scholarly journals Data from national health registers as endpoints for the Tromsø Study: Correctness and completeness of stroke diagnoses

2021 ◽  
pp. 140349482110211
Author(s):  
Torunn Varmdal ◽  
Maja-Lisa Løchen ◽  
Tom Wilsgaard ◽  
Inger Njølstad ◽  
Audhild Nyrnes ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
National Health ◽  
Epidemiological Studies ◽  
Data Set ◽  
Patient Register ◽  
Disease Register ◽  
The Impact ◽  
Health Registers ◽  
Stroke Register ◽  
Norwegian Patient

Aim: To assess whether stroke diagnoses in national health registers are sufficiently correct and complete to replace manual collection of endpoint data for the Tromsø Study, a population-based epidemiological study. Method: Using the Tromsø Study Cardiovascular Disease Register for 2013–2014 as the gold standard, we calculated correctness (defined as positive predictive value, PPV) and completeness (defined as sensitivity) of stroke cases in four different data subsets derived from the Norwegian Patient Register and the Norwegian Stroke Register. We calculated the sensitivity and PPV with 95% confidence intervals (CIs) assuming a normal approximation of the binomial distribution. Results: In the Norwegian Stroke Register we found a sensitivity of 79.8% (95% CI 74.2–85.4) and a PPV of 97.5% (95% CI 95.1–99.9). In the Norwegian Patient Register the sensitivity was 86.4% (95% CI 81.6–91.1) and the PPV was 84.2% (95% CI 79.2–89.2). The overall highest levels were found in a subset based on a linkage between the Norwegian Stroke Register and the Norwegian Patient Register, with a sensitivity of 88.9% (95% CI 84.5–93.3), and a PPV of 89.3% (95% CI 85.0–93.6). Conclusions: Data from the Norwegian Patient Register and from the linked data set between the Norwegian Patient Register and the Norwegian Stroke Register had acceptable levels of correctness and completeness to be considered as endpoint sources for the Tromsø Study Cardiovascular Disease Register. The benefits of using data from national registers as endpoints in epidemiological studies must be weighed against the impact of potentially decreased data quality.

scholarly journals The Impact of Sedentary Behavior and Self-Rated Health on Cardiovascular Disease and Cancer among South Korean Elderly Persons Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2014–2018 Data

2021 ◽  
Vol 18 (14) ◽  
pp. 7426
Author(s):  
Soojin Park ◽  
Jinyoung Nam
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Sedentary Behavior ◽  
Elderly People ◽  
National Health ◽  
Elderly Persons ◽  
Nutrition Examination Survey ◽  
Self Rated Health ◽  
Health And Nutrition ◽  
The Impact

Cardiovascular disease and cancer have increased the risk of mortality and morbidity in elderly persons worldwide. The aim of this study was to investigate the association of sedentary behavior and self-rated health with cardiovascular disease or cancer in elderly people. The data of 6785 elderly persons aged above 65 years from the Korea National Health and Nutrition Examination Survey 2014–2018 were examined. Binary logistic regression analyses assessed the association of sedentary behavior, self-rated health, and other risk factors with cardiovascular disease or cancer. Prolonged sedentary behavior in elderly people was associated with a high risk for cardiovascular disease (odds ratio (OR): 1.28, 95% confidence interval (CI): 1.08–1.52). There was a high risk for cardiovascular disease (OR: 2.36, 95% CI: 1.85–3.01) or cancer (OR: 1.48, 95% CI: 1.17–1.88) in elderly people who had poor self-rated health. This study identified the association between prolonged sedentary behavior and cardiovascular disease, and between poor self-rated health and cancer. Since prolonged sedentary behavior is related to cardiovascular disease, efforts are needed to reduce sedentary behavior hours and maintain good self-rated health.

