; Austria (0.57), Korea (0.56) and Hungary (0.44) for undetermined intent and Japan (4.35), Estonia (3.70) and Korea (2.73) for all intents combined. Korea ranked 12th and 3rd for unintentional intent and all intents combined, respectively. By contrast, Belgium ranked 2nd and 15th for intentional self-harm and all intents combined, respectively. The proportion of deaths of each intent among all drowning deaths in each country varied greatly: from 26.2% in Belgium to 96.8% in Chile for unintentional intent; 0.7% in Mexico to 57.4% in Belgium for intentional self-harm; 0.0% in nine countries to 4.9% in Mexico for assault and 0.0% in Israel and Turkey to 38.3% in Austria for undetermined intent.ConclusionsA large variation in the practice of classifying undetermined intent in drowning deaths across countries was noted and this variation hinders valid international comparisons of intent-specific (unintentional and intentional self-harm) drowning mortality rates.

Download Full-text