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Gao YN, Coombes B, Ryu E, Pazdernik V, Jenkins G, Pendegraft R, Biernacka J, Olfson M. Phenotypic distinctions in depression and anxiety: a comparative analysis of comorbid and isolated cases. Psychol Med 2023; 53:7766-7774. [PMID: 37403468 DOI: 10.1017/s0033291723001745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND Anxiety and depression are frequently comorbid yet phenotypically distinct. This study identifies differences in the clinically observable phenome across a wide variety of physical and mental disorders comparing patients with diagnoses of depression without anxiety, anxiety without depression, or both depression and anxiety. METHODS Using electronic health records for 14 994 participants with depression and/or anxiety in the Mayo Clinic Biobank, a phenotype-based phenome-wide association study (Phe2WAS) was performed to test for differences between these groups across a broad range of clinical diagnoses observed in the electronic health record. Additional analyses were performed to determine the temporal sequencing of diagnoses. RESULTS Compared to patients diagnosed only with anxiety, those diagnosed only with depression were more likely to have diagnoses of obesity (OR 1.75; p = 1 × 10-27), sleep apnea (OR 1.71; p = 1 × 10-22), and type II diabetes (OR 1.74; p = 9 × 10-18). Compared to those diagnosed only with depression, those diagnosed only with anxiety were more likely to have diagnoses of palpitations (OR 1.91; p = 2 × 10-25), benign skin neoplasms (OR 1.61; p = 2 × 10-17), and cardiac dysrhythmias (OR 1.45; p = 2 × 10-12). Patients with comorbid depression and anxiety were more likely to have diagnoses of other mental health disorders, substance use disorders, sleep problems, and gastroesophageal reflux relative to isolated depression. CONCLUSIONS While depression and anxiety are closely related, this study suggests that phenotypic distinctions exist between depression and anxiety. Improving phenotypic characterization within the broad categories of depression and anxiety could improve the clinical assessment of depression and anxiety.
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Affiliation(s)
- Y Nina Gao
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Brandon Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Pazdernik
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Gregory Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Richard Pendegraft
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Joanna Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark Olfson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
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2
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Coombes BJ, Landi I, Choi KW, Singh K, Fennessy B, Jenkins GD, Batzler A, Pendegraft R, Nunez NA, Gao YN, Ryu E, Wickramaratne P, Weissman MM, Pathak J, Mann JJ, Smoller JW, Davis LK, Olfson M, Charney AW, Biernacka JM. The genetic contribution to the comorbidity of depression and anxiety: a multi-site electronic health records study of almost 178 000 people. Psychol Med 2023; 53:7368-7374. [PMID: 38078748 PMCID: PMC10719682 DOI: 10.1017/s0033291723000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Depression and anxiety are common and highly comorbid, and their comorbidity is associated with poorer outcomes posing clinical and public health concerns. We evaluated the polygenic contribution to comorbid depression and anxiety, and to each in isolation. METHODS Diagnostic codes were extracted from electronic health records for four biobanks [N = 177 865 including 138 632 European (77.9%), 25 612 African (14.4%), and 13 621 Hispanic (7.7%) ancestry participants]. The outcome was a four-level variable representing the depression/anxiety diagnosis group: neither, depression-only, anxiety-only, and comorbid. Multinomial regression was used to test for association of depression and anxiety polygenic risk scores (PRSs) with the outcome while adjusting for principal components of ancestry. RESULTS In total, 132 960 patients had neither diagnosis (74.8%), 16 092 depression-only (9.0%), 13 098 anxiety-only (7.4%), and 16 584 comorbid (9.3%). In the European meta-analysis across biobanks, both PRSs were higher in each diagnosis group compared to controls. Notably, depression-PRS (OR 1.20 per s.d. increase in PRS; 95% CI 1.18-1.23) and anxiety-PRS (OR 1.07; 95% CI 1.05-1.09) had the largest effect when the comorbid group was compared with controls. Furthermore, the depression-PRS was significantly higher in the comorbid group than the depression-only group (OR 1.09; 95% CI 1.06-1.12) and the anxiety-only group (OR 1.15; 95% CI 1.11-1.19) and was significantly higher in the depression-only group than the anxiety-only group (OR 1.06; 95% CI 1.02-1.09), showing a genetic risk gradient across the conditions and the comorbidity. CONCLUSIONS This study suggests that depression and anxiety have partially independent genetic liabilities and the genetic vulnerabilities to depression and anxiety make distinct contributions to comorbid depression and anxiety.
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Affiliation(s)
- Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Isotta Landi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karmel W Choi
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kritika Singh
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brian Fennessy
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Greg D Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Richard Pendegraft
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Y Nina Gao
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Priya Wickramaratne
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | | | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York, USA
| | - J John Mann
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Jordan W Smoller
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Lea K Davis
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark Olfson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
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Ryu E, Wi CI, Wheeler PH, King KS, Carlson RE, Juhn YJ, Takahashi PY. The Role of Individual-Level Socioeconomic Status on Nursing Home Placement Accounting for Neighborhood Characteristics. J Am Med Dir Assoc 2023; 24:1048-1053.e2. [PMID: 36841262 PMCID: PMC10962058 DOI: 10.1016/j.jamda.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Independent living is desirable for many older adults. Although several factors such as physical and cognitive functions are important predictors for nursing home placement (NHP), it is also reported that socioeconomic status (SES) affects the risk of NHP. In this study, we aimed to examine whether an individual-level measure of SES is associated with the risk of NHP after accounting for neighborhood characteristics. DESIGN A population-based study (Olmsted County, Minnesota, USA). SETTING AND PARTICIPANTS Older adults (age 65+ years) with no prior history of NHP. METHODS Electronic health records (EHR) were used to identify individuals with any NHP between April 1, 2012 (baseline date) and April 30, 2019. Association between the (HOUsing-based index of SocioEconomic Status (HOUSES) index, an individual-level SES measure based on housing characteristics of current residence, and risk of NHP was tested using random effects Cox proportional hazard model adjusting for area deprivation index (ADI), an aggregated SES measure that captures neighborhood characteristics, and other pertinent confounders such as age and chronic disease burden. RESULTS Among 15,031 older adults, 3341 (22.2%) experienced NHP during follow-up period (median: 7.1 years). At baseline date, median age was 73 years old with 55% female persons, 91% non-Hispanic Whites, and median number of chronic conditions of 4. Accounting for pertinent confounders, the HOUSES index was strongly associated with risk of NHP (hazard ratio 1.89; 95% confidence interval 1.66‒2.15 for comparing the lowest vs highest quartiles), which was not influenced by further accounting for ADI. CONCLUSIONS AND IMPLICATIONS This study demonstrates that an individual-level SES measure capturing current individual-specific socioeconomic circumstances plays a significant role for predicting NHP independent of neighborhood characteristics where they reside. This study suggests that older adults who are at higher risk of NHP can be identified by utilizing the HOUSES index and potential individual-level intervention strategies can be applied to reduce the risk for those with higher risk.
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Affiliation(s)
- Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Philip H Wheeler
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Katherine S King
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Rachel E Carlson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Young J Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Paul Y Takahashi
- Division of Primary Care and Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Bielinski SJ, Yanes Cardozo LL, Takahashi PY, Larson NB, Castillo A, Podwika A, De Filippis E, Hernandez V, Mahajan GJ, Gonzalez C, Shubhangi, Decker PA, Killian JM, Olson JE, St. Sauver JL, Shah P, Vella A, Ryu E, Liu H, Marshall GD, Cerhan JR, Singh D, Summers RL. Predictors of Metformin Failure: Repurposing Electronic Health Record Data to Identify High-Risk Patients. J Clin Endocrinol Metab 2023; 108:1740-1746. [PMID: 36617249 PMCID: PMC10271218 DOI: 10.1210/clinem/dgac759] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
CONTEXT Metformin is the first-line drug for treating diabetes but has a high failure rate. OBJECTIVE To identify demographic and clinical factors available in the electronic health record (EHR) that predict metformin failure. METHODS A cohort of patients with at least 1 abnormal diabetes screening test that initiated metformin was identified at 3 sites (Arizona, Mississippi, and Minnesota). We identified 22 047 metformin initiators (48% female, mean age of 57 ± 14 years) including 2141 African Americans, 440 Asians, 962 Other/Multiracial, 1539 Hispanics, and 16 764 non-Hispanic White people. We defined metformin failure as either the lack of a target glycated hemoglobin (HbA1c) (<7%) within 18 months of index or the start of dual therapy. We used tree-based extreme gradient boosting (XGBoost) models to assess overall risk prediction performance and relative contribution of individual factors when using EHR data for risk of metformin failure. RESULTS In this large diverse population, we observed a high rate of metformin failure (43%). The XGBoost model that included baseline HbA1c, age, sex, and race/ethnicity corresponded to high discrimination performance (C-index of 0.731; 95% CI 0.722, 0.740) for risk of metformin failure. Baseline HbA1c corresponded to the largest feature performance with higher levels associated with metformin failure. The addition of other clinical factors improved model performance (0.745; 95% CI 0.737, 0.754, P < .0001). CONCLUSION Baseline HbA1c was the strongest predictor of metformin failure and additional factors substantially improved performance suggesting that routinely available clinical data could be used to identify patients at high risk of metformin failure who might benefit from closer monitoring and earlier treatment intensification.
