scholarly journals The impact of neighborhood racial/ethnic residential segregation on tobacco use in the Atherosclerosis Risk in Communities (ARIC) study

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Miranda R. Jones ◽  
John R. Barber ◽  
Corinne E. Joshu ◽  
Elizabeth A. Platz
Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lindsay G Smith ◽  
Pamela L Lutsey ◽  
Laura R Loehr ◽  
Anna Kucharska-Newton ◽  
Lin Y Chen ◽  
...  

Background: Atrial fibrillation (AF) is associated with increased risk of hospitalization. However, little is known about the impact of AF on non-inpatient healthcare utilization or about sex or race differences in AF-related utilization. We examined rates of inpatient and outpatient utilization by AF status in the Atherosclerosis Risk in Communities (ARIC) study. Methods and Results: ARIC cohort participants with incident AF enrolled in fee-for-service Medicare, Parts A and B, for at least 12 continuous months between 1991 and 2009 were matched on age, sex, race and center to up to three participants without AF. Healthcare utilization was ascertained from inpatient and outpatient Medicare claims and classified based on primary ICD-9 code. The analysis included 944 AF and 2,761 non-AF participants. The average number of days hospitalized per year was 13.1 (95% confidence interval [CI]: 11.5-15.0) and 2.8 (95% CI: 2.5-3.1) for those with and without AF, respectively. The corresponding number of outpatient claims per year was 53.2 (95% CI: 50.4-56.1) and 23.0 (95% CI: 22.2-23.8) for those with and without AF, respectively (Table). Most utilization in AF patients was attributable to non-AF conditions, particularly other-cardiovascular disease (CVD)-related reasons; the adjusted rate ratio for days hospitalized per year for other-CVD-related reasons was 4.76 (95% CI: 3.51 - 6.44) for those with compared to those without AF. There was suggestive evidence that sex modified the association between AF and inpatient utilization, with AF related to greater utilization in women than men. The association between AF and healthcare utilization was similar in whites and blacks. Conclusions: This study highlights the considerably greater healthcare utilization (inpatient and outpatient) among those with AF; the differential in utilization due to other-CVD-related reasons was substantial. In addition to recommended heart rate or rhythm treatment, accompanying cardiovascular comorbidities should be evaluated and managed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Nicholas Reed ◽  
Emmanuel Garcia-Morales ◽  
Priya Palta ◽  
Frank Lin ◽  
Josef Coresh ◽  
...  

Abstract Hearing Loss (HL) is common among older adults and is associated with factors (e.g., walking speed and social isolation) that may mediate an association with frailty. In the Atherosclerosis Risk in Communities (ARIC) study, frailty was defined as a composite variable (unintentional weight loss, energy expenditure, walking speed, low energy, and grip strength) while HL was measured using pure-tone audiometry. Among, 3179 participants in 2015-2017, 251 (7.9%) were frail. In a model adjusted for demographic and clinical risk factors, mild HL (n=1263; Odds Ratio[OR]=1.42; 95%Confidence Interval[CI]=1.01-2.01) and moderate HL (n=854; OR=1.67; 95%CI=1.09-2.55) were associated with higher odds of frailty relative to those without HL (n=1063). Among participants who completed an ARIC visit 2-years later, the odds of developing frailty tended to be higher among those with mild (OR=1.46; 95%CI=0.91-2.33) and moderate HL (OR=1.43; 95%CI=0.77-2.67). Future research should focus on mechanisms underlying association and determine the impact of treatment of HL. Part of a symposium sponsored by Sensory Health Interest Group.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1398-P
Author(s):  
MARY R. ROONEY ◽  
OLIVE TANG ◽  
B. GWEN WINDHAM ◽  
JUSTIN B. ECHOUFFO TCHEUGUI ◽  
PAMELA LUTSEY ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047356
Author(s):  
Carlton R Moore ◽  
Saumya Jain ◽  
Stephanie Haas ◽  
Harish Yadav ◽  
Eric Whitsel ◽  
...  

ObjectivesUsing free-text clinical notes and reports from hospitalised patients, determine the performance of natural language processing (NLP) ascertainment of Framingham heart failure (HF) criteria and phenotype.Study designA retrospective observational study design of patients hospitalised in 2015 from four hospitals participating in the Atherosclerosis Risk in Communities (ARIC) study was used to determine NLP performance in the ascertainment of Framingham HF criteria and phenotype.SettingFour ARIC study hospitals, each representing an ARIC study region in the USA.ParticipantsA stratified random sample of hospitalisations identified using a broad range of International Classification of Disease, ninth revision, diagnostic codes indicative of an HF event and occurring during 2015 was drawn for this study. A randomly selected set of 394 hospitalisations was used as the derivation dataset and 406 hospitalisations was used as the validation dataset.InterventionUse of NLP on free-text clinical notes and reports to ascertain Framingham HF criteria and phenotype.Primary and secondary outcome measuresNLP performance as measured by sensitivity, specificity, positive-predictive value (PPV) and agreement in ascertainment of Framingham HF criteria and phenotype. Manual medical record review by trained ARIC abstractors was used as the reference standard.ResultsOverall, performance of NLP ascertainment of Framingham HF phenotype in the validation dataset was good, with 78.8%, 81.7%, 84.4% and 80.0% for sensitivity, specificity, PPV and agreement, respectively.ConclusionsBy decreasing the need for manual chart review, our results on the use of NLP to ascertain Framingham HF phenotype from free-text electronic health record data suggest that validated NLP technology holds the potential for significantly improving the feasibility and efficiency of conducting large-scale epidemiologic surveillance of HF prevalence and incidence.


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