scholarly journals Cohort profile: the Swedish Prescribed Drugs and Health Cohort (SPREDH)

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023155 ◽  
Author(s):  
Shao-Hua Xie ◽  
Giola Santoni ◽  
Fredrik Mattsson ◽  
Eivind Ness-Jensen ◽  
Jesper Lagergren
Keyword(s):  
Causes Of Death ◽  
Disease Risk ◽  
Healthcare Utilisation ◽  
Patient Characteristics ◽  
Population Based ◽  
Health Data ◽  
Case Control Studies ◽  
Swedish Population ◽  
Drug Register ◽  
Incident Cancer

PurposeThe Swedish Prescribed Drugs and Health Cohort (SPREDH) is a Swedish population-based cohort based on data from four nationwide health data registers, created with the aim of investigating how the use of selected medications influences cancer risk and other outcomes.ParticipantsThe cohort includes 8 421 115 users of selected common medications who have been followed-up for a total of 82 281 720 person-years from 1 July 2005 to 31 December 2015.Finding to dateThe data in SPREDH were prospectively collected from the following national health data registers in Sweden: Prescribed Drug Register, Patient Register, Cancer Register and Causes of Death Register. Data on basic patient characteristics, use of the selected common medications, healthcare utilisation, diagnoses (including detailed information on cancers), and dates and causes of death are available for all cohort participants. The cohort currently includes 801 766 incident cancer cases.Future plansThe data in SPREDH can be used for various types of epidemiological research, particularly for examining how the use of the selected medications influences disease risk and other outcomes. We are initially planning cohort studies and nested case-control studies on selected medications in relation to the risk and prognosis of oesophageal and gastric cancers.

Cancer Risk in Patients with Autoimmune Hepatitis: A Nationwide Population-Based Cohort Study with Histopathology

2021 ◽  
Author(s):  
Rajani Sharma ◽  
Elizabeth C Verna ◽  
Tracey G Simon ◽  
Jonas Söderling ◽  
Hannes Hagström ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Cancer Risk ◽  
Autoimmune Hepatitis ◽  
Cox Regression ◽  
Population Based ◽  
Swedish Population ◽  
Non Melanoma Skin Cancer ◽  
Incident Cancer ◽  
Increased Risk

Abstract We aimed to determine the risk of incident cancer in autoimmune hepatitis (AIH) compared to the general population and siblings. AIH was defined by the presence of a medical diagnosis of AIH and a liver biopsy in a nationwide Swedish population-based cohort study. We identified 5,268 adults with AIH diagnosed 1969-2016 and 22,996 matched general population reference individuals and 4,170 sibling comparators. Using Cox regression, hazard ratios (HRs) were determined for any incident cancer and sub-types determined from the Swedish Cancer Register. During follow-up, a cancer diagnosis was made in 1,119 individuals with AIH (17.2/1000 person-years) and 4,450 reference individuals (12.0/1000 person-years). This corresponded to an HR of 1.53 (95%CI: 1.42,1.66). Cancer risk was highest in those with cirrhosis. There was a 29.18-fold increased risk of hepatocellular carcinoma (HCC) (95%CI, 17.52,48.61). The annual incidence risk of HCC in individuals with AIH who had cirrhosis was 1.1% per year. AIH was also linked to non-melanoma skin cancer (HR=2.69) and lymphoma (HR=1.89). Sibling analyses yielded similar risk estimates for any cancer (HR=1.84) and HCC (HR=23.10). AIH is associated with an increased risk of any cancer, in particular, HCC and extra-hepatic malignancies. The highest risk for cancer, especially HCC, is in patients with cirrhosis.

The influence of human leukocyte antigen-DRB1*15:01 and its interaction with smoking in MS development is dependent on DQA1*01:01 status

2019 ◽  
Vol 26 (13) ◽  
pp. 1638-1646 ◽  
Author(s):  
Anna Karin Hedström ◽  
Ola Hössjer ◽  
Jan Hillert ◽  
Pernilla Stridh ◽  
Ingrid Kockum ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Population Based ◽  
Case Control ◽  
Case Control Studies ◽  
Swedish Population ◽  
Leukocyte Antigen ◽  
Smoking Interaction ◽  
Additive Scale