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Affiliation(s)
- Suzette J Bielinski
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Licy L Yanes Cardozo
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Paul Y Takahashi
- Division of Community Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Nicholas B Larson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Alexandra Castillo
- Center for Informatics and Analytics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | | | - Eleanna De Filippis
- Division of Endocrinology, Diabetes, and Metabolism Department of Medicine, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
| | | | - Gouri J Mahajan
- UMMC Biobank-School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | | | - Shubhangi
- Mountain Park Health Center, Phoenix, AZ 85012, USA
| | - Paul A Decker
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Jill M Killian
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Janet E Olson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer L St. Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, USA
| | - Pankaj Shah
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Adrian Vella
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Euijung Ryu
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Hongfang Liu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Gailen D Marshall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - James R Cerhan
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Richard L Summers
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Ryu E, Jenkins GD, Wang Y, Olfson M, Talati A, Lepow L, Coombes BJ, Charney AW, Glicksberg BS, Mann JJ, Weissman MM, Wickramaratne P, Pathak J, Biernacka JM. The importance of social activity to risk of major depression in older adults. Psychol Med 2023; 53:2634-2642. [PMID: 34763736 PMCID: PMC9095757 DOI: 10.1017/s0033291721004566] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Several social determinants of health (SDoH) have been associated with the onset of major depressive disorder (MDD). However, prior studies largely focused on individual SDoH and thus less is known about the relative importance (RI) of SDoH variables, especially in older adults. Given that risk factors for MDD may differ across the lifespan, we aimed to identify the SDoH that was most strongly related to newly diagnosed MDD in a cohort of older adults. METHODS We used self-reported health-related survey data from 41 174 older adults (50-89 years, median age = 67 years) who participated in the Mayo Clinic Biobank, and linked ICD codes for MDD in the participants' electronic health records. Participants with a history of clinically documented or self-reported MDD prior to survey completion were excluded from analysis (N = 10 938, 27%). We used Cox proportional hazards models with a gradient boosting machine approach to quantify the RI of 30 pre-selected SDoH variables on the risk of future MDD diagnosis. RESULTS Following biobank enrollment, 2073 older participants were diagnosed with MDD during the follow-up period (median duration = 6.7 years). The most influential SDoH was perceived level of social activity (RI = 0.17). Lower level of social activity was associated with a higher risk of MDD [hazard ratio = 2.27 (95% CI 2.00-2.50) for highest v. lowest level]. CONCLUSION Across a range of SDoH variables, perceived level of social activity is most strongly related to MDD in older adults. Monitoring changes in the level of social activity may help identify older adults at an increased risk of MDD.
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Affiliation(s)
- Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Gregory D. Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Yanshan Wang
- Department of AI and Informatics, Mayo Clinic, Rochester, USA
| | - Mark Olfson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Lauren Lepow
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Brandon J. Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Alexander W. Charney
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Benjamin S. Glicksberg
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, USA
| | - J. John Mann
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Myrna M. Weissman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | - Priya Wickramaratne
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA
| | | | - Joanna M. Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, USA
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Adekkanattu P, Olfson M, Susser LC, Patra B, Vekaria V, Coombes BJ, Lepow L, Fennessy B, Charney A, Ryu E, Miller KD, Pan L, Yangchen T, Talati A, Wickramaratne P, Weissman M, Mann J, Biernacka JM, Pathak J. Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records. J Affect Disord 2023; 324:102-113. [PMID: 36529406 PMCID: PMC10327872 DOI: 10.1016/j.jad.2022.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/09/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Medical comorbidity and healthcare utilization in patients with treatment resistant depression (TRD) is usually reported in convenience samples, making estimates unreliable. There is only limited large-scale clinical research on comorbidities and healthcare utilization in TRD patients. METHODS Electronic Health Record data from over 3.3 million patients from the INSIGHT Clinical Research Network in New York City was used to define TRD as initiation of a third antidepressant regimen in a 12-month period among patients diagnosed with major depressive disorder (MDD). Age and sex matched TRD and non-TRD MDD patients were compared for anxiety disorder, 27 comorbid medical conditions, and healthcare utilization. RESULTS Out of 30,218 individuals diagnosed with MDD, 15.2 % of patients met the criteria for TRD (n = 4605). Compared to MDD patients without TRD, the TRD patients had higher rates of anxiety disorder and physical comorbidities. They also had higher odds of ischemic heart disease (OR = 1.38), stroke/transient ischemic attack (OR = 1.57), chronic kidney diseases (OR = 1.53), arthritis (OR = 1.52), hip/pelvic fractures (OR = 2.14), and cancers (OR = 1.41). As compared to non-TRD MDD, TRD patients had higher rates of emergency room visits, and inpatient stays. In relation to patients without MDD, both TRD and non-TRD MDD patients had significantly higher levels of anxiety disorder and physical comorbidities. LIMITATIONS The INSIGHT-CRN data lack information on depression severity and medication adherence. CONCLUSIONS TRD patients compared to non-TRD MDD patients have a substantially higher prevalence of various psychiatric and medical comorbidities and higher health care utilization. These findings highlight the challenges of developing interventions and care coordination strategies to meet the complex clinical needs of TRD patients.
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Affiliation(s)
| | - Mark Olfson
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | | | | | | | | | - Lauren Lepow
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Fennessy
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Lifang Pan
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Tenzin Yangchen
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Ardesheer Talati
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Priya Wickramaratne
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Myrna Weissman
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - John Mann
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
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Juhn Y, Wi CI, Absah I, Choung RS, Goodson R, Bublitz J, King K, Ryu E, Zaniletti I, Murray J. Geocoding and algorithmic approach to identify biological family members of patients with celiac disease in electronic health records. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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8
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Juhn YJ, Wi CI, Takahashi PY, Ryu E, King KS, Hickman JA, Yao JD, Binnicker MJ, Natoli TL, Evans TK, Sampathkumar P, Patten C, Luyts D, Pirçon JY, Damaso S, Pignolo RJ. Incidence of Respiratory Syncytial Virus Infection in Older Adults Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2250634. [PMID: 36662530 PMCID: PMC9860520 DOI: 10.1001/jamanetworkopen.2022.50634] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/20/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Little is known about the burden and outcomes of respiratory syncytial virus (RSV)-positive acute respiratory infection (ARI) in community-dwelling older adults. Objective To assess the incidence of RSV-positive ARI before and during the COVID-19 pandemic, and to assess outcomes for RSV-positive ARI in older adults. Design, Setting, and Participants This was a community-based cohort study of adults residing in southeast Minnesota that followed up with 2325 adults aged 50 years or older for 2 RSV seasons (2019-2021) to assess the incidence of RSV-positive ARI. The study assessed outcomes at 2 to 4 weeks, 6 to 7 months, and 12 to 13 months after RSV-positive ARI. Exposure RSV-positive and -negative ARI. Main Outcomes and Measures RSV status was the main study outcome. Incidence and attack rates of RSV-positive ARI were calculated during each RSV season, including before (October 2019 to April 2020) and during (October 2020 to April 2021) COVID-19 pandemic, and further calculated during non-RSV season (May to September 2021) for assessing impact of COVID-19. The self-reported quality of life (QOL) by Short-Form Health Survey-36 (SF-36) and physical functional measures (eg, 6-minute walk and spirometry) at each time point was assessed. Results In this study of 2325 participants, the median (range) age of study participants was 67 (50-98) years, 1380 (59%) were female, and 2240 (96%) were non-Hispanic White individuals. The prepandemic incidence rate of RSV-positive ARI was 48.6 (95% CI, 36.9-62.9) per 1000 person-years with a 2.50% (95% CI, 1.90%-3.21%) attack rate. No RSV-positive ARI case was identified during the COVID-19 pandemic RSV season. Incidence of 10.2 (95% CI, 4.1-21.1) per 1000 person-years and attack rate of 0.42%; (95% CI, 0.17%-0.86%) were observed during the summer of 2021. Based on prepandemic RSV season results, participants with RSV-positive ARI (vs matched RSV-negative ARI) reported significantly lower QOL adjusted mean difference (limitations due to physical health, -16.7 [95% CI, -31.8 to -1.8]; fatigue, -8.4 [95% CI, -14.3 to -2.4]; and difficulty in social functioning, -11.9 [95% CI, -19.8 to -4.0] within 2 to 4 weeks after RSV-positive ARI [ie, short-term outcome]). Compared with participants with RSV-negative ARI, those with RSV-positive ARI also had lower QOL (fatigue: -4.0 [95% CI, -8.5 to -1.3]; difficulty in social functioning, -5.8 [95% CI, -10.3 to -1.3]; and limitation due to emotional problem, -7.0 [95% CI, -12.7 to -1.3] at 6 to 7 months after RSV-positive ARI [intermediate-term outcome]; fatigue, -4.4 [95% CI, -7.3 to -1.5]; difficulty in social functioning, -5.2 [95% CI, -8.7 to -1.7] and limitation due to emotional problem, -5.7 [95% CI, -10.7 to -0.6] at 12-13 months after RSV-positive ARI [ie, long-term outcomes]) independent of age, sex, race and/or ethnicity, socioeconomic status, and high-risk comorbidities. Conclusions and Relevance In this cohort study, the burden of RSV-positive ARI in older adults during the pre-COVID-19 period was substantial. After a reduction of RSV-positive ARI incidence from October 2020 to April 2021, RSV-positive ARI re-emerged during the summer of 2021. RSV-positive ARI was associated with significant long-term lower QOL beyond the short-term lower QOL in older adults.
