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Kuang A, Xu C, Southern DA, Sandhu N, Quan H. Validated administrative data based ICD-10 algorithms for chronic conditions: A systematic review. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202744. [PMID: 38971056 DOI: 10.1016/j.jeph.2024.202744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE This systematic review aimed to identify ICD-10 based validated algorithms for chronic conditions using health administrative data. METHODS A comprehensive systematic literature search using Ovid MEDLINE, Embase, PsycINFO, Web of Science and CINAHL was performed to identify studies, published between 1983 and May 2023, on validated algorithms for chronic conditions using administrative health data. Two reviewers independently screened titles and abstracts and reviewed full text of selected studies to complete data extraction. A third reviewer resolved conflicts arising at the screening or study selection stages. The primary outcome was validated studies of ICD-10 based algorithms with both sensitivity and PPV of ≥70 %. Studies with either sensitivity or PPV <70 % were included as secondary outcomes. RESULTS Overall, the search identified 1686 studies of which 54 met the inclusion criteria. Combining a previously published literature search, a total of 61 studies were included for data extraction. The study identified 40 chronic conditions with high validity and 22 conditions with moderate validity. The validated algorithms were based on administrative data from different countries including Canada, USA, Australia, Japan, France, South Korea, and Taiwan. The algorithms identified included several types of cancers, cardiovascular conditions, kidney diseases, gastrointestinal disorders, and peripheral vascular diseases, amongst others. CONCLUSION With ICD-10 prominently used across the world, this up-to-date systematic review can prove to be a helpful resource for research and surveillance initiatives using administrative health data for identifying chronic conditions.
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Affiliation(s)
- Angela Kuang
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Claire Xu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Danielle A Southern
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Namneet Sandhu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Hude Quan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Park SJ, Kim M, Jeong S, Park YJ, Choi S, Chang J, Oh YH, Cho SW, Park YJ, Park SM. Association Between Antibiotic Exposure and Thyroid Cancer: A Nationwide Cohort Study in South Korea. Thyroid 2024; 34:112-122. [PMID: 38009221 DOI: 10.1089/thy.2023.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Background: Although recent studies have introduced antibiotics as a potential risk factor for thyroid cancer, further studies are necessary. We examined the association between long-term antibiotic usage and thyroid cancer risk. Methods: This nationwide cohort study investigated 9,804,481 individuals aged 20 years or older who participated in health screening (2005-2006) with follow-up ending on December 31, 2019, using the Korean National Health Insurance Service database. Multivariable Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for thyroid cancer risk according to the cumulative days of antibiotic prescription and the number of antibiotic classes, respectively. A 1:1 propensity score (PS) matching was also performed for analysis. Results: Compared with nonusers of antibiotics, participants prescribed ≥365 days of antibiotics showed an increased risk of thyroid cancer (aHR, 1.71; CI, 1.66-1.78) after adjusting for covariates including age, smoking status, comorbidities including thyroid-related diseases, and the number of head and neck computed tomography scans. Participants prescribed ≥365 days of antibiotics also had a significantly increased risk of thyroid cancer (aHR, 1.37; CI, 1.34-1.40) compared with participants prescribed 1-14 days of antibiotics. Association remained significant in the 1:1 PS-matched cohort. Moreover, compared with nonusers of antibiotics, the 5 or more antibiotic class user group had a higher thyroid cancer risk (aHR, 1.71; CI, 1.65-1.78). Conclusions: Long-term antibiotic prescriptions and an increasing number of antibiotic classes may be associated with a higher risk of thyroid cancer in a duration-dependent manner. The effects of long-term antibiotic exposure on thyroid cancer should be further investigated.
