Unsolicited Patient Complaints among Otolaryngologists

Objectives To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. Methods This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes. Results The study included 29,778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as “responders” reduced the number of complaints an average of 45% in the first 2 years following intervention. Discussion Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists. Implications for Practice Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.

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Risk factors and incidence over time for lower extremity amputations in people with type 1 diabetes: an observational cohort study of 46,088 patients from the Swedish National Diabetes Registry

Diabetologia ◽

10.1007/s00125-021-05550-z ◽

2021 ◽

Author(s):

Sara Hallström ◽

Ann-Marie Svensson ◽

Aldina Pivodic ◽

Arndís F. Ólafsdóttir ◽

Magnus Löndahl ◽

...

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Lower Extremity ◽

Renal Dysfunction ◽

Diabetes Registry ◽

Male Sex ◽

The Impact ◽

Over Time ◽

Age And Sex

Abstract Aims/hypothesis The aim of this work was to study the incidence over time of lower extremity amputations and determine variables associated with increased risk of amputations in people with type 1 diabetes. Methods Individuals with type 1 diabetes registered in the Swedish National Diabetes Registry with no previous amputation from 1 January 1998 and followed to 2 October 2019 were included. Time-updated Cox regression and gradient of risk per SD were used to evaluate the impact of risk factors on the incidence of amputation. Age- and sex-adjusted incidences were estimated over time. Results Of 46,088 people with type 1 diabetes with no previous amputation (mean age 32.5 years [SD 14.5], 25,354 [55%] male sex), 1519 (3.3%) underwent amputation. Median follow-up was 12.4 years. The standardised incidence for any amputation in 1998–2001 was 2.84 (95% CI 2.32, 3.36) per 1000 person-years and decreased to 1.64 (95% CI 1.38, 1.90) per 1000 person-years in 2017–2019. The incidence for minor and major amputations showed a similar pattern. Hyperglycaemia and renal dysfunction were the strongest risk factors for amputation, followed by older age, male sex, cardiovascular comorbidities, smoking and hypertension. Glycaemic control and age- and sex-adjusted renal function improved during the corresponding time period as amputations decreased. Conclusions/interpretation The incidence of amputation and of the most prominent risk factors for amputation, including renal dysfunction and hyperglycaemia, has improved considerably during recent years for people with type 1 diabetes. This finding has important implications for quality of life, health economics and prognosis regarding CVD, indicating a trend shift in the treatment of type 1 diabetes. Graphical abstract

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The Impact of Intervention-Related Risk Factors on the Risk of Ventilator-Associated Pneumonia Is High in a Neurosurgical Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1059 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s407-s409

Author(s):

Ksenia Ershova ◽

Oleg Khomenko ◽

Olga Ershova ◽

Ivan Savin ◽

Natalia Kurdumova ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Negative Slope ◽

Infection Prevention And Control ◽

Ventilator Associated Pneumonia ◽

Related Factors ◽

Icu Patients ◽

The Impact ◽

Adf Test ◽

Over Time

Background: Ventilator-associated pneumonia (VAP) represents the highest burden among all healthcare-associated infections (HAIs), with a particularly high rate in patients in neurosurgical ICUs. Numerous VAP risk factors have been identified to provide a basis for preventive measures. However, the impact of individual factors on the risk of VAP is unclear. The goal of this study was to evaluate the dynamics of various VAP risk factors given the continuously declining prevalence of VAP in our neurosurgical ICU. Methods: This prospective cohort unit-based study included neurosurgical patients who stayed in the ICU >48 consecutive hours in 2011 through 2018. The infection prevention and control (IPC) program was implemented in 2010 and underwent changes to adopt best practices over time. We used a 2008 CDC definition for VAP. The dynamics of VAP risk factors was considered a time series and was checked for stationarity using theAugmented Dickey-Fuller test (ADF) test. The data were censored when a risk factor was present during and after VAP episodes. Results: In total, 2,957 ICU patients were included in the study, 476 of whom had VAP. Average annual prevalence of VAP decreased from 15.8 per 100 ICU patients in 2011 to 9.5 per 100 ICU patients in 2018 (Welch t test P value = 7.7e-16). The fitted linear model showed negative slope (Fig. 1). During a study period we observed substantial changes in some risk factors and no changes in others. Namely, we detected a decrease in the use of anxiolytics and antibiotics, decreased days on mechanical ventilation, and a lower rate of intestinal dysfunction, all of which were nonstationary processes with a declining trend (ADF testP > .05) (Fig. 2). However, there were no changes over time in such factors as average age, comorbidity index, level of consciousness, gender, and proportion of patients with brain trauma (Fig. 2). Conclusions: Our evidence-based IPC program was effective in lowering the prevalence of VAP and demonstrated which individual measures contributed to this improvement. By following the dynamics of known VAP risk factors over time, we found that their association with declining VAP prevalence varies significantly. Intervention-related factors (ie, use of antibiotics, anxiolytics and mechanical ventilation, and a rate of intestinal dysfunction) demonstrated significant reduction, and patient-related factors (ie, age, sex, comorbidity, etc) remained unchanged. Thus, according to the discriminative model, the intervention-related factors contributed more to the overall risk of VAP than did patient-related factors, and their reduction was associated with a decrease in VAP prevalence in our neurosurgical ICU.Funding: NoneDisclosures: None