Background: HLA-DRB1*15:01, absence of HLA-A*02:01, and smoking interact to increase multiple sclerosis (MS) risk. Objective: To analyze whether MS-associated human leukocyte antigen (HLA) alleles, apart from DRB1*15:01 and absence of A*02:01, interact with smoking in MS development, and to explore whether the established HLA-smoking interaction is affected by the DQA1*01:01 allele, which confers a protective effect only in the presence of DRB1*15:01. Methods: In two Swedish population-based case–control studies (5838 cases, 5412 controls), subjects with different genotypes and smoking habits were compared regarding MS risk, by calculating odds ratios with 95% confidence intervals employing logistic regression. Interaction on the additive scale between different genotypes and smoking was evaluated. Results: The DRB1*08:01 allele interacted with smoking to increase MS risk. The interaction between DRB1*15:01 and both the absence of A*02:01 and smoking was confined to DQA1*01:01 negative subjects, whereas no interactions occurred among DQA1*01:01 positive subjects. Conclusion: Multifaceted interactions take place between different class II alleles and smoking in MS development. The influence of DRB1*15:01 and its interaction with the absence of A*02:01 and smoking is dependent on DQA1*01:01 status which may be due to differences in the responding T-cell repertoires.

scholarly journals Case–case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States – 2005–2015

2019 ◽  
Vol 147 ◽  
Author(s):  
K. M. Benedict ◽  
S. A. Collier ◽  
E. P. Marder ◽  
M. C. Hlavsa ◽  
K. E. Fullerton ◽  
...  
Keyword(s):  
Comparison Group ◽  
Disease Risk ◽  
The United States ◽  
Population Based ◽  
Case Control ◽  
Surveillance Data ◽  
Recreational Water ◽  
National Surveillance ◽  
Case Control Studies ◽  
Routine Surveillance

AbstractUnderstanding endemic infectious disease risk factors through traditional epidemiological tools is challenging. Population-based case–control studies are costly and time-consuming. A case–case analyses using surveillance data addresses these limitations by using resources more efficiently. We conducted a case–case analyses using routine surveillance data reported by 16 U.S. states (2005–2015), wherein reported cases of salmonellosis were used as a comparison group to identify exposure associations with reported cases of cryptosporidiosis and giardiasis. Odds ratios adjusted for age and reporting state (aOR) and 95% confidence intervals (95% CI) were calculated. A total of 10 704 cryptosporidiosis cases, 17 544 giardiasis cases, and 106 351 salmonellosis cases were included in this analyses. When compared with cases of salmonellosis, exposure to treated recreational water (aOR 4.7, 95% CI 4.3–5.0) and livestock (aOR: 3.2; 95% CI: 2.9–3.5) were significantly associated with cryptosporidiosis and exposure to untreated drinking (aOR 4.1, 95% CI 3.6–4.7) and recreational water (aOR 4.1, 95% CI 3.7–4.5) were associated with giardiasis. Our analyses shows that routine surveillance data with standardised exposure information can be used to identify associations of interest for cryptosporidiosis and giardiasis.

Nicotine might have a protective effect in the etiology of multiple sclerosis

2013 ◽  
Vol 19 (8) ◽  
pp. 1009-1013 ◽  
Author(s):  
AK Hedström ◽  
J Hillert ◽  
T Olsson ◽  
L Alfredsson
Keyword(s):  
Multiple Sclerosis ◽  
Immune Responses ◽  
Protective Effect ◽  
Lower Risk ◽  
Population Based ◽  
Case Control ◽  
Case Control Studies ◽  
Swedish Population ◽  
Moist Snuff ◽  
High Doses

Objective: The use of moist snuff is common in Sweden and leads to exposure to high doses of nicotine. Recent studies indicate that exposure to nicotine could modulate immune responses. The aim of this study was to investigate the influence of snuff use on the risk of developing multiple sclerosis (MS), taking smoking habits into consideration. Methods: In two Swedish population-based, case-control studies (7883 cases, 9437 controls), subjects with different snuff use habits were compared regarding MS risk, by calculating odds ratios (ORs) with 95% confidence intervals (CIs). Results: Snuff-takers have a decreased risk of developing MS compared with those who have never used moist snuff (OR 0.83, 95% CI 0.75–0.92), and we found clear evidence of an inverse dose-response correlation between cumulative dose of snuff use and the risk of developing the disease. We further observed that subjects who combined smoking and snuff use had a significantly lower risk for MS than smokers who had never used moist snuff, also after adjustment for amount of smoking. Conclusions: Our results add evidence to the hypothesis that nicotine exerts anti-inflammatory and immune-modulating effects in a way that might decrease the risk of developing MS.