Abstract P206: Modeling The Impact Of The Tobacco 21 Policy In El Paso, Texas

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Sonya S Panjwani ◽  
Yan Li ◽  
Whitney R Garney
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Costs ◽  
National Health ◽  
Smoking Prevalence ◽  
El Paso ◽  
Population Characteristics ◽  
The Us ◽  
The Impact ◽  
Care Costs

Introduction: On December 20, 2019, the federal Tobacco 21 (T21) law was passed. This new legislation raised the minimum legal purchase age for tobacco products from 18 to 21 years. Thirty-three states in the US have implemented the law, but 19 states have yet to enact it. Public health practitioners and policymakers need more evidence on the impact of the T21 Policy at the local level to encourage adequate enforcement. Objective: To project the health and economic impact of the T21 Policy in El Paso, Texas, which is the focus area of the Heart Racial and Ethnic Approaches to Community Health (REACH) Program implemented by the American Heart Association. Methods: Using an agent-based model of smoking behavior and a microsimulation model of cardiovascular disease, we projected the long-term effects of the T21 Policy on smoking prevalence and cardiovascular health outcomes in El Paso, Texas. Population characteristics and model parameters were estimated based on data from the National Health Interview Survey, US Life Tables, and the National Health and Nutrition Examination Survey. Annual smoking prevalence was derived from the Texas Behavioral Risk Factor Surveillance System and County Health Rankings. The policy effects were determined from established effect sizes from published literature. Results: The estimated prevalence of smoking in El Paso, Texas decreased by 2.7% among 18-24 year olds and by 5.2% among 25-44 year olds in 20 years with the implementation of the T21 policy; these results are statistically significant (p<0.01 for both population groups). Our results also revealed that the T21 Policy could prevent cardiovascular disease such as coronary heart disease (CHD) and stroke. Specifically, compared to the no-policy situation, the policy would prevent 5.4 CHD events (from 305.2 to 299.8) per 1,000 adults and 10.8 stroke events (from 232.6 to 221.8) per 1,000 adults over lifetime. The model also projected a reduction in health care costs due to the T21 Policy, as the estimated lifetime health care costs decreased from $425,672 per person without the T21 Policy to $423,376 per person with the policy. Conclusions: This study provides important information for policymakers to understand the potential impacts of the T21 Policy in El Paso, Texas. The projected decreases in tobacco use, cardiovascular disease, and health care costs as a result of the T21 Policy could assist in advocating for T21 Policy enactment in other areas of the US.

PP290 Ongoing Swedish Initiatives To Improve The Potential For Real World Data Assessment Of Medical Devices

2021 ◽  
Vol 37 (S1) ◽  
pp. 32-32
Author(s):  
Amanda Hansson Hedblom ◽  
Rhodri Saunders
Keyword(s):  
Medical Device ◽  
National Health ◽  
Medical Devices ◽  
Laboratory Data ◽  
Register Data ◽  
Real World Data ◽  
Patient Reported ◽  
The Impact ◽  
Health Registers

IntroductionIn 2020, the Swedish regions cemented a national managed-introduction project for medical devices, to ensure equal, cost-effective, and appropriate use. Health technology assessment (HTA) is an important component of the project. Swedish national health registers have world-class coverage and completeness but may lack information enabling adequate evaluation of medical devices. This study reviews the current situation and ongoing initiatives. Additionally, the potential for medical device health economics and outcomes research (HEOR) using Swedish registers is assessed.MethodsA review of Swedish national health registers was undertaken, focusing on available data, and contextualized for the purpose of HEOR for medical devices. Additionally, the review included an evaluation of the Swedish reimbursement authority's (The Dental and Pharmaceutical Benefits Agency, TLV) ongoing initiatives to improve the potential to follow-up the impact of the technologies they assess and develop value-based pricing schemes.ResultsFive registers were deemed the most relevant national health registers for device research. They include high-quality longitudinal data and are linkable on a per-patient basis. For devices, main limitations include limited data on specialized outpatient care, lags in updating certain registers, lack of laboratory data, and challenges in identifying the specific device used. Reports indicate that certain limitations are being addressed, including pilot-studies investigating the opportunity for automated reporting of data from regional systems, and app-collected patient-reported health data.ConclusionsSwedish registers provide comprehensive sources for HEOR studies, but limitations related to the assessment of medical device impact remain. As is common with register data reporting grouped diagnoses and interventions, specific devices are not directly identifiable in the national health registers. For some devices, this might be addressable through linkage with other data-sources. Swedish authorities are undertaking several initiatives that will likely improve the potential for HTA and follow-up of medical devices using national health register data.

Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Kuan-Ying Lee ◽  
Chung-Yi Li ◽  
Kun-Chia Chang ◽  
Tsung-Hsueh Lu ◽  
Ying-Yeh Chen
Keyword(s):  
Young People ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Birth Registry ◽  
Data Set ◽  
Parental Suicide ◽  
The Impact ◽  
Age At Exposure

Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-­based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.

Hyperuricemia as risk factor for cardiovascular disease – what’s new?

2020 ◽  
pp. 5-11
Author(s):  
Yu. V. Zhernakova
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Epidemiological Studies ◽  
Point Of View ◽  
Medical Society ◽  
High Cardiovascular Risk ◽  
Management Algorithm ◽  
Russian Medical

A significant number of epidemiological studies have shown that hyperuricemia is highly associated with the risk of developing cardiovascular disease, chronic kidney disease, and diabetes. In this connection, increased attention is required to monitor serum uric acid levels in patients, not only from a rheumatological point of view, but also with regard to reducing cardiovascular and renal risks. This article is a review of studies on the association of hyperuricemia with cardiovascular risk and a new consensus for the management of patients with hyperuricemia and high cardiovascular risk, published in december 2019 by a group of experts of the Russian Medical Society for Arterial Hypertension, which, among other things, includes a management algorithm of this category of patients.

State Medical Boards' Perceptions of a Minimum Data Set and Current Practices for Collecting Physician Information

2013 ◽  
Vol 99 (4) ◽  
pp. 40-45 ◽  
Author(s):  
Aaron Young ◽  
Philip Davignon ◽  
Margaret B. Hansen ◽  
Mark A. Eggen
Keyword(s):  
Media Coverage ◽  
The United States ◽  
Minimum Data Set ◽  
Direct Patient Care ◽  
Physician Workforce ◽  
Data Set ◽  
Minimum Data ◽  
State Medical Boards ◽  
The Impact ◽  
Current Practices

ABSTRACT Recent media coverage has focused on the supply of physicians in the United States, especially with the impact of a growing physician shortage and the Affordable Care Act. State medical boards and other entities maintain data on physician licensure and discipline, as well as some biographical data describing their physician populations. However, there are gaps of workforce information in these sources. The Federation of State Medical Boards' (FSMB) Census of Licensed Physicians and the AMA Masterfile, for example, offer valuable information, but they provide a limited picture of the physician workforce. Furthermore, they are unable to shed light on some of the nuances in physician availability, such as how much time physicians spend providing direct patient care. In response to these gaps, policymakers and regulators have in recent years discussed the creation of a physician minimum data set (MDS), which would be gathered periodically and would provide key physician workforce information. While proponents of an MDS believe it would provide benefits to a variety of stakeholders, an effort has not been attempted to determine whether state medical boards think it is important to collect physician workforce data and if they currently collect workforce information from licensed physicians. To learn more, the FSMB sent surveys to the executive directors at state medical boards to determine their perceptions of collecting workforce data and current practices regarding their collection of such data. The purpose of this article is to convey results from this effort. Survey findings indicate that the vast majority of boards view physician workforce information as valuable in the determination of health care needs within their state, and that various boards are already collecting some data elements. Analysis of the data confirms the potential benefits of a physician minimum data set (MDS) and why state medical boards are in a unique position to collect MDS information from physicians.