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Affiliation(s)
- Young J. Juhn
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Paul Y. Takahashi
- Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Katherine S. King
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Joel A. Hickman
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Joseph D. Yao
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Matthew J. Binnicker
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Traci L. Natoli
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tamara K. Evans
- Department of Medicine Research, Mayo Clinic, Rochester, Minnesota
| | | | - Christi Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Robert J. Pignolo
- Divisions of Hospital Internal Medicine, Endocrinology, and Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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9
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Wi CI, Gent JF, Bublitz JT, King KS, Ryu E, Sorrentino K, Plano J, McKay L, Porcher J, Wheeler PH, Chiarella SE, DeWan AT, Godri Pollitt KJ, Sheares BJ, Leaderer B, Juhn YJ. Paired Indoor and Outdoor Nitrogen Dioxide Associated With Childhood Asthma Outcomes in a Mixed Rural-Urban Setting: A Feasibility Study. J Prim Care Community Health 2023; 14:21501319231173813. [PMID: 37243352 DOI: 10.1177/21501319231173813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Nitrogen dioxide (NO2) is known to be a trigger for asthma exacerbation. However, little is known about the role of seasonal variation in indoor and outdoor NO2 levels in childhood asthma in a mixed rural-urban setting of North America. METHODS This prospective cohort study, as a feasibility study, included 62 families with children (5-17 years) that had diagnosed persistent asthma residing in Olmsted County, Minnesota. Indoor and outdoor NO2 concentrations were measured using passive air samples over 2 weeks in winter and 2 weeks in summer. We assessed seasonal variation in NO2 levels in urban and rural residential areas and the association with asthma control status collected from participants' asthma diaries during the study period. RESULTS Outdoor NO2 levels were lower (median: 2.4 parts per billion (ppb) in summer, 3.9 ppb in winter) than the Environmental Protection Agency (EPA) annual standard (53 ppb). In winter, a higher level of outdoor NO2 was significantly associated with urban residential living area (P = .014) and lower socioeconomic status (SES) (P = .027). For both seasons, indoor NO2 was significantly higher (P < .05) in rural versus urban areas and in homes with gas versus electric stoves (P < .05). Asthma control status was not associated with level of indoor or outdoor NO2 in this cohort. CONCLUSIONS NO2 levels were low in this mixed rural-urban community and not associated with asthma control status in this small feasibility study. Further research with a larger sample size is warranted for defining a lower threshold of NO2 concentration with health effect on asthma in mixed rural-urban settings.
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Affiliation(s)
| | | | | | | | | | | | - Julie Plano
- Yale School of Public Health, New Haven, CT, USA
| | - Lisa McKay
- Yale School of Public Health, New Haven, CT, USA
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10
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Wi CI, King KS, Ryu E, Natoli TL, Miller RP, Spiten MJ, Borah BJ, Takahashi PY, Yao X, Noseworthy PA, Pignolo RJ, Juhn YJ. Application of Innovative Subject Recruitment System for Batch Enrollment: A Pilot Study. J Prim Care Community Health 2023; 14:21501319231194967. [PMID: 37646152 PMCID: PMC10467239 DOI: 10.1177/21501319231194967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Using a digital process that leverages electronic health records (EHRs) can ease many of the challenges presented by the traditional enrollment process for clinical trials. We tested if automated batch enrollment using a technology-enabled subject recruitment system (TESRS) enhances recruitment while preserving representation of research subjects for the study population in our study setting. METHODS An ongoing community-based prospective adult cohort study was used to randomize 600 subjects who were eligible by age and residential address to TESRS (n = 300) and standard mailing method (n = 300), respectively, for 3 months. Then, TESRS was initiated and included automatic identification of patients' preference for being contacted (online patient portal vs postal mail) from EHRs and automatic sending out of invitation letters followed by completion of a short online survey for checking eligibility and the digital consent process if eligible. We compared (1) median time to consent from invitation sent out per subject and total subjects recruited after a 3-month recruitment period, (2) the estimated study staff's time, and (3) representation of sociodemographic characteristics (e.g., age, sex, race, SES measured by HOUSES index, and rural residence) between subjects recruited via TESRS and those via traditional mailing methods. RESULTS Median age of randomized subjects (n = 600) was 63 years with 52.0% female and 89.2% non-Hispanic White. Over a 3-month period, results showed consent rate via TESRS was 13% (39/297) similar to 11% (31/295) via standard mailing. However, recruitment was significantly faster with the TESRS approach (median 7 vs 26 days) given the study staff's effort. Study staff's time saved by using TESRS compared to standard mailing approach was estimated at 40 min per subject (equivalent to 200 h for 300 subjects). No significant differences in characteristics of research subjects from the study population were found. CONCLUSION Our study demonstrated the utility of TESRS as a subject recruitment digital technology which significantly enhanced the recruitment effort while reducing the study staff burden of recruitment while maintaining the consistency of characteristics of recruited subjects. The strategy and support for implementing and testing TESRS in other study settings should be considered.
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Affiliation(s)
- Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
| | - Katherine S. King
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Traci L. Natoli
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
| | - Ryan P. Miller
- Department of Information Technology, Mayo Clinic, Phoenix, AZ, USA
| | - Matthew J. Spiten
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
| | - Bijan J. Borah
- Department of Health Services Research, Mayo Clinic, Rochester, MN, USA
| | - Paul Y. Takahashi
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Xiaoxi Yao
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Robert J. Pignolo
- Department of Medicine, Divisions of Hospital Internal Medicine, Endocrinology, and Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN, USA
| | - Young J. Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
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11
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Wickramaratne PJ, Yangchen T, Lepow L, Patra BG, Glicksburg B, Talati A, Adekkanattu P, Ryu E, Biernacka JM, Charney A, Mann JJ, Pathak J, Olfson M, Weissman MM. Social connectedness as a determinant of mental health: A scoping review. PLoS One 2022; 17:e0275004. [PMID: 36228007 PMCID: PMC9560615 DOI: 10.1371/journal.pone.0275004] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Public health and epidemiologic research have established that social connectedness promotes overall health. Yet there have been no recent reviews of findings from research examining social connectedness as a determinant of mental health. The goal of this review was to evaluate recent longitudinal research probing the effects of social connectedness on depression and anxiety symptoms and diagnoses in the general population. A scoping review was performed of PubMed and PsychInfo databases from January 2015 to December 2021 following PRISMA-ScR guidelines using a defined search strategy. The search yielded 66 unique studies. In research with other than pregnant women, 83% (19 of 23) studies reported that social support benefited symptoms of depression with the remaining 17% (5 of 23) reporting minimal or no evidence that lower levels of social support predict depression at follow-up. In research with pregnant women, 83% (24 of 29 studies) found that low social support increased postpartum depressive symptoms. Among 8 of 9 studies that focused on loneliness, feeling lonely at baseline was related to adverse outcomes at follow-up including higher risks of major depressive disorder, depressive symptom severity, generalized anxiety disorder, and lower levels of physical activity. In 5 of 8 reports, smaller social network size predicted depressive symptoms or disorder at follow-up. In summary, most recent relevant longitudinal studies have demonstrated that social connectedness protects adults in the general population from depressive symptoms and disorders. The results, which were largely consistent across settings, exposure measures, and populations, support efforts to improve clinical detection of high-risk patients, including adults with low social support and elevated loneliness.