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Affiliation(s)
- Sun Jae Park
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Minseo Kim
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- College of Medicine, Jeonbuk National University, Jeonju, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, South Korea
| | - Young Jun Park
- Medical Research Center, Genomic Medicine Institute, Seoul National University, Seoul, South Korea
| | - Seulggie Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, South Korea
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Wijarnpreecha K, Li F, Lundin SK, Suresh D, Song MW, Tao C, Chen VL, Lok ASF. Higher mortality among lean patients with non-alcoholic fatty liver disease despite fewer metabolic comorbidities. Aliment Pharmacol Ther 2023; 57:1014-1027. [PMID: 36815445 PMCID: PMC10682563 DOI: 10.1111/apt.17424] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) can develop in individuals who are not overweight. Whether lean persons with NAFLD have lower mortality and lower incidence of cirrhosis, cardiovascular diseases (CVD), diabetes mellitus (DM) and cancer than overweight/obese persons with NAFLD remains inconclusive. We compared mortality and incidence of cirrhosis, CVD, DM and cancer between lean versus non-lean persons with NAFLD. METHODS This is a retrospective study of adults with NAFLD in a single centre from 2012 to 2021. Primary outcomes were mortality and new diagnosis of cirrhosis, CVD, DM and cancer. Outcomes were modelled using competing risk analysis and Cox proportional hazards regression analysis. RESULTS A total of 18,594 and 13,420 patients were identified for cross-sectional and longitudinal analysis respectively: approximately 11% lean, 25% overweight, 28% class 1 obesity and 35% class 2-3 obesity. The median age was 51.0 years, 54.6% were women. The median follow-up was 49.3 months. Lean patients had lower prevalence of metabolic diseases at baseline and lower incidence of cirrhosis and DM than non-lean patients and no difference in CVD, any cancer or obesity-related cancer during follow-up. However, lean patients had significantly higher mortality with incidence per 1000 person-years of 16.67, 10.11, 7.37 and 8.99, respectively, in lean, overweight, obesity class 1 and obesity class 2-3 groups respectively. CONCLUSIONS Lean patients with NAFLD had higher mortality despite lower incidence of cirrhosis and DM, and similar incidence of CVD and cancer and merit similar if not more attention as non-lean patients with NAFLD.
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Affiliation(s)
- Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Fang Li
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sori K. Lundin
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Deepika Suresh
- Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Michael W. Song
- Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Cui Tao
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Vincent L. Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Anna S. F. Lok
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
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Jung M, Lee BJ, Lee S, Shin J. Clinical outcomes and predictors of a gap in direct-acting oral anticoagulant therapy in the elderly: A time-varying analysis of a nationwide cohort study. Thromb Res 2023; 226:61-68. [PMID: 37121013 DOI: 10.1016/j.thromres.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION As direct-acting oral anticoagulants (DOACs) have short half-lives of around 12 h, even a short gap in DOAC therapy may diminish anticoagulation effects, increasing risks of adverse clinical outcomes. We aimed to evaluate clinical consequences of a gap in DOAC therapy with atrial fibrillation (AF) and to identify its potential predictors. MATERIALS AND METHODS In this retrospective cohort study, we included DOAC users aged over 65 years with AF from the 2018 Korean nationwide claims database. We defined a gap in DOAC therapy as no claim for a DOAC one or more days after the due date of a refill prescription. We used a time-varying-analysis method. The primary outcome was a composite of death and thrombotic events including ischemic stroke/transient ischemic attack or systemic embolism. Potential predictors of a gap included sociodemographic and clinical factors. RESULTS AND CONCLUSIONS Among 11,042 DOAC users, 4857 (44.0 %) patients had at least one gap. Standard national health insurance, non-metropolitan locations of medical institutions, history of liver disease, chronic obstructive pulmonary disease, cancer, or dementia, and use of diuretics or non-oral agents were associated with increased risks of a gap. In contrast, history of hypertension, ischemic heart disease, or dyslipidemia were associated with a decreased risk of a gap. A short gap in DOAC therapy was significantly associated with a higher risk of the primary outcome compared to no gap (hazard ratio 4.04, 95 % confidence interval 2.95-5.52). The predictors could be utilized to identify at-risk patients to provide additional support to prevent a gap.
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Affiliation(s)
- Minji Jung
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, United States
| | - Beom-Jin Lee
- Research Institute of Pharmaceutical Sciences and Technology, Ajou University, Suwon, Republic of Korea
| | - Sukhyang Lee
- Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea.
| | - Jaekyu Shin
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, United States.
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Kim HM, Kim J, Kim H, Park SC, Lee JK, Kang DR, Kim SY, Kim HS. Risk of Gastric Cancer among Patients with Newly Diagnosed Ulcerative Colitis: A Nationwide Population-Based Study. J Clin Med 2023; 12:jcm12082843. [PMID: 37109180 PMCID: PMC10141013 DOI: 10.3390/jcm12082843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/01/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Few studies have investigated the risk of gastric cancer (GC) in ulcerative colitis (UC), and the results have been inconsistent. This study aimed to assess the risk of gastric cancer in newly diagnosed UC patients. METHODS Based on claims data from Korean National Health Insurance from January 2006 to December 2015, we identified 30,546 patients with UC and randomly selected 88,829 non-UC individuals as controls, who were matched by age and sex. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for gastric cancer events, with covariates taken into account. RESULTS During the study period, a total of 77 (0.25%) patients with UC and 383 (0.43%) non-UC individuals were diagnosed with GC. After multivariable adjustment, the HR for GC was 0.60 (95% CI: 0.47-0.77) in patients with UC, using non-UC individuals as the reference group. When stratified by age, the adjusted HRs for GC in UC patients were 0.19 (95% CI: 0.04-0.98) for those aged 20-39 years at the time of UC diagnosis, 0.65 (95% CI: 0.45-0.94) for 40-59, and 0.60 (95% CI: 0.49-0.80) for ≥60 as compared to non-UC individuals in the corresponding age groups. When stratified by sex, the adjusted HR for GC was 0.54 (95% CI: 0.41-0.73) in male UC patients of all ages. Within UC patients, a multivariable analysis revealed that the HR for GC was 12.34 (95% CI: 2.23-68.16) for those aged ≥ 60 years at the time of diagnosis of UC. CONCLUSIONS Patients with UC had a decreased GC risk compared with non-UC individuals in South Korea. Within the UC population, advancing age (≥60 years) was identified as a significant risk factor for GC.
