Genetic parameters for periodontal disease: an analysis of electronic dental treatment records linked to pedigree, genomic, sociodemographic and clinical data

ABSTRACT BackgroundElectronic health records provides unprecedented opportunity for their re-use in genetic epidemiological research. However, electronic health records data from clinical settings, such as dental practices may be inaccurate or of insufficient granularity to be of use in research. In this study, we wish to determine the utility of National Health Service (NHS) electronic dental treatment records in genetic epidemiological research. ObjectiveTo estimate the heritability of periodontal disease using NHS electronic dental treatment records linked to health and non-health data within the Generation Scotland: Scottish Family Health Study (GS:SFHS). ApproachWe linked 852,355 NHS Scotland electronic dental treatment records from April 2000 to July 2015 to 20,626 participants within the GS:SFHS with pedigree, genomic, sociodemographic and clinical data. We then conducted a proof-of-principle genetic epidemiological analysis using periodontal (gum) disease treatment records. The data set analysed, consisted of 160,508 dental treatment records from 13,717 study participants; 3,387 of which were periodontal treatment records (from 2,192 study participants). We adjusted for the effects of previous treatment record, interval since last treatment, age, sex, treatment year, and treatment month, Scottish index of multiple deprivation, alcohol consumption, diabetes diagnosis, and smoking status in a linear model in the statistical software ASReml. We then calculated the mean risk of periodontal disease for each study participant based on residuals extracted from the aforementioned model. Genome-complex trait analysis (GCTA; with correction for population stratification) was used to estimate the pedigree and genomic based heritability of periodontal disease. ResultsWe estimate the familial heritability of periodontal (gum) disease at 10.42% (95% confidence interval 5.97-14.88%). The genomic component did not contribute significantly to the heritability estimate. Conclusionwe have demonstrated the usefulness of electronic dental treatment records in population based genetic epidemiological research .This study has also, to the best of our knowledge provided the first population based estimates of the genetic parameters for periodontal disease; confirming its familial nature. This invaluable and unique data resource will allow the acceleration of oral health research in Scotland and the exploration of research questions that could not be considered previously.

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Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study

Journal Of Clinical Periodontology ◽

10.1111/jcpe.13113 ◽

2019 ◽

Vol 46 (6) ◽

pp. 642-649 ◽

Cited By ~ 1

Author(s):

Hsiao‐Wei Lin ◽

Chun‐Min Chen ◽

Yi‐Chun Yeh ◽

Yen‐Yu Chen ◽

Ru‐Yu Guo ◽

...

Keyword(s):

Cohort Study ◽

Periodontal Disease ◽

Ischaemic Stroke ◽

Dental Treatment ◽

Population Based ◽

Treatment Procedures ◽

Subsequent Risk

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The Sweden cohort consortium (Cohort.se)

European Journal of Public Health ◽

10.1093/eurpub/ckz185.549 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J S Sundstrom

Keyword(s):

Scientific Literature ◽

Population Based ◽

Research Projects ◽

High Quality ◽

Epidemiological Research ◽

The Public ◽

Research Findings ◽

Study Participants ◽

National Infrastructure ◽

Swedish Cohort

Abstract The scientific literature is continuously flooded with non-replicable results from underpowered studies. The insight that very large sample sizes are needed in order to generate robust results has led to the establishment of very large cohorts and cohort consortia in the last decades. Sweden is a country with unique opportunities for epidemiological research. Sweden has a large number of carefully collected population-based cohorts that have been followed for decades, ongoing recruitment into several cohorts, and a variety of high-quality national socio-demographic and medical registries covering the whole population since many decades. However, Swedish cohort research is poorly coordinated. Many research projects are underpowered by using only one cohort at a time, leading to uncertain results with little benefit to patients and the public. We have proposed a coordination of all Swedish cohorts in a common national infrastructure, the Swedish Cohort Consortium (Cohorts.se), aiming to facilitate greater use of Swedish cohorts for better-powered research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on less common exposures and outcomes, leading to better utilization of study participants’ data, better return of funders’ investments, and higher benefit to patients and populations. A standing Swedish cohort consortium may drive development of epidemiological research methods and strengthen the Swedish epidemiological competence, community, and competitiveness.

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The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.697 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 216-216

Author(s):

Ahmed Shakarchi ◽

Emmanuel Garcia Morales ◽

Nicholas Reed ◽

Bonnielin Swenor

Keyword(s):

Older Adults ◽

Hearing Aids ◽

Population Based ◽

Sensory Impairment ◽

Loss To Follow Up ◽

Increased Risk ◽

Cox Proportional Hazard Regression ◽

Study Participants ◽

Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

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Section 1: Health and Clinical Management: Leveraging Information Technology to Improve Quality and Safety

Yearbook of Medical Informatics ◽

10.1055/s-0038-1638515 ◽

2007 ◽

Vol 16 (01) ◽

pp. 22-29

Author(s):

D. W. Bates ◽

J. S. Einbinder

Keyword(s):