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Affiliation(s)
- Priya J. Wickramaratne
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Tenzin Yangchen
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Lauren Lepow
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Braja G. Patra
- Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Benjamin Glicksburg
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ardesheer Talati
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Prakash Adekkanattu
- Department of Information Technologies and Services, Weill Cornell Medicine, New York, NY, United States of America
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Joanna M. Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Alexander Charney
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - J. John Mann
- Division of Molecular Imaging and the Neuropathology, Departments of Psychiatry and Radiology, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Jyotishman Pathak
- Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
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Choi BS, Taslakian EN, Wi CI, Shin YH, Seol HY, Ryu E, Boyce TG, Johnson JN, King KS, Kwon JH, Juhn YJ. Atopic asthma as a potentially significant but unrecognized risk factor for Kawasaki disease in children. J Asthma 2022; 59:1767-1775. [PMID: 34347558 PMCID: PMC8885770 DOI: 10.1080/02770903.2021.1963765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/30/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Childhood asthma is known to be associated with risks of both respiratory and non-respiratory infections. Little is known about the relationship between asthma and the risk of Kawasaki disease (KD). We assessed associations of asthma status and asthma phenotype (e.g. atopic asthma) with KD. METHODS We performed a population-based retrospective case-control study, using KD cases between January 1, 1979, and December 31, 2016, and two matched controls per case. KD cases were defined by the American Heart Association diagnostic criteria. Asthma status prior to KD (or control) index dates was ascertained by the two asthma criteria, Predetermined Asthma Criteria (PAC) and Asthma Predictive Index (API, a surrogate phenotype of atopic asthma). We assessed whether 4 phenotypes (both PAC + and API+; PAC + only; API + only, and non-asthmatics) were associated with KD. RESULTS There were 124 KD cases during the study period. The group having both PAC + and API + was significantly associated with the increased odds of KD, compared to non-asthmatics (odds ratio [OR] 4.3; 95% CI: 1.3 - 14.3). While asthma defined by PAC was not associated with KD, asthma defined by PAC positive with eosinophilia (≥4%) was significantly associated with the increased odds of KD (OR: 6.7; 95% CI: 1.6 - 28.6) compared to non-asthmatics. Asthma status defined by API was associated with KD (OR = 4.7; 95% CI: 1.4-15.1). CONCLUSIONS Atopic asthma may be associated with increased odds of KD. Further prospective studies are needed to determine biological mechanisms underlying the association between atopic asthma and increased odds of KD.
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Affiliation(s)
- Bong Seok Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea
- Precision Population Medicine Lab, Mayo Clinic, Rochester, Minnesota
| | - Editt Nikoyan Taslakian
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington
| | - Chung-Il Wi
- Precision Population Medicine Lab, Mayo Clinic, Rochester, Minnesota
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Hee Yun Seol
- Precision Population Medicine Lab, Mayo Clinic, Rochester, Minnesota
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Thomas G. Boyce
- Department of Pediatrics, Levine Children’s Hospital, Charlotte, North Carolina
| | - Jonathan N. Johnson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Katherine S. King
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Jung Hyun Kwon
- Precision Population Medicine Lab, Mayo Clinic, Rochester, Minnesota
- Department of Pediatrics, Korea University, College of Medicine, Seoul, Korea
| | - Young J. Juhn
- Precision Population Medicine Lab, Mayo Clinic, Rochester, Minnesota
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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13
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Takahashi P, Wi C, Ryu E, King K, Hickman J, Pignolo R, Juhn Y. Influenza infection is not associated with phenotypical frailty in older patients, a prospective cohort study. Health Sci Rep 2022; 5:e750. [PMID: 35989948 PMCID: PMC9376026 DOI: 10.1002/hsr2.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aims Influenza is a challenging infectious illness for older adults. It is not completely clear whether influenza is associated with frailty or functional decline. We sought to determine the association between incident influenza infection and frailty and prefrailty in community patients over 50 years of age. We also investigated the association between influenza vaccination and frailty and prefrailty as a secondary aim. Methods This was a prospective community cohort study from October 2019 to November 2020 in participants over 50 years. The primary outcome was the development of frailty as defined by three of five frailty criteria (slow gait speed, low grip strength, 5% weight loss, low energy, and low physical functioning). The primary predictor was a positive polymerase chain reaction (PCR) for influenza infection. Influenza vaccination was based on electronic health record reviewing 1 year before enrollment. We reported the relationship between influenza and frailty by calculating odds ratios (OR) with 95% confidence intervals (CI) after adjustment for age, sex, socioeconomic status, Charlson Comorbidity Index (CCI), influenza vaccine, and previous self‐rated frailty from multinomial logistic regression model comparing frail and prefrail to nonfrail subjects. Results In 1135 participants, the median age was 67 years (interquartile range 60−74), with 41% men. Eighty‐one participants had PCR‐confirmed influenza (7.1%). Frailty was not associated with influenza, with an OR of 0.50 (95% CI 0.17−1.43) for frail participants compared to nonfrail participants. Influenza vaccination is associated with frailty, with an OR of 1.69 (95% CI 1.09−2.63) for frail compared to nonfrail. Frailty was associated with a higher CCI with an OR of 1.52 (95% CI 1.31−1.76). Conclusion We did not find a relationship between influenza infection and frailty. We found higher vaccination rates in participants with frailty compared to nonfrail participants While influenza was not associated with frailty, future work may involve longer follow‐up.
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Affiliation(s)
| | - Chung‐Il Wi
- Mayo Clinic Rochester, Health Science Research Rochester Minnesota USA
| | - Euijung Ryu
- Mayo Clinic Rochester Rochester Minnesota USA
| | | | | | - Robert Pignolo
- Mayo Clinic College of Medicine and Science Rochester Minnesota USA
| | - Young Juhn
- Mayo Clinic Rochester Rochester Minnesota USA
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14
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Juhn YJ, Ryu E, Wi CI, King KS, Malik M, Romero-Brufau S, Weng C, Sohn S, Sharp RR, Halamka JD. Assessing socioeconomic bias in machine learning algorithms in health care: a case study of the HOUSES index. J Am Med Inform Assoc 2022; 29:1142-1151. [PMID: 35396996 PMCID: PMC9196683 DOI: 10.1093/jamia/ocac052] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/24/2022] [Accepted: 04/05/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Artificial intelligence (AI) models may propagate harmful biases in performance and hence negatively affect the underserved. We aimed to assess the degree to which data quality of electronic health records (EHRs) affected by inequities related to low socioeconomic status (SES), results in differential performance of AI models across SES. MATERIALS AND METHODS This study utilized existing machine learning models for predicting asthma exacerbation in children with asthma. We compared balanced error rate (BER) against different SES levels measured by HOUsing-based SocioEconomic Status measure (HOUSES) index. As a possible mechanism for differential performance, we also compared incompleteness of EHR information relevant to asthma care by SES. RESULTS Asthmatic children with lower SES had larger BER than those with higher SES (eg, ratio = 1.35 for HOUSES Q1 vs Q2-Q4) and had a higher proportion of missing information relevant to asthma care (eg, 41% vs 24% for missing asthma severity and 12% vs 9.8% for undiagnosed asthma despite meeting asthma criteria). DISCUSSION Our study suggests that lower SES is associated with worse predictive model performance. It also highlights the potential role of incomplete EHR data in this differential performance and suggests a way to mitigate this bias. CONCLUSION The HOUSES index allows AI researchers to assess bias in predictive model performance by SES. Although our case study was based on a small sample size and a single-site study, the study results highlight a potential strategy for identifying bias by using an innovative SES measure.
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Affiliation(s)
- Young J Juhn
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, USA
- Artificial Intelligence Program of Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Chung-Il Wi
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, USA
- Artificial Intelligence Program of Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Katherine S King
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Momin Malik
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard R Sharp
- Biomedical Ethics Program, Mayo Clinic, Rochester, Minnesota, USA
| | - John D Halamka
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA
- Mayo Clinic Platform, Rochester, Minnesota, USA
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15
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Sagheb E, Wi CI, Yoon J, Seol HY, Shrestha P, Ryu E, Park M, Yawn B, Liu H, Homme J, Juhn Y, Sohn S. Artificial Intelligence Assesses Clinicians' Adherence to Asthma Guidelines Using Electronic Health Records. J Allergy Clin Immunol Pract 2022; 10:1047-1056.e1. [PMID: 34800704 PMCID: PMC9007821 DOI: 10.1016/j.jaip.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/20/2021] [Accepted: 11/07/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Clinicians' asthma guideline adherence in asthma care is suboptimal. The effort to improve adherence can be enhanced by assessing and monitoring clinicians' adherence to guidelines reflected in electronic health records (EHRs), which require costly manual chart review because many care elements cannot be identified by structured data. OBJECTIVE This study was designed to demonstrate the feasibility of an artificial intelligence tool using natural language processing (NLP) leveraging the free text EHRs of pediatric patients to extract key components of the 2007 National Asthma Education and Prevention Program guidelines. METHODS This is a retrospective cross-sectional study using a birth cohort with a diagnosis of asthma at Mayo Clinic between 2003 and 2016. We used 1,039 clinical notes with an asthma diagnosis from a random sample of 300 patients. Rule-based NLP algorithms were developed to identify asthma guideline-congruent elements by examining care description in EHR free text. RESULTS Natural language processing algorithms demonstrated a sensitivity (0.82-1.0), specificity (0.95-1.0), positive predictive value (0.86-1.0), and negative predictive value (0.92-1.0) against manual chart review for asthma guideline-congruent elements. Assessing medication compliance and inhaler technique assessment were the most challenging elements to assess because of the complexity and wide variety of descriptions. CONCLUSIONS Natural language processing technologies may enable the automated assessment of clinicians' documentation in EHRs regarding adherence to asthma guidelines and can be a useful population management and research tool to assess and monitor asthma care quality. Multisite studies with a larger sample size are needed to assess the generalizability of these NLP algorithms.
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Affiliation(s)
- Elham Sagheb
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minn
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn
| | - Jungwon Yoon
- Department of Pediatrics, Myongji Hospital, Goyang, South Korea
| | - Hee Yun Seol
- Pusan National University, Yangsan Hospital, Yangsan, South Korea
| | - Pragya Shrestha
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minn
| | - Miguel Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minn
| | - Barbara Yawn
- Department of Family and Community Health, University of Minnesota, Minneapolis, Minn
| | - Hongfang Liu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minn
| | - Jason Homme
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn
| | - Young Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn.