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Affiliation(s)
- Hee Man Kim
- Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Jihoon Kim
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Hyunil Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Soon Chang Park
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Jung Kuk Lee
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Su Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
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Hirano T, Negishi M, Kuwatsuru Y, Arai M, Wakabayashi R, Saito N, Kuwatsuru R. Validation of algorithms to identify colorectal cancer patients from administrative claims data of a Japanese hospital. BMC Health Serv Res 2023; 23:274. [PMID: 36944932 PMCID: PMC10029250 DOI: 10.1186/s12913-023-09266-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Administrative claims data are a valuable source for clinical studies; however, the use of validated algorithms to identify patients is essential to minimize bias. We evaluated the validity of diagnostic coding algorithms for identifying patients with colorectal cancer from a hospital's administrative claims data. METHODS This validation study used administrative claims data from a Japanese university hospital between April 2017 and March 2019. We developed diagnostic coding algorithms, basically based on the International Classification of Disease (ICD) 10th codes of C18-20 and Japanese disease codes, to identify patients with colorectal cancer. For random samples of patients identified using our algorithms, case ascertainment was performed using chart review as the gold standard. The positive predictive value (PPV) was calculated to evaluate the accuracy of the algorithms. RESULTS Of 249 random samples of patients identified as having colorectal cancer by our coding algorithms, 215 were confirmed cases, yielding a PPV of 86.3% (95% confidence interval [CI], 81.5-90.1%). When the diagnostic codes were restricted to site-specific (right colon, left colon, transverse colon, or rectum) cancer codes, 94 of the 100 random samples were true cases of colorectal cancer. Consequently, the PPV increased to 94.0% (95% CI, 87.2-97.4%). CONCLUSION Our diagnostic coding algorithms based on ICD-10 codes and Japanese disease codes were highly accurate in detecting patients with colorectal cancer from this hospital's claims data. The exclusive use of site-specific cancer codes further improved the PPV from 86.3 to 94.0%, suggesting their desirability in identifying these patients more precisely.
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Affiliation(s)
- Takahiro Hirano
- Clinical Study Support, Inc., Daiei Bldg., 2F, 1-11-20 Nishiki, Naka-ku, Nagoya, 460-0003, Japan.
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan.
| | - Makiko Negishi
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Shin Nippon Biomedical Laboratories, Ltd., Tokyo, Japan
| | - Yoshiki Kuwatsuru
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Masafumi Arai
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryozo Wakabayashi
- Clinical Study Support, Inc., Daiei Bldg., 2F, 1-11-20 Nishiki, Naka-ku, Nagoya, 460-0003, Japan
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Naoko Saito
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryohei Kuwatsuru
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
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Chung MK, Lee CH, Park JS, Lim H, Lee J. Burden of comorbidities and medication use in childbearing women with rheumatic diseases: a nationwide population-based study. Korean J Intern Med 2022; 37:1250-1259. [PMID: 34233434 PMCID: PMC9666261 DOI: 10.3904/kjim.2021.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS We aimed to estimate the prevalence of comorbidities and medication use in Korean women with rheumatic diseases (RDs) during their childbearing years. METHODS We included women aged 20 to 44 years with seropositive rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS) (n = 41,547) and age-matched women without seropositive RA, SLE, and AS (n = 208,941) from the National Health Insurance Service-National Health Information Database (2009 to 2016). The prevalence of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), and cancer and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CSs), and disease-modifying anti-rheumatic drugs (DMARDs) were estimated. RESULTS Women of childbearing age with RDs were more likely to have at least one of the measured comorbidities than the controls (odds ratio [OR], 3.0; 95% confidence interval [CI], 2.9 to 3.1). The OR (95% CI) was 2.9 (2.8 to 3.0) for HTN, 2.8 (2.7 to 2.9) for HLD, 1.4 (1.4 to 1.5) for DM, and 1.3 (1.3 to 1.4) for cancer. The SLE group had the highest prevalence and odds of all four measured comorbidities. Almost all (97.9%) women of childbearing age with RDs were taking RD-related medications (NSAIDs, 81.6%; CSs, 77.8%; DMARDs, 87.3%). The RD group was 13.8 times more likely to take NSAIDs and 68.2 times more likely to take CSs than the controls. Use of NSAIDs was more prevalent in RA and AS than SLE, whereas use of CSs and DMARDs was more prevalent in RA and SLE than AS. CONCLUSION Korean women with RDs have a greater burden of comorbidities and medication use during their childbearing years than women without RDs of the same age.