Information Technology ◽

Patient Safety ◽

Clinical Data ◽

Data Exchange ◽

Personal Health Records ◽

Personal Health ◽

Health Records ◽

Provider Behavior ◽

Published Research ◽

Improve Patient

SummaryTo examine five areas that we will be central to informatics research in the years to come: changing provider behavior and improving outcomes, secondary uses of clinical data, using health information technology to improve patient safety, personal health records, and clinical data exchange.Potential articles were identified through Medline and Internet searches and were selected for inclusion in this review by the authors.We review highlights from the literature in these areas over the past year, drawing attention to key points and opportunities for future work.Informatics may be a key tool for helping to improve patient care quality, safety, and efficiency. However, questions remain about how best to use existing technologies, deploy new ones, and to evaluate the effects. A great deal of research has been done on changing provider behavior, but most work to date has shown that process benefits are easier to achieve than outcomes benefits, especially for chronic diseases. Use of secondary data (data warehouses and disease registries) has enormous potential, though published research is scarce. It is now clear in most nations that one of the key tools for improving patient safety will be information technology— many more studies of different approaches are needed in this area. Finally, both personal health records and clinical data exchange appear to be potentially transformative developments, but much of the published research to date on these topics appears to be taking place in the U.S.— more research from other nations is needed.

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Recent Trends in Youth Concussions: A Brief Report

Journal of Primary Care & Community Health ◽

10.1177/2150132720985058 ◽

2020 ◽

Vol 11 ◽

pp. 215013272098505

Author(s):

Andrew T. Askow ◽

Jacob L. Erickson ◽

Andrew R. Jagim

Keyword(s):

Incidence Rate ◽

Brain Injuries ◽

Population Based ◽

Health Records ◽

Medical Issues ◽

Number Of Patients ◽

Recent Trends ◽

Males And Females ◽

Large Health Care System

Objectives Concussions and mild traumatic brain injuries are important medical issues, particularly among youth as the long-term health consequences of these injuries can become increasingly problematic. The purpose of this study was to examine recent trends in diagnosed concussions among pediatric patients in a large health care system. Methods This was a retrospective, population-based epidemiology study design that queried all patient files (pediatrics included) using electronic medical health records and further stratified patients based on type of concussion, age, sex, and year from 2013 to 2018. Results Electronic health records from a cohort of 8 832 419 (nmales = 4 246 492; nfemales = 4 585 931) patient visits were assessed for concussion diagnosis and filtered for those whose concussive event led to a loss of consciousness (LOC) or not (nLOC). Of these patients, 12 068 were diagnosed with a concussion (LOC = 3 699; nLOC = 8 369) with an overall incidence rate of 1.37 concussions per 1000 patients. Overall, the number of patients diagnosed with a concussion increased by 5063 (LOC = 1351; nLOC = 3712) from 2013 to 2018. Males and females presented with similar rates of concussions 5919 (49.05%) and 6149 concussions (50.95%), respectively. Of total diagnosed concussions, 4972 (LOC = 815; nLOC = 4157) were under the age of 18 and represented 41.2% of all diagnosed concussions with an incidence rate of 6.79 per 1000 patients. Conclusion The number of concussions diagnosed appear to be on the rise with the largest number of concussions being diagnosed in those under the age of 18. Future studies should seek to determine primary causality and the long-term health implications of concussions with or without LOC.

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Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study

BMC Health Services Research ◽

10.1186/s12913-021-06762-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lisa M. Lix ◽

Shamsia Sobhan ◽

Audray St-Jean ◽

Jean-Marc Daigle ◽

Anat Fisher ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Mortality ◽

Population Based ◽

Vital Statistics ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Health Records ◽

Predictive Values ◽

Site Specific ◽

Hospital Deaths

Abstract Background Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. Methods Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. Results The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. Conclusions A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns.

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Comment on Shah et al. Cardiovascular Complications and Mortality After Diabetes Diagnosis for South Asian and Chinese Patients: A Population-Based Cohort Study. Diabetes Care 2013;36:2670–2676

Diabetes Care ◽

10.2337/dc13-2490 ◽

2014 ◽

Vol 37 (4) ◽

pp. e78-e79 ◽

Cited By ~ 1

Author(s):

Therese Tillin ◽

Naveed Sattar ◽

Nita Forouhi ◽

Alun D. Hughes ◽

Nish Chaturvedi

Keyword(s):

Cohort Study ◽

South Asian ◽

Diabetes Care ◽

Cardiovascular Complications ◽

Population Based ◽

Chinese Patients ◽

Diabetes Diagnosis ◽

Complications And Mortality

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Statin for Tuberculosis and Pneumonia in Patients with Asthma–Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm7110381 ◽

2018 ◽

Vol 7 (11) ◽

pp. 381 ◽

Cited By ~ 9

Author(s):

Jun-Jun Yeh ◽

Cheng-Li Lin ◽

Chung-Y. Hsu ◽

Zonyin Shae ◽

Chia-Hung Kao

Keyword(s):

Pulmonary Disease ◽

Inhaled Corticosteroids ◽

Population Based ◽

Overlap Syndrome ◽

Time Dependent ◽

Research Database ◽

Chronic Pulmonary Disease ◽

Oral Steroids ◽

Taiwan National Health Insurance ◽

Study Participants

We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma–chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000–2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34–0.70] and pneumonia (aHR 0.52, 95% CI 0.41–0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31–1.16) and 0.58 (0.40–0.85) for TB and 0.61 (0.39–0.95) and 0.57 (0.45–0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs.

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