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Long Term Implications in Surgical Re-assisting (L.I.S.A. study) During Covid-19 Outbreak: A Retrospective Observational Study on a Rural Population.

10.21203/rs.3.rs-892548/v1 ◽

2021 ◽

Author(s):

Nicolò Fabbri ◽

Antonio Pesce ◽

Lisa Uccellatori ◽

Salvatore Greco ◽

Francesco D'Urbano ◽

...

Keyword(s):

Regression Analysis ◽

Operative Management ◽

Surgical Interventions ◽

Male Sex ◽

Non Operative Management ◽

The Impact ◽

Colorectal Resections ◽

Surgical Operations ◽

Over Time

Abstract BackgroundThe spread of the COVID-19 is having a worldwide impact on surgicaltreatment. Our aim was to investigate the impact of the pandemic in a rural hospital in a lowdensely populated area.MethodsWe investigated the volume and type of surgical operations during the pandemic(March 2020 - February 2021) versus pre-pandemic period (March 2019 - February 2020) aswell as during the first and second pandemic waves compared to the pre-pandemic period.We compared the volume and timing of emergency appendectomy and cholecystectomyduring the pandemic versus pre-pandemic period, the volume, timing and stages of electivegastric and colorectal resections for cancer during the pandemic versus the pre-pandemicperiod.ResultsIn the prepandemic versus pandemic period, 42 versus 24 appendectomies and 174versus 126 cholecystectomies (urgent and elective) were performed. Patients operated onbefore as opposed to during the pandemic were older (58 vs. 52 years old, p=0.006),including for cholecystectomy (73 vs. 66 years old, p=0.01) and appendectomy (43 vs. 30years old, p = 0.04).The logistic regression analysis with regard to cholecystectomy and appendectomy performedin emergency showed that male sex and age were both associated to gangrenous typehistology, both in pandemic and prepandemic period. Finally, we found a reduction in cancerstage I and IIA in pandemic versus prepandemic period, with no increase in the moreadvanced stages.Conclusionsthe reduction in services imposed by governments during the first months oftotal lock down did not justify the whole decrease in surgical interventions in the year of thepandemic. Data suggest that greater "non-operative management" for cases of appendicitisand acute cholecystitis does not lead to an increase in cases operated over time, nor to anincrease in the "gangrenous" pattern, which seems to depend on age advanced and malepopulation.

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Abstract WP302: Racial Differences in Imaging Characteristics and Risk Factors for Primary Intracerebral Hemorrhage: Final Results from the DECIPHER Study

Stroke ◽

10.1161/str.44.suppl_1.awp302 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Chelsea S Kidwell ◽

Laura German ◽

Ravi S Menon ◽

Nawar Shara ◽

M. Christopher Gibbons ◽

...

Keyword(s):

Risk Factors ◽

Intracerebral Hemorrhage ◽

Racial Differences ◽

Demographic Data ◽

Black Communities ◽

Imaging Data ◽

Natural History Study ◽

Imaging Characteristics ◽

Primary Hemorrhage ◽

The Impact

Background: Previous studies have reported racial differences in the incidence, location and risk factors for primary intracerebral hemorrhage (ICH). We now report differences in imaging characteristics and risk factors for ICH from the DiffErenCes in the Imaging of Primary Hemorrhage based on Ethnicity or Race (DECIPHER) study. Methods: DECIPHER is a longitudinal, multicenter, MRI-based, natural history study of racial differences in primary ICH. Inclusion criteria were: primary ICH, age ≥ 18, baseline and 1 year MRI scan obtained. Clinical and demographic data were collected on all subjects. Results: A total of 193 subjects of black or white race were enrolled. Subject characteristics overall and by race are provided in the table. Black subjects were younger, had a higher rate of hypertension, cocaine use, and were more frequently smokers. White subjects had a higher rate of hyperlipidemia. A lobar ICH location was more frequent in the white subjects, while infratentorial hemorrhages were more common in blacks. 60% of blacks had 1 or more microbleeds compared to 52% of whites (NS), and blacks tended to have more severe white matter disease. Conclusions: In the DECIPHER study, there were significant racial differences both in the risk factors for primary ICH and in the imaging characteristics. Compared to whites, blacks have a greater rate of hypertension, as well as cocaine and tobacco use. Imaging findings are indicative of a more severe underlying small vessel vasculopathy in the black cohort. The risk factor information may be used to enhance prevention programs tailored for black communities at risk of ICH, while imaging data may provide a useful biomarker to assess the impact of these interventions.