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Affiliation(s)
- Min Kyung Chung
- Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul,
Korea
| | - Chan Hee Lee
- Division of Rheumatology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Jin Su Park
- Division of Rheumatology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Hyunsun Lim
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Jisoo Lee
- Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul,
Korea
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Jung SW, Lee H, Cha JM. Risk of malignancy in kidney transplant recipients: a nationwide population-based cohort study. BMC Nephrol 2022; 23:160. [PMID: 35484531 PMCID: PMC9047256 DOI: 10.1186/s12882-022-02796-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Post-transplant malignancy is major morbidity complicated in kidney transplantation (KT). In Korea, a few studies have investigated the sex- and age-dependent risk for post-transplant malignancy among KT recipients on a large scale. Methods We utilized a national health insurance database in Korea to investigate the relative risk of post-transplant malignancy in 12,634 KT recipients between 2007 and 2017. The same number of patients with acute appendicitis was included as a control group. The relative risk of malignancy was estimated using a multivariable-adjusted Cox model, and interaction analysis was performed to investigate age- and sex-predominant patterns. Results KT recipients had an overall 1.8-fold higher risk for post-transplant malignancy with an increased risk for 14 of 29 cancer types, among which Kaposi’s sarcoma, non-Hodgkin’s lymphoma, kidney, uterus, and bladder/urinary tract cancers were most prominent. Although the overall risk for post-transplant malignancy was similar between male and female KT recipients, head and neck cancer had a higher risk among male KT recipients, whereas non-Hodgkin’s lymphoma and bladder/urinary tract cancer had a higher risk among female KT recipients. Overall, the young (< 50 years) KT recipients had a higher risk for post-transplant malignancy than older ones (≥ 50 years), whose pattern was most prominent in non-Hodgkin’s lymphoma. In contrast, breast and nonmelanoma skin cancer showed a higher risk among older KT recipients. Conclusion KT recipients had an increased risk for a wide range of cancer types, some of which showed differential risk patterns with age and sex. Our result suggests that focused screening for predominant post-transplant malignancies may be an effective strategy for selected KT recipients. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02796-6.
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Affiliation(s)
- Su Woong Jung
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Hyemi Lee
- Department of Bigdata and Bioinformatics, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jae Myung Cha
- Department of Bigdata and Bioinformatics, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
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Kim M, Kim H, Park S, Joo J, Kim IJ, Kim BH. Risk factors for second primary malignancies following thyroid cancer: a nationwide cohort study. Eur J Endocrinol 2022; 186:561-571. [PMID: 35286279 DOI: 10.1530/eje-21-1208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/14/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Thyroid cancer survivors have a high risk of second primary malignancies (SPMs). We aimed to evaluate the site-specific incidence, prognosis, and risk factors for metachronous SPMs following thyroid cancer. DESIGN A nationwide cohort study. METHODS This study included data from the Korea National Health Insurance Service (between 2002 and 2018). Exposure to diagnostic radiation was defined by the number of computed tomography (CT) and positron emission tomography-CT scans after the index date. A cumulative radioactive iodine (RAI) dose >100 mCi was considered high-dose RAI. RESULTS During the median 6 years of follow-up, among 291 640 patients, 13 083 (4.5%) developed SPMs. Thyroid cancer survivors had a 26% increased risk of SPMs compared with the general population (standardized incidence ratio: 1.26; 95% CI: 1.22-1.29). Furthermore, those with SPMs had a significantly poorer survival rate than those without SPMs (hazard ratio: 11.85; 95% CI: 11.21-12.54; P < 0.001). Significantly elevated risks were observed in myeloid leukemia and 13 solid cancer sites: lip, salivary gland, small intestine, larynx, lung, mediastinum and pleura, mesothelium, breast, corpus uteri, ovary, prostate, kidney, and bladder. Frequent diagnostic medical radiation exposure and high-dose RAI therapy were independent risk factors for several SPMs, including the cancer of salivary gland, lung, mediastinum and pleura, breast, kidney, and bladder, as well as myeloid leukemia. CONCLUSIONS Frequent diagnostic radiation exposure and high-dose RAI therapy are independent risk factors for SPM following thyroid cancer. Clinicians need to consider minimizing unnecessary diagnostic radiation exposure and administering a high dose RAI only when justified in patients with thyroid cancer.