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minn.
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16
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Shrestha P, Wi CI, Liu H, King KS, Ryu E, Kwon JH, Sohn S, Park M, Juhn Y. Risk of pneumonia in asthmatic children using inhaled corticosteroids: a nested case-control study in a birth cohort. BMJ Open 2022; 12:e051926. [PMID: 35273042 PMCID: PMC8915358 DOI: 10.1136/bmjopen-2021-051926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Inhaled corticosteroids (ICSs) are important in asthma management, but there are concerns regarding associated risk of pneumonia. While studies in asthmatic adults have shown inconsistent results, this risk in asthmatic children is unclear. OBJECTIVE Our aim was to determine the association of ICS use with pneumonia risk in asthmatic children. METHODS A nested case-control study was performed in the Mayo Clinic Birth Cohort. Asthmatic children (<18 years) with a physician diagnosis of asthma were identified from electronic medical records of children born at Mayo Clinic from 1997 to 2016 and followed until 31 December 2017. Pneumonia cases defined by Infectious Disease Society of America were 1:1 matched with controls without pneumonia by age, sex and asthma index date. Exposure was defined as ICS prescription at least 90 days prior to pneumonia. Associations of ICS use, type and dose (low, medium and high) with pneumonia risk were analysed using conditional logistic regression. RESULTS Of the 2108 asthmatic children eligible for the study (70% mild intermittent and 30% persistent asthma), 312 children developed pneumonia during the study period. ICS use overall was not associated with risk of pneumonia (adjusted OR: 0.94, 95% CI: 0.62 to 1.41). Poorly controlled asthma was significantly associated with the risk of pneumonia (OR: 2.03, 95% CI: 1.35 to 3.05; p<0.001). No ICS type or dose was associated with risk of pneumonia. CONCLUSION ICS use in asthmatic children was not associated with risk of pneumonia but poorly controlled asthma was. Future asthma studies may need to include pneumonia as a potential outcome of asthma management.
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Affiliation(s)
- Pragya Shrestha
- Precision Population Science Lab, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Chung-Il Wi
- Precision Population Science Lab, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hongfang Liu
- Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Katherine S King
- Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Euijung Ryu
- Computational Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jung Hyun Kwon
- Precision Population Science Lab, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Pediatrics, Korea University Medical Center, Seoul, Republic of Korea
| | - Sunghwan Sohn
- Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Miguel Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Young Juhn
- Precision Population Science Lab, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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17
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Takahashi P, Ryu E, Larson N, Jenkins G, Christine K, Yost K, Olson J. Association of First Employment Characteristics and Hospitalization in the Mayo Clinic Biobank. Innov Aging 2021. [PMCID: PMC8681685 DOI: 10.1093/geroni/igab046.3564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Work history is associated with long term health outcomes We hypothesize that characteristics of the first work experience, such as age at first job and length of work (hereafter job) are associated with future risk of hospitalization. We further hypothesize that the length of work will be associated with hospitalization. We conducted a survey of adults >60 years using a nested case-control approach within the Mayo Clinic Biobank. We collected job related variables including age at job start, reason for ending, and length of time. To test associations between each variable and hospitalization, we used age and gender adjusted logistic regression models. Our study included 4,024 subjects: 1,801 cases and 2223 controls. The mean age at time of match was 77.3 years (SD 7.2 years) with 49.2% males. Older age at the first full-time job was associated with lower chance of hospitalization later in life (OR=0.81 [0.67, 0.97] for those who started the job over 22 compared to those started at 18 or less). Cases were more likely to have stopped working because of illness (OR=2.04 [95% CI 1.29,3.27]). Cases were less likely to have stopped working because of retirement (OR=0.82 [95% CI: 0.72, 0.93]). We found cases were employed with a slightly shorter time (20.5 yrs. (SD 16.6)) compared to controls (21.8 yrs. (SD 16.3)) (p=0.005). Cases started work earlier and stopped work more frequently because of illness/disability compared to controls. This could reflect educational attainment in controls. This study highlights work history as potential predictor of future hospitalization.
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Affiliation(s)
| | - Euijung Ryu
- Mayo Clinic, Rochester, Minnesota, United States
| | | | | | | | | | - Janet Olson
- Mayo Clinic, Rochester, Minnesota, United States
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18
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Patra BG, Sharma MM, Vekaria V, Adekkanattu P, Patterson OV, Glicksberg B, Lepow LA, Ryu E, Biernacka JM, Furmanchuk A, George TJ, Hogan W, Wu Y, Yang X, Bian J, Weissman M, Wickramaratne P, Mann JJ, Olfson M, Campion TR, Weiner M, Pathak J. Extracting social determinants of health from electronic health records using natural language processing: a systematic review. J Am Med Inform Assoc 2021; 28:2716-2727. [PMID: 34613399 PMCID: PMC8633615 DOI: 10.1093/jamia/ocab170] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/09/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Social determinants of health (SDoH) are nonclinical dispositions that impact patient health risks and clinical outcomes. Leveraging SDoH in clinical decision-making can potentially improve diagnosis, treatment planning, and patient outcomes. Despite increased interest in capturing SDoH in electronic health records (EHRs), such information is typically locked in unstructured clinical notes. Natural language processing (NLP) is the key technology to extract SDoH information from clinical text and expand its utility in patient care and research. This article presents a systematic review of the state-of-the-art NLP approaches and tools that focus on identifying and extracting SDoH data from unstructured clinical text in EHRs. MATERIALS AND METHODS A broad literature search was conducted in February 2021 using 3 scholarly databases (ACL Anthology, PubMed, and Scopus) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 6402 publications were initially identified, and after applying the study inclusion criteria, 82 publications were selected for the final review. RESULTS Smoking status (n = 27), substance use (n = 21), homelessness (n = 20), and alcohol use (n = 15) are the most frequently studied SDoH categories. Homelessness (n = 7) and other less-studied SDoH (eg, education, financial problems, social isolation and support, family problems) are mostly identified using rule-based approaches. In contrast, machine learning approaches are popular for identifying smoking status (n = 13), substance use (n = 9), and alcohol use (n = 9). CONCLUSION NLP offers significant potential to extract SDoH data from narrative clinical notes, which in turn can aid in the development of screening tools, risk prediction models, and clinical decision support systems.
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Affiliation(s)
- Braja G Patra
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Mohit M Sharma
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Veer Vekaria
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Prakash Adekkanattu
- Information Technologies and Services, Weill Cornell Medicine, New York, New York, USA
| | - Olga V Patterson
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah, USA
- US Department of Veterans Affairs, Salt Lake City, Utah, USA
| | | | - Lauren A Lepow
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Thomas J George
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - William Hogan
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA, and
| | - Yonghui Wu
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Xi Yang
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Myrna Weissman
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Priya Wickramaratne
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - J John Mann
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Mark Olfson
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Thomas R Campion
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
- Information Technologies and Services, Weill Cornell Medicine, New York, New York, USA
| | - Mark Weiner
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
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19
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Yoon J, Billings H, Wi CI, Hall E, Sohn S, Kwon JH, Ryu E, Shrestha P, Liu H, Juhn YJ. Establishing an expert consensus for the operational definitions of asthma-associated infectious and inflammatory multimorbidities for computational algorithms through a modified Delphi technique. BMC Med Inform Decis Mak 2021; 21:310. [PMID: 34749701 PMCID: PMC8573872 DOI: 10.1186/s12911-021-01663-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/13/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A subgroup of patients with asthma has been reported to have an increased risk for asthma-associated infectious and inflammatory multimorbidities (AIMs). To systematically investigate the association of asthma with AIMs using a large patient cohort, it is desired to leverage a broad range of electronic health record (EHR) data sources to automatically identify AIMs accurately and efficiently. METHODS We established an expert consensus for an operational definition for each AIM from EHR through a modified Delphi technique. A series of questions about the operational definition of 19 AIMS (11 infectious diseases and 8 inflammatory diseases) was generated by a core team of experts who considered feasibility, balance between sensitivity and specificity, and generalizability. Eight internal and 5 external expert panelists were invited to individually complete a series of online questionnaires and provide judgement and feedback throughout three sequential internal rounds and two external rounds. Panelists' responses were collected, descriptive statistics tabulated, and results reported back to the entire group. Following each round the core team of experts made iterative edits to the operational definitions until a moderate (≥ 60%) or strong (≥ 80%) level of consensus among the panel was achieved. RESULTS Response rates for each Delphi round were 100% in all 5 rounds with the achievement of the following consensus levels: (1) Internal panel consensus: 100% for 8 definitions, 88% for 10 definitions, and 75% for 1 definition, (2) External panel consensus: 100% for 12 definitions and 80% for 7 definitions. CONCLUSIONS The final operational definitions of AIMs established through a modified Delphi technique can serve as a foundation for developing computational algorithms to automatically identify AIMs from EHRs to enable large scale research studies on patient's multimorbidities associated with asthma.