IDENTIFICATION AND ASSESSMENT OF RISK FACTORS ROLE IN MYOCARDIAL INFARCTION DEVELOPMENT

2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Control Group ◽  
Biological Factors ◽  
Prevention And Treatment ◽  
High Level ◽  
Social Importance ◽  
The Impact

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.

The Impact of Green Labels on U.S. Hotel Net Operating Income: Operating Statements Analyses

2019 ◽  
Vol 11 (1) ◽  
pp. 156-173
Author(s):  
Spenser Robinson ◽  
A.J. Singh
Keyword(s):  
Environmental Design ◽  
Green Buildings ◽  
Small Sample ◽  
Sample Survey ◽  
Data Set ◽  
Operating Income ◽  
Energy Star ◽  
The Impact ◽  
Industry Professionals

This paper shows Leadership in Energy and Environmental Design (LEED) certified hospitality properties exhibit increased expenses and earn lower net operating income (NOI) than non-certified buildings. ENERGY STAR certified properties demonstrate lower overall expenses than non-certified buildings with statistically neutral NOI effects. Using a custom sample of all green buildings and their competitive data set as of 2013 provided by Smith Travel Research (STR), the paper documents potential reasons for this result including increased operational expenses, potential confusion with certified and registered LEED projects in the data, and qualitative input. The qualitative input comes from a small sample survey of five industry professionals. The paper provides one of the only analyses on operating efficiencies with LEED and ENERGY STAR hospitality properties.

Does Tax Increment Financing Pass the “But-for” Test in Missouri?

2019 ◽  
Vol 33 (3) ◽  
pp. 187-202
Author(s):  
Ahmed Rachid El-Khattabi ◽  
T. William Lester
Keyword(s):  
Economic Development ◽  
Kansas City ◽  
Time Series Data ◽  
Local Level ◽  
Conclusive Evidence ◽  
Series Data ◽  
Tax Increment Financing ◽  
Data Set ◽  
Development Indicators ◽  
The Impact

The use of tax increment financing (TIF) remains a popular, yet highly controversial, tool among policy makers in their efforts to promote economic development. This study conducts a comprehensive assessment of the effectiveness of Missouri’s TIF program, specifically in Kansas City and St. Louis, in creating economic opportunities. We build a time-series data set starting 1990 through 2012 of detailed employment levels, establishment counts, and sales at the census block-group level to run a set of difference-in-differences with matching estimates for the impact of TIF at the local level. Although we analyze the impact of TIF on a wide set of indicators and across various industry sectors, we find no conclusive evidence that the TIF program in either city has a causal impact on key economic development indicators.

Evaluation of the Aging Behavior of High Density Polyethylene in Thermal Oxidative Environment by Principal Component Analysis

2017 ◽  
Vol 727 ◽  
pp. 447-449 ◽  
Author(s):  
Jun Dai ◽  
Hua Yan ◽  
Jian Jian Yang ◽  
Jun Jun Guo
Keyword(s):  
Principal Component Analysis ◽  
Impact Strength ◽  
High Density Polyethylene ◽  
Tensile Modulus ◽  
Principal Component ◽  
Component Analysis ◽  
High Density ◽  
Aging Behavior ◽  
Data Set ◽  
The Impact

To evaluate the aging behavior of high density polyethylene (HDPE) under an artificial accelerated environment, principal component analysis (PCA) was used to establish a non-dimensional expression Z from a data set of multiple degradation parameters of HDPE. In this study, HDPE samples were exposed to the accelerated thermal oxidative environment for different time intervals up to 64 days. The results showed that the combined evaluating parameter Z was characterized by three-stage changes. The combined evaluating parameter Z increased quickly in the first 16 days of exposure and then leveled off. After 40 days, it began to increase again. Among the 10 degradation parameters, branching degree, carbonyl index and hydroxyl index are strongly associated. The tensile modulus is highly correlated with the impact strength. The tensile strength, tensile modulus and impact strength are negatively correlated with the crystallinity.

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