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Affiliation(s)
- Mijin Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyereen Kim
- Hyereen Kim's Internal Medicine Clinic, Yangsan, Korea
| | - Sojeong Park
- Data Science Team, Hanmi Pharmaceuticals Co., Ltd., Seoul, Korea
| | - Jaeeun Joo
- Data Science Team, Hanmi Pharmaceuticals Co., Ltd., Seoul, Korea
| | - In Ju Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Kim HM, Kim JH, Lee JK, Kang DR, Kim H, Kim SY, Kim HS. Age- and sex-specific risk of colorectal cancer in incident ulcerative colitis during the first 10 years after diagnosis: a nationwide population-based study. Scand J Gastroenterol 2021; 56:1279-1285. [PMID: 34376117 DOI: 10.1080/00365521.2021.1958370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We assessed the risk of colorectal cancer (CRC) in patients with ulcerative colitis (UC) using the nationwide population-based claims data. MATERIALS AND METHODS We analyzed the claims data of the Korean National Health Insurance (2006-2015). UC and CRC were defined using ICD-10 codes and UC-specific prescriptions in this study. Age- and sex-matched individuals without UC were randomly selected from the general population. Hazard ratios (HRs), adjusted for different covariates, were calculated using multivariate Cox proportional hazard regression. RESULTS In total, 30,546 and 88,829 individuals with and without UC, respectively, were enrolled. CRC developed in 85 (0.27%) among UC, and 340 (0.38%) among individuals without UC, respectively. The HR (95% confidence interval [CI]) of CRC in all UC patients was 0.74 (0.58-0.94). Further, UC patients were stratified according to sex (male vs. female: 0.60 [0.44-0.82] vs. 1.10 [0.75-1.61]) and age (HR = 14.37, 2.74, 0.58, and 0.70 for 0-19, 20-39, 40-59, and ≥60 years, respectively). HR was significantly higher for late-onset UC (≥60 years) than for early-onset UC (0-19 years). The long duration of 5-aminosalicylic acid use had a significantly low HR, with reference to the 1st quartile. CONCLUSIONS The risk of CRC varies with age and sex in Korean patients with UC during the first decade after diagnosis. Early-onset UC (<40 years) increases the CRC risk.
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Affiliation(s)
- Hee Man Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji Hoon Kim
- Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Kuk Lee
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyunil Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Su Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Kim H, Kim JH, Lee JK, Kang DR, Kim SY, Kim HS, Kim HM. Incident Crohn's Disease as a Risk Factor for Colorectal Cancer in the First 10 Years after Diagnosis: A Nationwide Population-Based Study. J Clin Med 2021; 10:4663. [PMID: 34682786 PMCID: PMC8539860 DOI: 10.3390/jcm10204663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
We investigated the risk of colorectal cancer (CRC) in patients with Crohn's disease (CD) using the claims data of the Korean National Health Insurance during 2006-2015. The data of 13,739 and 40,495 individuals with and without CD, respectively, were analyzed. Hazard ratios (HRs) were calculated using multivariate Cox proportional hazard regression tests. CRC developed in 25 patients (0.18%) and 42 patients (0.1%) of the CD and non-CD groups, respectively. The HR of CRC in the CD group was 2.07 (95% confidence interval (CI), 1.25-3.41). The HRs of CRC among men and women were 2.02 (95% CI 1.06-3.87) and 2.10 (95% CI, 0.96-4.62), respectively. The HRs of CRC in the age groups 0-19, 20-39, 40-59, and ≥60 years were 0.07, 4.86, 2.32, and 0.66, respectively. The HR of patients with late-onset CD (≥40 years) was significantly higher than that of those with early-onset CD (<40 years). CD patients were highly likely to develop CRC. Early-onset CD patients were significantly associated with an increased risk of CRC than matched individuals without CD. However, among CD patients, late-onset CD was significantly associated with an increased risk of CRC.
