scholarly journals Challenges and Pitfalls of Using Repeat Spirometry Recordings in Routine Primary Care Data to Measure FEV1 Decline in a COPD Population

2021 ◽  
Vol Volume 12 ◽  
pp. 119-130
Author(s):  
Hannah R Whittaker ◽  
Steven J Kiddle ◽  
Jennifer K Quint
Keyword(s):  
Primary Care ◽  
Primary Care Data ◽  
Fev1 Decline

scholarly journals CHARGE-AF in a national routine primary care electronic health records database in the Netherlands: validation for 5-year risk of atrial fibrillation and implications for patient selection in atrial fibrillation screening

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001459
Author(s):  
Jelle C L Himmelreich ◽  
Wim A M Lucassen ◽  
Ralf E Harskamp ◽  
Claire Aussems ◽  
Henk C P M van Weert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
High Risk ◽  
The Netherlands ◽  
Patient Selection ◽  
Low Cost ◽  
Calibration Plot ◽  
Primary Care Data ◽  
C Statistic ◽  
Kaplan Meier

AimsTo validate a multivariable risk prediction model (Cohorts for Heart and Aging Research in Genomic Epidemiology model for atrial fibrillation (CHARGE-AF)) for 5-year risk of atrial fibrillation (AF) in routinely collected primary care data and to assess CHARGE-AF’s potential for automated, low-cost selection of patients at high risk for AF based on routine primary care data.MethodsWe included patients aged ≥40 years, free of AF and with complete CHARGE-AF variables at baseline, 1 January 2014, in a representative, nationwide routine primary care database in the Netherlands (Nivel-PCD). We validated CHARGE-AF for 5-year observed AF incidence using the C-statistic for discrimination, and calibration plot and stratified Kaplan-Meier plot for calibration. We compared CHARGE-AF with other predictors and assessed implications of using different CHARGE-AF cut-offs to select high-risk patients.ResultsAmong 111 475 patients free of AF and with complete CHARGE-AF variables at baseline (17.2% of all patients aged ≥40 years and free of AF), mean age was 65.5 years, and 53% were female. Complete CHARGE-AF cases were older and had higher AF incidence and cardiovascular comorbidity rate than incomplete cases. There were 5264 (4.7%) new AF cases during 5-year follow-up among complete cases. CHARGE-AF’s C-statistic for new AF was 0.74 (95% CI 0.73 to 0.74). The calibration plot showed slight risk underestimation in low-risk deciles and overestimation of absolute AF risk in those with highest predicted risk. The Kaplan-Meier plot with categories <2.5%, 2.5%–5% and >5% predicted 5-year risk was highly accurate. CHARGE-AF outperformed CHA2DS2-VASc (Cardiac failure or dysfunction, Hypertension, Age >=75 [Doubled], Diabetes, Stroke [Doubled]-Vascular disease, Age 65-74, and Sex category [Female]) and age alone as predictors for AF. Dichotomisation at cut-offs of 2.5%, 5% and 10% baseline CHARGE-AF risk all showed merits for patient selection in AF screening efforts.ConclusionIn patients with complete baseline CHARGE-AF data through routine Dutch primary care, CHARGE-AF accurately assessed AF risk among older primary care patients, outperformed both CHA2DS2-VASc and age alone as predictors for AF and showed potential for automated, low-cost patient selection in AF screening.

Patients’ satisfaction after a geriatric assessment into primary care: data from FAP study

2018 ◽  
Vol 16 (4) ◽  
pp. 391-397
Author(s):  
Maxime Renoux ◽  
Bruno Chicoulaa ◽  
Christine Lagourdette ◽  
Emile Escourrou ◽  
Marion Secher ◽  
...  
Keyword(s):  
Primary Care ◽  
Geriatric Assessment ◽  
Patients Satisfaction ◽  
Primary Care Data

Primary care data

2018 ◽  
pp. 54-66
Author(s):  
Marilyn James ◽  
Elizabeth Stokes
Keyword(s):  
Primary Care ◽  
Primary Care Data

Cancer incidence in patients with a high normal platelet count: a cohort study using primary care data

