scholarly journals Identifying Patterns in Signs and Symptoms Preceding the Clinical Diagnosis of Alzheimer’s Disease: Retrospective Medical Record Review Study and a Nested Case-control Design

2018 ◽  
Vol 15 (8) ◽  
pp. 723-730 ◽  
Author(s):  
Fidelia Bature ◽  
Dong Pang ◽  
Anthea Robinson ◽  
Norma Polson ◽  
Yannis Pappas ◽  
...  
Keyword(s):  
Episodic Memory ◽  
Medical Record ◽  
Clinical Diagnosis ◽  
Odds Ratio ◽  
Control Design ◽  
Signs And Symptoms ◽  
Case Control ◽  
Record Review ◽  
Nested Case Control ◽  
Retrospective Medical Record Review

Objective: Evidence suggests that individuals with Alzheimer’s disease (AD) are often diagnosed in the later stages of their disease with a poor prognosis. This study is aimed to identify patterns in signs and symptoms preceding the clinical diagnosis of AD to suggest a predictive model for earlier diagnosis of the disease in the primary care. Design: A retrospective medical record review; nested case control design. Participants: Participants included one hundred and nine patients from three general practice (GP) surgeries in Milton Keynes and Luton Clinical Commissioning Groups (CCG) (37 cases with AD and 72 controls without AD). Main outcome measure: A retrospective analysis using the logistic regression of the presence of signs and symptoms before the diagnosis of AD was attained. Identification of the timing and sequence of appearance of these presentations as first reported before the clinical diagnosis was measured. Result: Episodic memory with an odds ratio of 1.85 was the most frequent presentation, documented in 1.38% of the controls and 75.6% in cases. Auditory disturbance with an odds ratio of 3.03, which has not previously been noted except in the form of auditory hallucination, could have a diagnostic value. Conclusion: Auditory disturbance, which occurred mostly in the Caucasian females, could discriminate individuals with AD from those without the disease. The symptom, which presented up to 14.5 (mean time) years prior to clinical diagnosis, was identified in Caucasians and mixed race individuals only. Strengths: The study demonstrates that auditory disturbance could allow an earlier diagnosis of AD in Caucasian females. Episodic memory was confirmed as being frequently noted in AD patients prior to a clinical diagnosis as per previous publications. This study supports the development of a scoring system for the earlier diagnosis of AD. The data used was free from the confounding effects of misinformation, as this was written at the point of collection, thereby benefitting from the use of GP data that is diversified, reliable and valid. Limitations: Limited sample size that will not allow for generalization of less frequent observations due to their low prevalence in case notes. Randomisation was not achieved; however, the best available nonrandomisation which is consecutive sampling was used. Patterns identified were in LOAD, the baseline could vary with other geographical areas.

Identifying signs and symptoms preceding the diagnosis of Alzheimer’s Disease: a retrospective medical record review

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696881
Author(s):  
Fidelia Bature ◽  
Dong Pang ◽  
Yannis Pappas ◽  
Barbara Guinn
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Diagnosis ◽  
Medical Record ◽  
Clinical Diagnosis ◽  
Signs And Symptoms ◽  
Medical Record Review ◽  
Control Group ◽  
Record Review ◽  
Retrospective Medical Record Review

BackgroundEarly diagnosis of Alzheimer’s disease (AD) is beneficial as interventions work well at this stage.AimThe study sought to identify patterns in signs and symptoms as reported by patients, 10 years preceding the clinical diagnosis of AD and suggest a predictive model for the early detection of the disease.MethodA retrospective medical record review and nested case-control design were carried out on the charts of 109 individuals (37 cases and 72 in the control group) in three GP surgeries in Milton Keynes and Luton, diagnosed between the year 2006–2016. Data extracted included the demographic and clinical data (signs and symptoms preceding the diagnosis of the disease). Logistic regression and correlation coefficient was used for analysis of variables to identify patterns.ResultsAuditory disturbances (tinnitus), a symptom that has not been reported in AD, could have a diagnostic value with 3.03 increased odds for associating with AD and a P-value of ≤0.05; the symptom was presented with a mean age of 14.5 years before the clinical diagnosis of the disease. There was a positive correlation between auditory disturbance and AD; episodic memory and AD; the female gender and AD all at 1% level (2tailed).ConclusionAuditory disturbance in the form of tinnitus has not been fully investigated in AD apart from auditory hallucinations and, as this symptom has been associated with other conditions. While further research is advocated in a large scale due to the insufficiency of the sample to initiate subgroup analysis, the result suggests that auditory disturbance could be a confounding factor to support future plans to improve the early diagnosis of AD.

scholarly journals THE RELATIONS BETWEEN DIABETES MELLITUS TYPE 2 ON THE INCIDENCE CATARACT IN BALAI KESEHATAN MATA MAKASSAR IN 2016