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3226The impact of cardiovascular risk factors on global longitudinal strain over a ten-year period in the general population: The Copenhagen City Heart Study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0045 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K G Skaarup ◽

M C H L Lassen ◽

S R B S Biering-Soerensen ◽

P G J Joergensen ◽

M A Appleyard ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Smoking Status ◽

Global Longitudinal Strain ◽

Spline Curves ◽

Heart Study ◽

Male Sex ◽

The Impact

Abstract Background Global longitudinal strain (GLS) of the left ventricle (LV) has proved to be a strong predictor of cardiovascular morbidity and mortality. GLS declines throughout adult-life as the LV remodels and adapts. Information on the impact of cardiac risk factors such as male sex, obesity, smoking status, hypertension, hypercholesterolemia, and diabetes on GLS through time has not yet been investigated. Purpose The aim of the present study was to investigate the impact of age, sex, body mass index (BMI), smoking status (current and previous vs never), mean arterial blood pressure (MAP), total plasma cholesterol (TPC), and HbA1c on GLS in the general population over a 10-year period. Method A total of 689 citizens recruited from the general population participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5) a prospective longitudinal study. At CCHS4 the mean age was 51 years and 45% were male. The average decline in GLS during the follow-up period was −0.65%. All participants underwent two echocardiographic examinations median 10.4 [IQR: 10.2, 10.9] years apart along with thorough health examinations. All analyses were adjusted for baseline GLS value (CCHS4 value). Results In regression models, increasing age, male sex, increasing BMI, MAP, hypertension, increasing HbA1c, and diabetes proved to be significantly associated with increased decline in GLS. Relationship between significant continuous cardiovascular risk factors and ΔGLS are displayed in restricted spline curves (Figure 1). In a multivariable regression model including all the investigated cardiovascular risk factors, estimated glomerular filtration rate, plasma pro B-type natriuretic peptide, heart rate, and previous ischemic heart disease, age (standardized β-coef. = −0.10, P=0.005), male sex (standardized β-coef. = −0.16, P<0.001), and MAP (standardized β-coef. = −0.07, P=0.009) remained independent predictors of an accelerated decline in GLS during a 10-year period. Restricted cubic spline curves Conclusion In the general population increasing age, male sex, and increasing MAP are all independently associated with an accelerated decline in GLS over a 10-year period.

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Recent Decrease in Acute GVHD and Increased Relapse in Children with Leukemia Receiving Unrelated Donor Bone Marrow Transplants.

Blood ◽

10.1182/blood.v110.11.1081.1081 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1081-1081

Author(s):

Stella M. Davies ◽

D. Wang ◽

T. Wang ◽

M. Arora ◽

O. Ringden ◽

...

Keyword(s):