2018 ◽  
Vol 35 (6) ◽  
pp. 671-675 ◽  
Author(s):  
Emily Ankus ◽  
Sarah J Price ◽  
Obioha C Ukoumunne ◽  
William Hamilton ◽  
Sarah E R Bailey
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Platelet Count ◽  
Cancer Incidence ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
Primary Care Data

scholarly journals Assessing and predicting adolescent and early adulthood common mental disorders using electronic primary care data: analysis of a prospective cohort study (ALSPAC) in Southwest England

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053624
Author(s):  
Daniel Smith ◽  
Kathryn Willan ◽  
Stephanie L Prady ◽  
Josie Dickerson ◽  
Gillian Santorelli ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Mental Disorders ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Common Mental Disorders ◽  
Free Text ◽  
Primary Care Data ◽  
Time Point

ObjectivesWe aimed to examine agreement between common mental disorders (CMDs) from primary care records and repeated CMD questionnaire data from ALSPAC (the Avon Longitudinal Study of Parents and Children) over adolescence and young adulthood, explore factors affecting CMD identification in primary care records, and construct models predicting ALSPAC-derived CMDs using only primary care data.Design and settingProspective cohort study (ALSPAC) in Southwest England with linkage to electronic primary care records.ParticipantsPrimary care records were extracted for 11 807 participants (80% of 14 731 eligible). Between 31% (3633; age 15/16) and 11% (1298; age 21/22) of participants had both primary care and ALSPAC CMD data.Outcome measuresALSPAC outcome measures were diagnoses of suspected depression and/or CMDs. Primary care outcome measure were Read codes for diagnosis, symptoms and treatment of depression/CMDs. For each time point, sensitivities and specificities for primary care CMD diagnoses were calculated for predicting ALSPAC-derived measures of CMDs, and the factors associated with identification of primary care-based CMDs in those with suspected ALSPAC-derived CMDs explored. Lasso (least absolute selection and shrinkage operator) models were used at each time point to predict ALSPAC-derived CMDs using only primary care data, with internal validation by randomly splitting data into 60% training and 40% validation samples.ResultsSensitivities for primary care diagnoses were low for CMDs (range: 3.5%–19.1%) and depression (range: 1.6%–34.0%), while specificities were high (nearly all >95%). The strongest predictors of identification in the primary care data for those with ALSPAC-derived CMDs were symptom severity indices. The lasso models had relatively low prediction rates, especially in the validation sample (deviance ratio range: −1.3 to 12.6%), but improved with age.ConclusionsPrimary care data underestimate CMDs compared to population-based studies. Improving general practitioner identification, and using free-text or secondary care data, is needed to improve the accuracy of models using clinical data.

scholarly journals Machine-learning based identification of undiagnosed dementia in primary care: a feasibility study

BJGP Open ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. bjgpopen18X101589 ◽  
Author(s):  
Emmanuel A Jammeh ◽  
Camille, B Carroll ◽  
Stephen, W Pearson ◽  
Javier Escudero ◽  
Athanasios Anastasiou ◽  
...  
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Case Control ◽  
Classification Model ◽  
Dementia Diagnosis ◽  
Machine Learning Classification ◽  
Primary Care Data ◽  
Dementia Risk ◽  
Diagnosis Of Dementia ◽  
Read Codes

BackgroundUp to half of patients with dementia may not receive a formal diagnosis, limiting access to appropriate services. It is hypothesised that it may be possible to identify undiagnosed dementia from a profile of symptoms recorded in routine clinical practice.AimThe aim of this study is to develop a machine learning-based model that could be used in general practice to detect dementia from routinely collected NHS data. The model would be a useful tool for identifying people who may be living with dementia but have not been formally diagnosed.Design & settingThe study involved a case-control design and analysis of primary care data routinely collected over a 2-year period. Dementia diagnosed during the study period was compared to no diagnosis of dementia during the same period using pseudonymised routinely collected primary care clinical data.MethodRoutinely collected Read-encoded data were obtained from 18 consenting GP surgeries across Devon, for 26 483 patients aged >65 years. The authors determined Read codes assigned to patients that may contribute to dementia risk. These codes were used as features to train a machine-learning classification model to identify patients that may have underlying dementia.ResultsThe model obtained sensitivity and specificity values of 84.47% and 86.67%, respectively.ConclusionThe results show that routinely collected primary care data may be used to identify undiagnosed dementia. The methodology is promising and, if successfully developed and deployed, may help to increase dementia diagnosis in primary care.

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