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Affiliation(s)
- Jungwon Yoon
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
- Department of Pediatrics, Myongji Hospital, Goyang-si, South Korea
| | - Heather Billings
- Office of Applied Scholarship and Education Science, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
| | - Elissa Hall
- Office of Applied Scholarship and Education Science, Mayo Clinic, Rochester, MN, USA
| | - Sunghwan Sohn
- Division of Digital Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jung Hyun Kwon
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Pragya Shrestha
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Division of Digital Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Young J Juhn
- Precision Population Science Lab, Mayo Clinic, Rochester, MN, USA.
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
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20
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Kwon JH, Wi CI, Seol HY, Park M, King K, Ryu E, Sohn S, Liu H, Juhn YJ. Risk, Mechanisms and Implications of Asthma-Associated Infectious and Inflammatory Multimorbidities (AIMs) among Individuals With Asthma: a Systematic Review and a Case Study. Allergy Asthma Immunol Res 2021; 13:697-718. [PMID: 34486256 PMCID: PMC8419637 DOI: 10.4168/aair.2021.13.5.697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/15/2021] [Indexed: 11/25/2022]
Abstract
Our prior work and the work of others have demonstrated that asthma increases the risk of a broad range of both respiratory (e.g., pneumonia and pertussis) and non-respiratory (e.g., zoster and appendicitis) infectious diseases as well as inflammatory diseases (e.g., celiac disease and myocardial infarction [MI]), suggesting the systemic disease nature of asthma and its impact beyond the airways. We call these conditions asthma-associated infectious and inflammatory multimorbidities (AIMs). At present, little is known about why some people with asthma are at high-risk of AIMs, and others are not, to the extent to which controlling asthma reduces the risk of AIMs and which specific therapies mitigate the risk of AIMs. These questions represent a significant knowledge gap in asthma research and unmet needs in asthma care, because there are no guidelines addressing the identification and management of AIMs. This is a systematic review on the association of asthma with the risk of AIMs and a case study to highlight that 1) AIMs are relatively under-recognized conditions, but pose major health threats to people with asthma; 2) AIMs provide insights into immunological and clinical features of asthma as a systemic inflammatory disease beyond a solely chronic airway disease; and 3) it is time to recognize AIMs as a distinctive asthma phenotype in order to advance asthma research and improve asthma care. An improved understanding of AIMs and their underlying mechanisms will bring valuable and new perspectives improving the practice, research, and public health related to asthma.
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Affiliation(s)
- Jung Hyun Kwon
- Precision Population Science Lab, Department of Pediatrics and Adolescence Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Chung-Il Wi
- Precision Population Science Lab, Department of Pediatrics and Adolescence Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hee Yun Seol
- Precision Population Science Lab, Department of Pediatrics and Adolescence Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Miguel Park
- Division of Allergy and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Katherine King
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Young J Juhn
- Precision Population Science Lab, Department of Pediatrics and Adolescence Medicine, Mayo Clinic, Rochester, MN, USA.
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21
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Seol HY, Shrestha P, Muth JF, Wi CI, Sohn S, Ryu E, Park M, Ihrke K, Moon S, King K, Wheeler P, Borah B, Moriarty J, Rosedahl J, Liu H, McWilliams DB, Juhn YJ. Artificial intelligence-assisted clinical decision support for childhood asthma management: A randomized clinical trial. PLoS One 2021; 16:e0255261. [PMID: 34339438 PMCID: PMC8328289 DOI: 10.1371/journal.pone.0255261] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/08/2021] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Clinical decision support (CDS) tools leveraging electronic health records (EHRs) have been an approach for addressing challenges in asthma care but remain under-studied through clinical trials. OBJECTIVES To assess the effectiveness and efficiency of Asthma-Guidance and Prediction System (A-GPS), an Artificial Intelligence (AI)-assisted CDS tool, in optimizing asthma management through a randomized clinical trial (RCT). METHODS This was a single-center pragmatic RCT with a stratified randomization design conducted for one year in the primary care pediatric practice of the Mayo Clinic, MN. Children (<18 years) diagnosed with asthma receiving care at the study site were enrolled along with their 42 primary care providers. Study subjects were stratified into three strata (based on asthma severity, asthma care status, and asthma diagnosis) and were blinded to the assigned groups. MEASUREMENTS Intervention was a quarterly A-GPS report to clinicians including relevant clinical information for asthma management from EHRs and machine learning-based prediction for risk of asthma exacerbation (AE). Primary endpoint was the occurrence of AE within 1 year and secondary outcomes included time required for clinicians to review EHRs for asthma management. MAIN RESULTS Out of 555 participants invited to the study, 184 consented for the study and were randomized (90 in intervention and 94 in control group). Median age of 184 participants was 8.5 years. While the proportion of children with AE in both groups decreased from the baseline (P = 0.042), there was no difference in AE frequency between the two groups (12% for the intervention group vs. 15% for the control group, Odds Ratio: 0.82; 95%CI 0.374-1.96; P = 0.626) during the study period. For the secondary end points, A-GPS intervention, however, significantly reduced time for reviewing EHRs for asthma management of each participant (median: 3.5 min, IQR: 2-5), compared to usual care without A-GPS (median: 11.3 min, IQR: 6.3-15); p<0.001). Mean health care costs with 95%CI of children during the trial (compared to before the trial) in the intervention group were lower than those in the control group (-$1,036 [-$2177, $44] for the intervention group vs. +$80 [-$841, $1000] for the control group), though there was no significant difference (p = 0.12). Among those who experienced the first AE during the study period (n = 25), those in the intervention group had timelier follow up by the clinical care team compared to those in the control group but no significant difference was found (HR = 1.93; 95% CI: 0.82-1.45, P = 0.10). There was no difference in the proportion of duration when patients had well-controlled asthma during the study period between the intervention and the control groups. CONCLUSIONS While A-GPS-based intervention showed similar reduction in AE events to usual care, it might reduce clinicians' burden for EHRs review resulting in efficient asthma management. A larger RCT is needed for further studying the findings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02865967.
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Affiliation(s)
- Hee Yun Seol
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Pragya Shrestha
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Joy Fladager Muth
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Chung-Il Wi
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Miguel Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Kathy Ihrke
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Sungrim Moon
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katherine King
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Philip Wheeler
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Bijan Borah
- Department of Health Service Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - James Moriarty
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jordan Rosedahl
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Hongfang Liu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Deborah B. McWilliams
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Young J. Juhn
- Precision Population Science Lab, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
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22
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Juhn YJ, Wheeler P, Wi CI, Bublitz J, Ryu E, Ristagno E, Patten C. Role of Geographic Risk Factors in COVID-19 Epidemiology: Longitudinal Geospatial Analysis. Mayo Clin Proc Innov Qual Outcomes 2021; 5:916-927. [PMID: 34308261 PMCID: PMC8272975 DOI: 10.1016/j.mayocpiqo.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To perform a geospatial and temporal trend analysis for coronavirus disease 2019 (COVID-19) in a Midwest community to identify and characterize hot spots for COVID-19. Participants and Methods We conducted a population-based longitudinal surveillance assessing the semimonthly geospatial trends of the prevalence of test confirmed COVID-19 cases in Olmsted County, Minnesota, from March 11, 2020, through October 31, 2020. As urban areas accounted for 84% of the population and 86% of all COVID-19 cases in Olmsted County, MN, we determined hot spots for COVID-19 in urban areas (Rochester and other small cities) of Olmsted County, MN, during the study period by using kernel density analysis with a half-mile bandwidth. Results As of October 31, 2020, a total of 37,141 individuals (30%) were tested at least once, of whom 2433 (7%) tested positive. Testing rates among race groups were similar: 29% (black), 30% (Hispanic), 25% (Asian), and 31% (white). Ten urban hot spots accounted for 590 cases at 220 addresses (2.68 cases per address) as compared with 1843 cases at 1292 addresses in areas outside hot spots (1.43 cases per address). Overall, 12% of the population residing in hot spots accounted for 24% of all COVID-19 cases. Hot spots were concentrated in neighborhoods with low-income apartments and mobile home communities. People living in hot spots tended to be minorities and from a lower socioeconomic background. Conclusion Geographic and residential risk factors might considerably account for the overall burden of COVID-19 and its associated racial/ethnic and socioeconomic disparities. Results could geospatially guide community outreach efforts (eg, testing/tracing and vaccine rollout) for populations at risk for COVID-19.