Risk Factors ◽

Acute Gvhd ◽

Marrow Transplant ◽

Hla Typing ◽

Unrelated Donor ◽

Resistant Disease ◽

Donor Bone Marrow ◽

The Impact ◽

Over Time ◽

Risk Of Relapse

Abstract Unrelated donor (URD) BMT is an effective treatment for leukemia in children, but significant morbidity and mortality occur as a result of acute graft versus host disease (GVHD). In addition, relapse is a major cause of treatment failure in children with otherwise successful transplants. We used the database of the Center for International Blood & Marrow Transplant Research (CIBMTR) to determine whether improved HLA typing and prophylaxis have changed incidence and risk factors for acute GVHD, and the impact of GVHD on treatment-related mortality and relapse. We analyzed outcomes of 638 myeloablative URD BMT performed between 1990 and 2003 for the treatment of AML, ALL, CML or MDS. Peripheral blood stem cell and cord blood recipients were excluded as risk factors for GVHD might differ. All recipients were <18 years of age, and had available high resolution HLA typing for HLA A, B, C and DRB1. Overall, 45% of children developed aGVHD grades II–IV, and 27% aGVHD grades III–IV. The data showed that risk of aGVHD was significantly higher in recipients of T-replete compared with T-depleted grafts (OR 3.12, 95%CI 2.02–4.83; p< 0.0001). Survival was reduced in children with grades II–IV aGVHD compared to those without (OR 1.96, 95% CI 1.46–2.62; p<0.0001). However, the occurrence of aGVHD reduced risk of relapse in children with ALL (OR 0.36 95% CI 0.17–0.75, p=0.004) but not in children with AML (OR 1.23, 95% CI 0.50–2.98; p=0.65). Outcomes have changed significantly over time. The risk of aGVHD was higher in children transplanted in earlier years (1990–1998, n=365) compared to 1999–2003 (n= 220) (OR 1.93 95%CI 1.27–2.91; p=0.002), suggesting that current prophylactic regimens may be more effective. In contrast to this recent improvement in risk of GVHD, risk of relapse was lower in children transplanted 1990–1998 compared with 1999–2003 (OR 0.47, 95% CI 0.28–0.78; p=0.004), possibly reflecting changes in the patient population currently referred for transplant, or perhaps a reduced graft versus leukemia effect with better control of GVHD. As more intense risk adapted chemotherapy has improved outcomes of upfront treatment of leukemia, children who are referred for transplant may have more resistant disease, increasing the difficulty of controlling disease with standard irradiation and chemotherapy preparative regimens. Overall survival of children with URD BMT has not changed over time, although it is possible that current results reflect treatment of children with more resistant disease compared with 10 years ago.

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The Impact of COVID-19 on Diabetes Mellitus and Hypertension: A Retrospective Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i43b32526 ◽

2021 ◽

pp. 68-77

Author(s):

S. Pavithra ◽

S. Lavanya ◽

P. Vaishnavi ◽

A. Rakesh Rosario ◽

Priyadharshini A ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Retrospective Study ◽

Diabetic Patients ◽

Hypertensive Patients ◽

Study Population ◽

The Impact

COVID-19 is a pathogenic virus that caused a pandemic outbreak in December 2019. The impact of this virus may be severe in the patients having co-morbidities like diabetes, hypertension, Chronic Kidney Disease, cardiovascular disease, etc. Aim and Objectives: This study Aims in Assessing the impact of COVID-19 on Diabetic and Hypertensive patients as well as COVID-19 patients without any co-morbidities. Objective of this is to evaluate the association between COVID-19 and its risk factors (diabetes and hypertension) and to evaluate whether the severity of the symptoms in COVID-19 patients is due to comorbidities or past medications. Methodology: A Retrospective study was conducted in SRM Hospital (Medical Records Department) for a period of 3 Months with the study population 670 at the age group of 25, known case of Diabetes and Hypertension. Cases of Pregnant women are excluded from the study. The patients were grouped into 4 categories 1) control group (patient without any co-morbidities) 2) diabetic patients 3) Hypertensive patient 4) Diabetic+Hypertension patient and studied their prescribing pattern by collecting the past medication history. Results and Discussion: There is a significant decrease in a lymphocyte in covid-19 Type 2 diabetic patients in our study. These results suggest that different mechanism exists for hypertension and diabetes mellitus as risk factors for covid-19. It is also known that these patients have impaired immune response to many infections [30]. In our retrospective study, we collected 670 covid-19 cases. It consists of 12.5% of diabetic patients and 6.6% of hypertensive patients. This study compared COVID-19 patients without any comorbidity (neither Type 2 diabetes mellitus nor hypertension) with covid- 19 patients with comorbidities (Type 2 diabetes mellitus and hypertension). COVID-19 patients with T2DM have an increased level of D-dimer compared to non-T2DM patients. Conclusion: Diabetic and hypertensive patients affected with COVID-19 are low in our study. Out of the total study population, only 12.5% are diabetic, 6.56% are hypertensive, and 9.25% were both diabetic and hypertensive. But when comparing in terms of severity, hypertensive and diabetic patients have severe effects than the control patients. In simpler terms, not every person who has diabetes and hypertension are affected with COVID-19, but those who were affected by COVID-19 showed more severity than the patients who don't have any comorbidities

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Effects of dietary style on adult enterovirus infection risk factors: a retrospective analysis

10.21203/rs.3.rs-64911/v1 ◽

2020 ◽

Author(s):

Linghua Yu ◽

Linlin Wang ◽

Huixing Yi ◽

Xiaojun Wu ◽

Fei Sun

Keyword(s):