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Affiliation(s)
- Hyunil Kim
- Department of Internal Medicine, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (H.K.); (S.Y.K.)
| | - Ji Hoon Kim
- Department of Medicine, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea;
| | - Jung Kuk Lee
- Center of Biomedical Data Science, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (J.K.L.); (D.R.K.)
| | - Dae Ryong Kang
- Center of Biomedical Data Science, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (J.K.L.); (D.R.K.)
| | - Su Young Kim
- Department of Internal Medicine, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (H.K.); (S.Y.K.)
| | - Hyun-Soo Kim
- Department of Internal Medicine, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (H.K.); (S.Y.K.)
| | - Hee Man Kim
- Department of Internal Medicine, College of Medicine, Yonsei University Wonju, Wonju 26426, Korea; (H.K.); (S.Y.K.)
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Fasting Plasma Glucose Variability and Gastric Cancer Risk in Individuals Without Diabetes Mellitus: A Nationwide Population-Based Cohort Study. Clin Transl Gastroenterol 2021; 11:e00221. [PMID: 32858572 PMCID: PMC7455226 DOI: 10.14309/ctg.0000000000000221] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Long-term glycemic variability is associated with various adverse health outcomes in patients with diabetes mellitus (DM). However, the relationship between glycemic variability and gastric cancer remains unclear. We aimed to investigate the association between glycemic variability and gastric cancer incidence in individuals without DM.
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Sehgal M, Ladabaum U, Mithal A, Singh H, Desai M, Singh G. Colorectal Cancer Incidence After Colonoscopy at Ages 45-49 or 50-54 Years. Gastroenterology 2021; 160:2018-2028.e13. [PMID: 33577872 DOI: 10.1053/j.gastro.2021.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Colorectal cancer (CRC) incidence at ages younger than 50 years is increasing, leading to proposals to lower the CRC screening initiation age to 45 years. Data on the effectiveness of CRC screening at ages 45-49 years are lacking. METHODS We studied the association between undergoing colonoscopy at ages 45-49 or 50-54 years and CRC incidence in a retrospective population-based cohort study using Florida's linked Healthcare Cost and Utilization Project databases with mandated reporting from 2005 to 2017 and Cox models extended for time-varying exposure. RESULTS Among 195,600 persons with and 2.6 million without exposure to colonoscopy at ages 45-49 years, 276 and 4844 developed CRC, resulting in CRC incidence rates of 20.8 (95% CI, 18.5-23.4) and 30.6 (95% CI, 29.8-31.5) per 100,000 person-years, respectively. Among 660,248 persons with and 2.4 million without exposure to colonoscopy at ages 50-54 years, 798 and 6757 developed CRC, resulting in CRC incidence rates of 19.0 (95% CI, 17.7-20.4) and 51.9 (95% CI, 50.7-53.1) per 100,000 person-years, respectively. The adjusted hazard ratios for incident CRC after undergoing compared with not undergoing colonoscopy were 0.50 (95% CI, 0.44-0.56) at ages 45-49 years and 0.32 (95% CI, 0.29-0.34) at ages 50-54 years. The results were similar for women and men (hazard ratio, 0.48; 95% CI, 0.40-0.57 and hazard ratio, 0.52; 95% CI, 0.43-0.62 at ages 45-49 years, and hazard ratio, 0.35; 95% CI, 0.31-0.39 and hazard ratio, 0.29; 95% CI, 0.26-0.32 at ages 50-54 years, respectively). CONCLUSIONS Colonoscopy at ages 45-49 or 50-54 years was associated with substantial decreases in subsequent CRC incidence. These findings can inform screening guidelines.
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Affiliation(s)
| | - Uri Ladabaum
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California.