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Key Words
- Acute Respiratory Infection, (ARI)
- COVID-19
- Confidence interval, (CI)
- Coronavirus disease 2019, (COVID-19)
- Electronic Health Records, (EHRs)
- Human coronavirus, (HCov)
- Middle East respiratory syndrome (MERS)-coronavirus, (MERS-CoV)
- Reverse transcription polymerase chain reaction, (RT-PCR)
- SARS-CoV-2
- Severe acute respiratory syndrome (SARS)-associated coronavirus, (SARS-CoV)
- Severe acute respiratory syndrome coronavirus 2, (SARS-CoV-2)
- Social determinants of health, (SDH)
- Socioeconomic status, (SES)
- epidemiology
- geospatial analysis
- social determinants of health
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Affiliation(s)
| | | | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine
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23
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Takahashi PY, Ryu E, Cerhan JR, Bielinski SJ, Olson JE. Pathway to Ascertain the Role of Pharmacogenomics in Healthcare Utilization Outcomes [Response to Letter]. Pharmgenomics Pers Med 2021; 14:545-546. [PMID: 33986611 PMCID: PMC8111333 DOI: 10.2147/pgpm.s316851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Paul Y Takahashi
- Division of Community Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Janet E Olson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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24
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Park MA, Jenkins SM, Smith CY, Pyle RC, Sacco KA, Ryu E, Hagan JB, Joshi AY, Snyder MR, Abraham RS. Pneumococcal serotype-specific cut-offs based on antibody responses to pneumococcal polysaccharide vaccination in healthy adults. Vaccine 2021; 39:2850-2856. [PMID: 33896666 DOI: 10.1016/j.vaccine.2021.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 02/08/2023]
Abstract
Antibody responses to pneumococcal polysaccharide vaccination are frequently used as a diagnostic tool for humoral immunodeficiencies, part of the larger collection of inborn errors of immunity. Currently, arbitrary criteria, such as a serotype specific titer of >/= 1.3 µg/mL is most often used as a cut-off for interpretation of pneumococcal antibody responses. The magnitude of the antibody response to each of the 23 serotypes in Pneumovax®, and serotype-specific cut-offs in healthy pneumococcal vaccine-naïve adults has not been previously characterized. IgG antibody concentrations were measured prospectively for 23 pneumococcal serotypes pre and 4-6 weeks post-Pneumovax® vaccination in 100 healthy adults, using a multiplex bead-based assay. Antibodies to 19 of 23 serotypes were informative for distinguishing subjects who responded to vaccination, and the serotype threshold was determined to be 9 of 19 serotypes, which characterized an antibody response to pneumococcal vaccination. While this study may facilitate classification of IgG serotype-specific antibody responses post-pneumococcal vaccination in adult patients undergoing diagnostic immunological evaluation for antibody immunodeficiencies or other relevant contexts, additional studies in healthy children and S. pneumoniae protein-conjugate-vaccinated healthy adults will need to be undertaken in the future.
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Affiliation(s)
- Miguel A Park
- Division of Allergic Diseases, Department of Medicine, USA; Mayo Clinic, Rochester, MN, USA
| | - Sarah M Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, USA; Mayo Clinic, Rochester, MN, USA
| | - Carin Y Smith
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, USA; Mayo Clinic, Rochester, MN, USA
| | - Regan C Pyle
- Division of Allergic Diseases, Department of Medicine, USA; Allergy, Asthma & Immunology of the Rockies, PC., Glenwood Springs, CO, USA
| | - Keith A Sacco
- Allergy & Immunology Program, National Institutes of Health, USA
| | - Euijung Ryu
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, USA; Mayo Clinic, Rochester, MN, USA
| | - John B Hagan
- Division of Allergic Diseases, Department of Medicine, USA; Mayo Clinic, Rochester, MN, USA
| | - Avni Y Joshi
- Division of Allergic Diseases, Department of Medicine, USA; Mayo Clinic, Rochester, MN, USA
| | - Melissa R Snyder
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Roshini S Abraham
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
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Juhn YJ, Wi CI, Ryu E, Sampathkumar P, Takahashi PY, Yao JD, Binnicker MJ, Natoli TL, Evans TK, King KS, Volpe S, Pirçon JY, Silvia Damaso, Pignolo RJ. Adherence to Public Health Measures Mitigates the Risk of COVID-19 Infection in Older Adults: A Community-Based Study. Mayo Clin Proc 2021; 96:912-920. [PMID: 33714601 PMCID: PMC7768210 DOI: 10.1016/j.mayocp.2020.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.
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Affiliation(s)
- Young J Juhn
- Department of Pediatric and Internal Medicine, Mayo Clinic, Rochester, MN.
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Paul Y Takahashi
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Joseph D Yao
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Traci L Natoli
- Department of Medicine Research, Mayo Clinic, Rochester, MN
| | - Tamara K Evans
- Department of Medicine Research, Mayo Clinic, Rochester, MN
| | - Katherine S King
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | | | - Robert J Pignolo
- Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN.
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26
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Takahashi PY, Ryu E, Bielinski SJ, Hathcock M, Jenkins GD, Cerhan JR, Olson JE. No Association Between Pharmacogenomics Variants and Hospital and Emergency Department Utilization: A Mayo Clinic Biobank Retrospective Study. Pharmgenomics Pers Med 2021; 14:229-237. [PMID: 33603442 PMCID: PMC7886254 DOI: 10.2147/pgpm.s281645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023]
Abstract
Background The use of pharmacogenomics data is increasing in clinical practice. However, it is unknown if pharmacogenomics data can be used more broadly to predict outcomes like hospitalization or emergency department (ED) visit. We aim to determine the association between selected pharmacogenomics phenotypes and hospital utilization outcomes (hospitalization and ED visits). Methods This cohort study utilized 10,078 patients from the Mayo Clinic Biobank in the RIGHT protocol with sequence and interpreted phenotypes for 10 selected pharmacogenes including CYP2D6, CYP2C9, CYP2C19, CYP3A5, HLA B 5701, HLA B 5702, HLA B 5801, TPMT, SLCO1B1, and DPYD. The primary outcome was hospitalization with ED visits as a secondary outcome. We used Cox proportional hazards model to test the association between each pharmacogenomics phenotype and the risk of the outcomes. Results During the follow-up period (median [in years] = 7.3), 13% (n=1354) and 8% (n=813) of the subjects experienced hospitalization and ED visits, respectively. Compared to subjects who did not experience hospitalization, hospitalized patients were older (median age [in years]: 67 vs 65), poorer self-rated health (15% vs 4.7% for fair/poor), and higher disease burden (median number of chronic conditions: 7 vs 4) at baseline. There was no association of hospitalization with any of the pharmacogenomics phenotypes. The pharmacogenomics phenotypes were not associated with disease burden, a well-established risk factor for hospital utilization outcomes. Similar findings were observed for patients with ED visits during the follow-up period. Conclusion We found no association of 10 well-established pharmacogenomics phenotypes with either hospitalization or ED visits in this relatively large biobank population and outside the context of specific drug use related to these genes. Traditional risk factors for hospitalization like age and self-rated health were much more likely to predict hospitalization and/or ED visits than this pharmacogenomics information.
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Affiliation(s)
- Paul Y Takahashi
- Division of Community Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew Hathcock
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Gregory D Jenkins
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Janet E Olson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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27
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Bobo WV, Ryu E, Petterson TM, Lackore K, Cheng Y, Liu H, Suarez L, Preisig M, Cooper LT, Roger VL, Pathak J, Chamberlain AM. Bi-directional association between depression and HF: An electronic health records-based cohort study. J Comorb 2021; 10:2235042X20984059. [PMID: 33489926 PMCID: PMC7768856 DOI: 10.1177/2235042x20984059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/21/2020] [Accepted: 12/05/2020] [Indexed: 11/16/2022]
Abstract
Objective: To determine whether a bi-directional relationship exists between depression and HF within a single population of individuals receiving primary care services, using longitudinal electronic health records (EHRs). Methods: This retrospective cohort study utilized EHRs for adults who received primary care services within a large healthcare system in 2006. Validated EHR-based algorithms identified 10,649 people with depression (depression cohort) and 5,911 people with HF (HF cohort) between January 1, 2006 and December 31, 2018. Each person with depression or HF was matched 1:1 with an unaffected referent on age, sex, and outpatient service use. Each cohort (with their matched referents) was followed up electronically to identify newly diagnosed HF (in the depression cohort) and depression (in the HF cohort) that occurred after the index diagnosis of depression or HF, respectively. The risks of these outcomes were compared (vs. referents) using marginal Cox proportional hazard models adjusted for 16 comorbid chronic conditions. Results: 2,024 occurrences of newly diagnosed HF were observed in the depression cohort and 944 occurrences of newly diagnosed depression were observed in the HF cohort over approximately 4–6 years of follow-up. People with depression had significantly increased risk for developing newly diagnosed HF (HR 2.08, 95% CI 1.89–2.28) and people with HF had a significantly increased risk of newly diagnosed depression (HR 1.34, 95% CI 1.17–1.54) after adjusting for all 16 comorbid chronic conditions. Conclusion: These results provide evidence of a bi-directional relationship between depression and HF independently of age, sex, and multimorbidity from chronic illnesses.