Risk Factors ◽

Gut Microbiota ◽

Dietary Patterns ◽

Dietary Pattern ◽

Clinical Characteristics ◽

Protective Factor ◽

Demographic Data ◽

Adult Patients ◽

Phone Calls ◽

The Impact

Abstract Background: Gut microbiota serves as a defense against enteric pathogens, whereas dietary intake influences the composition and function of gut microbiota. We aimed to examine the impact of diet on the enteroviral infection in adult patients of hand, foot, and mouth disease (HFMD). Methods: A total of 266 adult patients of HFMD were recruited in this study, with 80 healthyvolunteers served as the control. Swab samples and clinical characteristics were collected. Enteroviral genotype was further assessed by PCR testing. Social-demographic data and dietary records were obtained through follow-up phone calls. Dietary patterns were derived with PCA analysis. Correlation between dietary patterns and clinical characteristics, enterovirus genotype, and HFMD risk factors were evaluated. Results:Three distinct dietary patterns were identified in the participants, which were modern, "atypical south", and "traditional north", respectively. This study found the dietary pattern of adult HFMD significantly differed from that of the controls. A vast majority of controls followed the modern pattern, which was a healthy diet. In contrast, the result showed unhealthy dietary patterns ('atypical south' and 'traditional north') were risk factors for adult HFMD. Besides, the dining place was a leading contributor to the dietary pattern. Our data showed eating at a food stall, or take-out is a risk factor of adult HFMD, whereas eating at the dining room is a protective factor. Conclusions:Our study indicated dietary pattern was associated with the incidence of adult HMFD. Improving the dietetic habit might contribute to HFMD prevention.

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Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

10.21203/rs.3.rs-34163/v2 ◽

2020 ◽

Author(s):

Marius Kryzauskas ◽

Augustinas Bausys ◽

Austeja Elzbieta Degutyte ◽

Vilius Abeciunas ◽

Eligijus Poskus ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Rectal Resection ◽

Multivariable Analysis ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Male Sex ◽

The Impact

Abstract Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR=10.54, p=0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR=2.40, p=0.004), CCI score >5 (OR=1.72, p=0.025) and T3/T4 stage tumors (OR=2.25, p=0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p=0.009 and p=0.001) and rectal (p=0.003 and p=0.014) surgery.Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

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The impact of age on genetic risk for common diseases

10.1101/2020.07.17.208280 ◽

2020 ◽

Author(s):

Xilin Jiang ◽

Chris Holmes ◽

Gil McVean

Keyword(s):

Risk Factors ◽

Recent Work ◽

Genetic Risk ◽

Genetic Risk Factors ◽

Individual Risk ◽

Uk Biobank ◽

Common Diseases ◽

The Impact ◽

The Relationship ◽

Over Time

AbstractInherited genetic variation contributes to individual risk for many complex diseases and is increasingly being used for predictive patient stratification. Recent work has shown that genetic factors are not equally relevant to human traits across age and other contexts, though the reasons for such variation are not clear. Here, we introduce methods to infer the form of the relationship between genetic risk for disease and age and to test whether all genetic risk factors behave similarly. We use a proportional hazards model within an interval-based censoring methodology to estimate age-varying individual variant contributions to genetic risk for 24 common diseases within the British ancestry subset of UK Biobank, applying a Bayesian clustering approach to group variants by their risk profile over age and permutation tests for age dependency and multiplicity of profiles. We find evidence for age-varying risk profiles in nine diseases, including hypertension, skin cancer, atherosclerotic heart disease, hypothyroidism and calculus of gallbladder, several of which show evidence, albeit weak, for multiple distinct profiles of genetic risk. The predominant pattern shows genetic risk factors having the greatest impact on risk of early disease, with a monotonic decrease over time, at least for the majority of variants although the magnitude and form of the decrease varies among diseases. We show that these patterns cannot be explained by a simple model involving the presence of unobserved covariates such as environmental factors. We discuss possible models that can explain our observations and the implications for genetic risk prediction.Author summaryThe genes we inherit from our parents influence our risk for almost all diseases, from cancer to severe infections. With the explosion of genomic technologies, we are now able to use an individual’s genome to make useful predictions about future disease risk. However, recent work has shown that the predictive value of genetic information varies by context, including age, sex and ethnicity. In this paper we introduce, validate and apply new statistical methods for investigating the relationship between age and genetic risk. These methods allow us to ask questions such as whether risk is constant over time, precisely how risk changes over time and whether all genetic risk factors have similar age profiles. By applying the methods to data from the UK Biobank, a prospective study of 500,000 people, we show that there is a tendency for genetic risk to decline with increasing age. We consider a series of possible explanations for the observation and conclude that there must be processes acting that we are currently unaware of, such as distinct phases of life in which genetic risk manifests itself, or interactions between genes and the environment.

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