| | - Alka Mithal
- Institute of Clinical Outcomes Research and Education, Woodside, California
| | - Harminder Singh
- Section of Gastroenterology, University of Manitoba, Winnipeg, Canada
| | - Manisha Desai
- Division of Bioinformatics Research, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Gurkirpal Singh
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California; Institute of Clinical Outcomes Research and Education, Woodside, California
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Kim SY, Kim HS, Kim YT, Lee JK, Park HJ, Kim HM, Kang DR. Colonoscopy Versus Fecal Immunochemical Test for Reducing Colorectal Cancer Risk: A Population-Based Case-Control Study. Clin Transl Gastroenterol 2021; 12:e00350. [PMID: 33928919 PMCID: PMC8088829 DOI: 10.14309/ctg.0000000000000350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 03/12/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Use of colonoscopy or the fecal immunochemical test (FIT) for colorectal cancer (CRC) prevention is supported by previous studies. However, there is little specific evidence regarding comparative effectiveness of colonoscopy or FIT for reducing CRC risk. In this study, we compared the association of CRC risk with colonoscopy and FIT using a nationwide database. METHODS This population-based case-control study used colonoscopy and FIT claims data from the Korean National Health Insurance System from 2002 to 2013. Data were analyzed from 61,221 patients with newly diagnosed CRC (case group) and 306,099 individuals without CRC (control group). Multivariable logistic regression models were used to evaluate the association between CRC and colonoscopy or FIT. RESULTS Colonoscopy was associated with a reduced subsequent CRC risk (adjusted odds ratio [OR] 0.29). Stronger associations were found between colonoscopy and distal CRC, compared with proximal CRC (0.24 vs 0.47). In an analysis stratified by sex, the association was weaker in female subjects compared with male subjects (0.33 vs 0.27). Any FIT exposure was associated with CRC risk with an OR of 0.74; this association was stronger for distal cancer. As the frequency of cumulative FIT assessments increased (from 1 to ≥5), the OR of FIT exposure for CRC gradually decreased from 0.81 to 0.45. DISCUSSION The association of colonoscopy or FIT with reduced CRC risk was stronger for distal CRC than for proximal CRC. FIT showed less CRC risk reduction than colonoscopy. However, as the frequency of cumulative FIT assessments increased, the association with CRC prevention became stronger.
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Affiliation(s)
- Su Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yun Tae Kim
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Kuk Lee
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hong Jun Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hee Man Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryoung Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
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Kim M, Kim B, Choi YJ, Lee HJ, Lee H, Park JB, Lee SP, Han KD, Kim YJ, Kim HK. Sex differences in the prognosis of patients with hypertrophic cardiomyopathy. Sci Rep 2021; 11:4854. [PMID: 33649405 PMCID: PMC7921653 DOI: 10.1038/s41598-021-84335-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/10/2021] [Indexed: 12/11/2022] Open
Abstract
We investigated sex-related differences in the prognosis of patients with hypertrophic cardiomyopathy (HCM) using the Korea National Health Insurance Service database. From 2010 to 2016, 9524 patients diagnosed with HCM and had more than 1-year follow-up period were analyzed. The primary endpoint was the composite of cardiovascular death or new-onset heart failure (HF) admission. Propensity score-matching analysis was performed to adjust for different baseline characteristics. With a 4.4-years’ median follow-up interval (range 2.0–6.6 years) and male predominance (77.6%), women with HCM were older (52.6 ± 9.7 vs. 51.4 ± 9.1, p < 0.001), had lower incomes, more comorbidities based on Charlson comorbidity index. Women with HCM had a higher incidence of the primary endpoint than men (incidence rate: 34.15 vs. 22.83 per 1000 person-years, log-rank p < 0.001). Multivariable Cox analysis showed that female sex was a poor prognostic factor for the primary endpoint (HR 1.43, 95% CI 1.24–1.64, p < 0.001). This was mainly driven by a higher incidence of new-onset HF admission (HR 1.55, 95% CI 1.34–1.80). However, there was no difference in the incidence of cardiovascular death between the sexes. This result was concordant in the propensity score-matched cohort. In conclusion, women with HCM have worse prognosis, which was mainly driven by a higher new-onset HF admission.
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Affiliation(s)
- Minkwan Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.,Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Bongsung Kim
- Department of Statistics and Actuarial Science, The Soongsil University, Seoul, Republic of Korea
| | - You-Jung Choi
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun-Jung Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Heesun Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jun-Bean Park
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Pyo Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, The Soongsil University, Seoul, Republic of Korea
| | - Yong-Jin Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyung-Kwan Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
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Diagnostic accuracy of administrative database for bile duct cancer by ICD-10 code in a tertiary institute in Korea. Hepatobiliary Pancreat Dis Int 2020; 19:575-580. [PMID: 32249128 DOI: 10.1016/j.hbpd.2020.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 03/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Administrative database provides valuable information for large cohort studies, especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer (BDC). The aim of this study was to evaluate the diagnostic accuracy of administrative database for BDC by International Classification of Diseases (ICD)-10 codes in a tertiary institute. METHODS BDC and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of BDC were identified in the National Health Insurance Service (NHIS) database by ICD 10-code supported by V code. The control group was selected from cases without ICD-10 codes for BDC. A definite or possible diagnosis was defined according to pathologic reports. Medical records, images, and pathology reports were analyzed to evaluate ICD-10 codes for BDC. Sensitivity, specificity, positive predictive value, and negative predictive value for BDC were analyzed according to diagnostic criteria and cancer locations. RESULTS A total of 1707 patients with BDC and 1707 controls were collected. Among those with BDC, 1320 (77.3%) were diagnosed by definite criteria. Most (99.4%) of them had adenocarcinoma. Rate of definite diagnosis was the highest for ampulla of Vater (88.9%), followed by that for extrahepatic (84.9%) and intrahepatic (68.3%) BDCs. False positive cases commonly had hepatocellular carcinomas. For overall diagnosis of BDC, sensitivity, specificity, positive predictive value, and negative predictive value were 99.94%, 98.33%, 98.30%, and 99.94%, respectively. Diagnostic accuracies were similar regardless of diagnostic criteria or tumor locations. CONCLUSIONS Administrative database for BDC collected according to ICD-10 code with V code shows good accuracy.