Prevalence, Patient Characteristics, and Pharmacological Treatment of Children, Adolescents, and Adults Diagnosed With ADHD in Sweden

2014 ◽  
Vol 22 (1) ◽  
pp. 3-13 ◽  
Author(s):  
MaiBritt Giacobini ◽  
Emma Medin ◽  
Ewa Ahnemark ◽  
Leo J. Russo ◽  
Peter Carlqvist
Keyword(s):  
Pharmacological Treatment ◽  
Patient Characteristics ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Autism Spectrum ◽  
Drug Register ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
National Patient ◽  
Adolescents And Adults

Objective: The objective of this study was to describe the epidemiology of diagnosed ADHD and the pharmacological treatment of patients with ADHD in Sweden. Specifically, this study estimates the prevalence of patients with a newly registered diagnosis of ADHD over a 5-year period, and the prevalence of all patients with a registered ADHD diagnoses over a 6-year period in Sweden. Method: Two population-based registries were used as data sources for this study; the National Patient Register (NPR) and the Prescribed Drug Register (PDR). The international Classification of Diseases 10th Revison (ICD-10) was used to identify patients with ADHD. Results: The annual prevalence of ADHD in the general population of Sweden was found to be 1.1 per 1,000 persons in the year 2006 increasing to 4.8 per 1,000 persons in 2011. The corresponding prevalence for newly diagnosed patients increased from 0.6 per 1,000 persons in 2007 to 1.3 per 1,000 persons in 2011. The majority of diagnosed patients received pharmacological treatment, with methylphenidate being the most common dispensed drug. Comorbidities in the autism spectrum were most common for younger patients, while substance abuse, anxiety, and personality disorder were the most common comorbidities in older patients. Conclusion: From 2006 to 2011, the number of patients diagnosed with ADHD has increased in Sweden over all ages. The majority of patients diagnosed with ADHD in Sweden received a pharmacological treatment regardless of age. An ADHD diagnosis was often accompanied with psychiatric comorbidity.

Incidence of paediatric 10-fold medication errors in Wales

2020 ◽  
pp. archdischild-2020-319130
Author(s):  
Yincent Tse ◽  
David Tuthill
Keyword(s):  
Medication Errors ◽  
Reporting System ◽  
Patient Characteristics ◽  
Population Based ◽  
Population Surveillance ◽  
Near Miss ◽  
Surveillance Study ◽  
High Resource ◽  
Improvement Strategies ◽  
Iatrogenic Harm

ObjectivesTo estimate the incidence, characteristics and outcomes of 10-fold or greater or a tenth or less medication errors in children aged <16 years in Wales.DesignPopulation-based surveillance study July 2017 to June 2019. Cases were identified by paediatricians and hospital pharmacists using monthly electronic Welsh Paediatric Surveillance Unit (WPSU) reporting system.Patients‘Definite’ incident occurred when children received all or any of the incorrect dose of medication. ‘Near miss’ was where the prescribed, prepared or dispensed medication was not administered to the child.Main outcome measuresIncidence, patient characteristics, setting, drug characteristics, outcome, harm and enabling or preventive factors.ResultsIn total, 50 10-fold errors were reported; 20 definite and 30 near miss cases. This yields a minimum annual incidence of 1 per 3797 admissions, or 4.6/100 000 children. Of these, 43 were overdoses and 7 underdoses. 33 incidents occurred in children <5 years of age. Overall, 37 different medications were involved with the majority, 31 cases, being administered enterally. Of these 31 enteral medication errors, all definite cases (10) had received liquid preparations. Temporary harm occurred in 5/20 (25%) definite cases with one requiring intensive care; all fully recovered.ConclusionsIn this first ever population surveillance study in a high-resource healthcare system, 10-fold errors in children were rare, sometimes prevented and uncommonly caused harm. We recommend country-wide improvements be made to reduce iatrogenic harm. Understanding the enabling and preventive factors may help national improvement strategies to reduce these errors.

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