scholarly journals Age, Sex, and Race Selection at Death from Leukemia and the Lymphomas

Blood ◽  
1953 ◽  
Vol 8 (8) ◽  
pp. 693-702 ◽  
Author(s):  
ALEXANDER G. GILLIAM
Keyword(s):  
United States ◽  
Causes Of Death ◽  
Age Distribution ◽  
Large City ◽  
The United States ◽  
Cooperative Study ◽  
State Data ◽  
Hospital Experience ◽  
Death Data

Abstract Attention has been called to the distinction between "age incidence", which is a measure of risk, and "age distribution" which is not such a measure except under certain unusual circumstances which probably do not exist for any hospital experience in the United States. Examples to illustrate this distinction were drawn from death data for deaths attributed to leukemia and the lymphomas in the United States in 1949. The sex and race selection have been recorded for the types of leukemia and lymphoma separable in the sixth revision of The International List of Causes of Death. The age selection at death attributed to the numerically important of these causes has also been presented. To determine the age, sex, and race selection (incidence) of these diseases, with full confidence in adequacy of their classification, will require a cooperative study designed to apply uniform diagnostic technics to all cases occurring in some definable population such as a large city or a state. Data derived from individual hospitals or from literature summations are generally inadequate for this purpose.

scholarly journals 55 Malignant primary brain and other central nervous system tumours diagnosed in the Canadian population from 2009 to 2013

2018 ◽  
Vol 45 (S3) ◽  
pp. S16-S17
Author(s):  
EV Walker ◽  
F Davis ◽  
Keyword(s):  
United States ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Tumour ◽  
Age Distribution ◽  
Paediatric Population ◽  
The United States ◽  
Incidence Rates ◽  
Canadian Population ◽  
Cns Tumours

The Canadian Brain Tumour Registry (CBTR) project was established in 2016 with the aim of enhancing infrastructure for surveillance and clinical research to improve health outcomes for brain tumour patients in Canada. We present a national surveillance report on malignant primary brain and central nervous system (CNS) tumours diagnosed in the Canadian population from 2009-2013. Patients were identified through the Canadian Cancer Registry (CCR); an administrative dataset that includes cancer incidence data from all provinces/territories in Canada. Cancer diagnoses are coded using the ICD-O3 system. Tumour types were classified by site and histology using The Central Brain Tumour Registry of the United States definitions. Incidence rates (IR) and 95% confidence intervals (CI) were calculated per 100,000 person-years and standardized to the 2011 census population age-distribution. Overall, 12,115 malignant brain and CNS tumours were diagnosed in the Canadian population from 2009-2013 (IR:8.43;95%CI:8.28,8.58). Of these, 6,845 were diagnosed in males (IR:9.72;95%CI:9.49,9.95) and 5,270 in females (IR:7.20;95%CI:7.00,7.39). The most common histology overall was glioblastoma (IR:4.06;95%CI:3.95,4.16). Among those aged 0-19 years, 1,130 malignant brain and CNS tumours were diagnosed from 2009-2013 (IR:3.36;95%CI:3.16,3.56). Of these, 625 were diagnosed in males (IR:3.32;95%CI:3.34,3.92) and 505 in females (IR:3.08;95%CI:2.81,3.36). The most common histology among the paediatric population was pilocytic astrocytoma (IR:0.73;95%CI:0.64,0.83). The presentation will include: IRs for other histologies, the geographic distribution of cases and a comparison between Canada and the United States.

scholarly journals 1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Standard Treatment ◽  
Age Distribution ◽  
Public Health Problem ◽  
The United States ◽  
Adverse Outcomes ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p< 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p< 0.0001) and during non-summer months (OR 2.2, p< 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

Changing Trends in Age and Sex Distributions of Lyme Disease—United States, 1992-2016

2021 ◽  
pp. 003335492110267
Author(s):  
Kiersten J. Kugeler ◽  
Paul S. Mead ◽  
Amy M. Schwartz ◽  
Alison F. Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Disease Incidence ◽  
Age Distribution ◽  
Relative Size ◽  
The United States ◽  
Male Predominance ◽  
Age Related ◽  
Over Time ◽  
Age And Sex

Lyme disease is the most common vector-borne disease in the United States and is characterized by a bimodal age distribution and male predominance. We examined trends in reported cases during a 25-year period to describe changes in the populations most affected by Lyme disease in the United States. We examined demographic characteristics of people with confirmed cases of Lyme disease reported to the Centers for Disease Control and Prevention during 1992-2016 through the National Notifiable Diseases Surveillance System. We grouped cases into 5-year periods (1992-1996, 1997-2001, 2002-2006, 2007-2011, 2012-2016). We calculated the average annual incidence by age and sex and used incidence rate ratios (IRRs) to describe changes in Lyme disease incidence by age and sex over time. We converted patient age at time of illness into patient birth year to ascertain disease patterns according to birth cohorts. The incidence of Lyme disease in the United States doubled from 1992-1996 to 2012-2016 (IRR = 1.74; 95% CI, 1.70-1.78) and increased disproportionately among males; IRRs were 39%-89% higher among males than among females for most age groups. During the study period, children aged 5-9 years were most frequently and consistently affected. In contrast, the average age of adults with Lyme disease increased over time; of all adults, people born during 1950-1964 were the most affected by Lyme disease. Our findings suggest that age-related behaviors and susceptibilities may drive infections among children, and the shifting peak among adults likely reflects a probability proportional to the relative size of the baby boom population. These findings can inform targeted and efficient public health education and intervention efforts.

Narrowing the mindware gap in medicine

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Pat Croskerry
Keyword(s):  
United States ◽  
Cognitive Performance ◽  
Clinical Reasoning ◽  
Medical Errors ◽  
Medical Error ◽  
Causes Of Death ◽  
The United States ◽  
Morbidity And Mortality ◽  
Medical Educators ◽  
High Degree

Abstract Medical error is now recognized as one of the leading causes of death in the United States. Of the medical errors, diagnostic failure appears to be the dominant contributor, failing in a significant number of cases, and associated with a high degree of morbidity and mortality. One of the significant contributors to diagnostic failure is the cognitive performance of the provider, how they think and decide about the process of diagnosis. This thinking deficit in clinical reasoning, referred to as a mindware gap, deserves the attention of medical educators. A variety of specific approaches are outlined here that have the potential to close the gap.

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