2019 ◽  
Vol 6 (1) ◽  
pp. 99
Author(s):  
A. NURUL AMALIAH ◽  
AMI FEBRIZA
Keyword(s):  
Diabetes Mellitus ◽  
Medical Record ◽  
Odds Ratio ◽  
Diabetes Mellitus Type 2 ◽  
Control Design ◽  
Case Control ◽  
Moderate Correlation ◽  
Chi Square ◽  
Diabetes Melitus

The aim of this research was to know about the correlation between cataract occurance with Diabetes Mellitus. This research was performed in Medical Record Departement of Balai Kesehatan Mata Masyarakat Makassar using medical record on the period of January 2016 to October 2016 with case control design, consist of 74 subjects which were divided into cataract as case, consist of 37 subjects and without cataract as control, consist of 37 subjects. Data of diabetes mellitus history were collected from patient medical recordand analyzed by Chi Square with the significance’s degree was p<0.05. The result showed moderate correlation between cataract occurance and diabetes mellitus (p=0.002) with Odds Ratio (OR) 4,563 (IC :1,683 – 12,371)KEYWORDS : Cataract, Diabetes Melitus

scholarly journals Estimating causal log-odds ratio using the case-control sample and its application in the pharmaco-epidemiology study

2018 ◽  
Vol 28 (7) ◽  
pp. 2165-2178
Author(s):  
Anqi Zhu ◽  
Donglin Zeng ◽  
Pengyue Zhang ◽  
Lang Li
Keyword(s):  
Side Effects ◽  
Medical Record ◽  
Odds Ratio ◽  
Control Design ◽  
Case Control ◽  
Superior Performance ◽  
Drug Event ◽  
Epidemiology Study ◽  
Drug Induced ◽  
Log Odds

One important goal in pharmaco-epidemiology studies is to understand the causal relationship between drug exposures and their clinical outcomes, including adverse drug events. In order to achieve this goal, however, we need to resolve several challenges. Most of pharmaco-epidemiology data are observational and confounding is largely present due to many co-medications. The pharmaco-epidemiology study data set is often sampled from large medical record databases using a matched case-control design, and it may not be representative of the original patient population in the medical record databases. Data analysis method needs to handle a large sample size that cannot be handled using existing statistical analysis packages. In this paper, we tackle these challenges both methodologically and computationally. We propose a conditional causal log-odds ratio (OR) definition to characterize causal effects of drug exposures on a binary adverse drug event adjusting for individual level confounders. Using a case-control design, we present a propensity score estimation using only case samples and we provide sufficient conditions for the consistency of the estimation of the causal log-odds ratio using case-based propensity scores. Computationally, we implement a principle component analysis to reduce high-dimensional confounders. Extensive simulation studies are performed to demonstrate superior performance of our method to existing methods. Finally, we apply the proposed method to analyze drug-induced myopathy data sampled from a de-identified subset of medical record database (close to 5 million patient records), The Indiana Network for Patient Care. Our method identified 70 drug-induced myopathy ( p < 0.05) out 72 drugs, which have myoathy side effects on their FDA drug labels. These 70 drugs include three statins who are known for their myopathy side effects.

scholarly journals Padded Headgear does not Reduce the Incidence of Match Concussions in Professional Men’s Rugby Union: A Case-control Study of 417 Cases

2021 ◽  
Author(s):  
Keith A. Stokes ◽  
Matthew Cross ◽  
Sean Williams ◽  
Carly McKay ◽  
Brent E. Hagel ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Head Injuries ◽  
Median Number ◽  
Case Control ◽  
Rugby Union ◽  
Return To Play ◽  
Injury Incidence ◽  
Video Footage ◽  
Four Seasons ◽  
Nested Case Control

AbstractConcussion is the most common match injury in rugby union. Some players wear padded headgear, but whether this protects against concussion is unclear. In professional male rugby union players, we examined: (i) the association between the use of headgear and match concussion injury incidence, and (ii) whether wearing headgear influenced time to return to play following concussion. Using a nested case-control within a cohort study, four seasons (2013–2017) of injury data from 1117 players at the highest level of rugby union in England were included. Cases were physician-diagnosed concussion injuries. Controls were other contact injuries (excluding all head injuries). We determined headgear use by viewing video footage. Sixteen percent of cases and controls wore headgear. Headgear use had no significant effect on concussion injury incidence (adjusted odds ratio=1.05, 95% CI: 0.71–1.56). Median number of days absent for concussion whilst wearing headgear was 8 days, compared with 7 days without headgear. Having sustained a concussion in the current or previous season increased the odds of concussion more than four-fold (odds ratio=4.55, 95% CI: 3.77–5.49). Wearing headgear was not associated with lower odds of concussions or a reduced number of days' absence following a concussion.

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