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Effect of Helicobacter pylori eradication after subtotal gastrectomy on the survival rate of patients with gastric cancer: follow-up for up to 15 years. Gastric Cancer 2020; 23:1051-1063. [PMID: 32361784 DOI: 10.1007/s10120-020-01076-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Helicobacter pylori (HP) is known to play an important role in the development of gastric cancer (GC). The aim of this study was to analyze the effect of HP eradication on the survival rate and cancer recurrence in patients who underwent subtotal gastrectomy for GC. DESIGN Totally 1,031 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital from 2003 to 2017 and positive for HP infection were analyzed. The overall and GC-related survival according to HP eradication were compared; risk factors for GC-specific death and cancer recurrence were analyzed, and propensity score matching (PSM) was performed. RESULTS Statistically significant benefits of overall and GC-specific survival were observed in the eradicated group compared to the non-eradicated group (P < 0.001), and these benefits were maintained after PSM (P < 0.001) in both of early and advance stage. In Cox proportional hazards multivariate analyses, cancer stage (stage II, adjusted hazard ratio [aHR] = 9.33, P < 0.001; stage III or IV, aHR = 26.17, P < 0.001), and HP positivity (aHR = 3.41, P = 0.001) were independent risk factors for GC-specific death; cancer stage (cancer stage II, aHR = 7.08, P < 0.001; cancer stage III or IV, aHR = 19.64, P < 0.001) and HP positivity (aHR = 2.70; P = 0.005) were independent risk factors for cancer recurrence. CONCLUSION Our results suggest that HP needed to be conducted more intensively in patients who are surgically treated for GC, regardless of cancer stage.
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Hwang YJ, Park SM, Ahn S, Lee JC, Park YS, Kim N. Accuracy of an administrative database for pancreatic cancer by international classification of disease 10 th codes: A retrospective large-cohort study. World J Gastroenterol 2019; 25:5619-5629. [PMID: 31602162 PMCID: PMC6785515 DOI: 10.3748/wjg.v25.i37.5619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/03/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Korean National Health Insurance (NHI) claims database provides large-cohort. However, studies regarding accuracy of administrative database for pancreatic cancer (PC) have not been reported. We aimed to identify accuracy of NHI database regarding PC classified by international classification of disease (ICD)-10 codes.
AIM To identify the accuracy and usefulness of administrative database in PC and the accurate ICD codes for PC with location.
METHODS Study and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of PC were identified in NHI database by international classification of diseases, 10th revision edition (ICD-10 codes) supported with V codes. V code is issued by medical doctors for covering 95% of medical cost by Korean government. According to pathologic reports, definite or possible diagnoses were defined using medical records, images, and pathology.
RESULTS A total of 1846 cases with PC and controls were collected. Among PC, only 410 (22.2%) cases were identified as specific cancer sites including head in 234 (12.7%) cases, tail in 104 (5.6%) cases and body in 72 (3.9%) cases. Among PC, 910 (49.3%) cases were diagnosed by definite criteria. Most of these were adenocarcinoma (98.0%). The rates of definite diagnosis of PC were highest in head (70.1%) followed by body (47.2%) and tail (43.3%). False-positive cases were pancreatic cystic neoplasm and metastasis to the pancreas. In terms of the overall diagnosis of PC, sensitivity, specificity, positive predictive value, and negative predictive value were 99.95%, 98.72%, 98.70%, and 99.95%, respectively. Diagnostic accuracy was similar both in terms of diagnostic criteria and tumor locations.
CONCLUSION Korean NHI claims database collected according to ICD-10 code with V code for PC showed good accuracy.
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Affiliation(s)
- Young-Jae Hwang
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju 28644, South Korea
| | - Soomin Ahn
- Departments of Pathology, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
| | - Jong-Chan Lee
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
| | - Young Soo Park
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
| | - Nayoung Kim
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
- Department of Internal Medicine and Institute of Liver Research and Tumor Microenvironment Global Core Research Center, Seoul National University College of Medicine, Seoul 08826, South Korea
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