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Affiliation(s)
- William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Tanya M Petterson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Kandace Lackore
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Yijing Cheng
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Division of Digital Health Science, Mayo Clinic, Rochester, MN, USA
| | - Laura Suarez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Veronique L Roger
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jyotishman Pathak
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, NY, USA
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28
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Munn‐Chernoff MA, Johnson EC, Chou Y, Coleman JR, Thornton LM, Walters RK, Yilmaz Z, Baker JH, Hübel C, Gordon S, Medland SE, Watson HJ, Gaspar HA, Bryois J, Hinney A, Leppä VM, Mattheisen M, Ripke S, Yao S, Giusti‐Rodríguez P, Hanscombe KB, Adan RA, Alfredsson L, Ando T, Andreassen OA, Berrettini WH, Boehm I, Boni C, Boraska Perica V, Buehren K, Burghardt R, Cassina M, Cichon S, Clementi M, Cone RD, Courtet P, Crow S, Crowley JJ, Danner UN, Davis OS, Zwaan M, Dedoussis G, Degortes D, DeSocio JE, Dick DM, Dikeos D, Dina C, Dmitrzak‐Weglarz M, Docampo E, Duncan LE, Egberts K, Ehrlich S, Escaramís G, Esko T, Estivill X, Farmer A, Favaro A, Fernández‐Aranda F, Fichter MM, Fischer K, Föcker M, Foretova L, Forstner AJ, Forzan M, Franklin CS, Gallinger S, Giegling I, Giuranna J, Gonidakis F, Gorwood P, Gratacos Mayora M, Guillaume S, Guo Y, Hakonarson H, Hatzikotoulas K, Hauser J, Hebebrand J, Helder SG, Herms S, Herpertz‐Dahlmann B, Herzog W, Huckins LM, Hudson JI, Imgart H, Inoko H, Janout V, Jiménez‐Murcia S, Julià A, Kalsi G, Kaminská D, Karhunen L, Karwautz A, Kas MJ, Kennedy JL, Keski‐Rahkonen A, Kiezebrink K, Kim Y, Klump KL, Knudsen GPS, La Via MC, Le Hellard S, Levitan RD, Li D, Lilenfeld L, Lin BD, Lissowska J, Luykx J, Magistretti PJ, Maj M, Mannik K, Marsal S, Marshall CR, Mattingsdal M, McDevitt S, McGuffin P, Metspalu A, Meulenbelt I, Micali N, Mitchell K, Monteleone AM, Monteleone P, Nacmias B, Navratilova M, Ntalla I, O'Toole JK, Ophoff RA, Padyukov L, Palotie A, Pantel J, Papezova H, Pinto D, Rabionet R, Raevuori A, Ramoz N, Reichborn‐Kjennerud T, Ricca V, Ripatti S, Ritschel F, Roberts M, Rotondo A, Rujescu D, Rybakowski F, Santonastaso P, Scherag A, Scherer SW, Schmidt U, Schork NJ, Schosser A, Seitz J, Slachtova L, Slagboom PE, Slof‐Op't Landt MC, Slopien A, Sorbi S, Świątkowska B, Szatkiewicz JP, Tachmazidou I, Tenconi E, Tortorella A, Tozzi F, Treasure J, Tsitsika A, Tyszkiewicz‐Nwafor M, Tziouvas K, Elburg AA, Furth EF, Wagner G, Walton E, Widen E, Zeggini E, Zerwas S, Zipfel S, Bergen AW, Boden JM, Brandt H, Crawford S, Halmi KA, Horwood LJ, Johnson C, Kaplan AS, Kaye WH, Mitchell J, Olsen CM, Pearson JF, Pedersen NL, Strober M, Werge T, Whiteman DC, Woodside DB, Grove J, Henders AK, Larsen JT, Parker R, Petersen LV, Jordan J, Kennedy MA, Birgegård A, Lichtenstein P, Norring C, Landén M, Mortensen PB, Polimanti R, McClintick JN, Adkins AE, Aliev F, Bacanu S, Batzler A, Bertelsen S, Biernacka JM, Bigdeli TB, Chen L, Clarke T, Degenhardt F, Docherty AR, Edwards AC, Foo JC, Fox L, Frank J, Hack LM, Hartmann AM, Hartz SM, Heilmann‐Heimbach S, Hodgkinson C, Hoffmann P, Hottenga J, Konte B, Lahti J, Lahti‐Pulkkinen M, Lai D, Ligthart L, Loukola A, Maher BS, Mbarek H, McIntosh AM, McQueen MB, Meyers JL, Milaneschi Y, Palviainen T, Peterson RE, Ryu E, Saccone NL, Salvatore JE, Sanchez‐Roige S, Schwandt M, Sherva R, Streit F, Strohmaier J, Thomas N, Wang J, Webb BT, Wedow R, Wetherill L, Wills AG, Zhou H, Boardman JD, Chen D, Choi D, Copeland WE, Culverhouse RC, Dahmen N, Degenhardt L, Domingue BW, Frye MA, Gäebel W, Hayward C, Ising M, Keyes M, Kiefer F, Koller G, Kramer J, Kuperman S, Lucae S, Lynskey MT, Maier W, Mann K, Männistö S, Müller‐Myhsok B, Murray AD, Nurnberger JI, Preuss U, Räikkönen K, Reynolds MD, Ridinger M, Scherbaum N, Schuckit MA, Soyka M, Treutlein J, Witt SH, Wodarz N, Zill P, Adkins DE, Boomsma DI, Bierut LJ, Brown SA, Bucholz KK, Costello EJ, Wit H, Diazgranados N, Eriksson JG, Farrer LA, Foroud TM, Gillespie NA, Goate AM, Goldman D, Grucza RA, Hancock DB, Harris KM, Hesselbrock V, Hewitt JK, Hopfer CJ, Iacono WG, Johnson EO, Karpyak VM, Kendler KS, Kranzler HR, Krauter K, Lind PA, McGue M, MacKillop J, Madden PA, Maes HH, Magnusson PK, Nelson EC, Nöthen MM, Palmer AA, Penninx BW, Porjesz B, Rice JP, Rietschel M, Riley BP, Rose RJ, Shen P, Silberg J, Stallings MC, Tarter RE, Vanyukov MM, Vrieze S, Wall TL, Whitfield JB, Zhao H, Neale BM, Wade TD, Heath AC, Montgomery GW, Martin NG, Sullivan PF, Kaprio J, Breen G, Gelernter J, Edenberg HJ, Bulik CM, Agrawal A. Shared genetic risk between eating disorder‐ and substance‐use‐related phenotypes: Evidence from genome‐wide association studies. Addict Biol 2021; 26:e12880. [DOI: 10.1111/adb.12880] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/09/2019] [Accepted: 01/13/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Melissa A. Munn‐Chernoff
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Emma C. Johnson
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Yi‐Ling Chou
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Jonathan R.I. Coleman
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Laura M. Thornton
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Raymond K. Walters
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Zeynep Yilmaz
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Jessica H. Baker
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Scott Gordon
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Sarah E. Medland
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Hunna J. Watson
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- School of Psychology Curtin University Perth Western Australia Australia
- School of Paediatrics and Child Health University of Western Australia Perth Western Australia Australia
| | - Héléna A. Gaspar
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Virpi M. Leppä
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Manuel Mattheisen
- Department of Biomedicine Aarhus University Aarhus Denmark
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
- Department of Psychiatry, Psychosomatics and Psychotherapy University of Würzburg Germany
| | - Stephan Ripke
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin Germany
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Paola Giusti‐Rodríguez
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Ken B. Hanscombe
- Department of Medical and Molecular Genetics King's College London, Guy's Hospital London UK
| | - Roger A.H. Adan
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
- Center for Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
- Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Tetsuya Ando
- Department of Behavioral Medicine, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
| | - Ole A. Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, NORMENT Centre University of Oslo, Oslo University Hospital Oslo Norway
| | - Wade H. Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Claudette Boni
- Centre of Psychiatry and Neuroscience INSERM U894 Paris France
| | - Vesna Boraska Perica
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Department of Medical Biology, School of Medicine University of Split Split Croatia
| | - Katharina Buehren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | | | - Matteo Cassina
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
- Institute of Neuroscience and Medicine (INM‐1) Research Center Juelich Germany
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | - Roger D. Cone
- Department of Molecular and Integrative Physiology, Life Sciences Institute University of Michigan Ann Arbor Michigan USA
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post‐Acute Care, CHRU Montpellier University of Montpellier Montpellier France
| | - Scott Crow
- Department of Psychiatry University of Minnesota Minneapolis Minnesota USA
| | - James J. Crowley
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Unna N. Danner
- Altrecht Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
| | - Oliver S.P. Davis
- MRC Integrative Epidemiology Unit University of Bristol Bristol UK
- School of Social and Community Medicine University of Bristol Bristol UK
| | - Martina Zwaan
- Department of Psychosomatic Medicine and Psychotherapy Hannover Medical School Hannover Germany
| | - George Dedoussis
- Department of Nutrition and Dietetics Harokopio University Athens Greece
| | | | | | - Danielle M. Dick
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
- Department of Human & Molecular Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Dimitris Dikeos
- Department of Psychiatry, Athens University Medical School Athens University Athens Greece
| | - Christian Dina
- l'institut du thorax INSERM, CNRS, Univ Nantes Nantes France
| | | | - Elisa Docampo
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Laramie E. Duncan
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Centre for Mental Health University Hospital of Würzburg Würzburg Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Geòrgia Escaramís
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Tõnu Esko
- Estonian Genome Center University of Tartu Tartu Estonia
- Program in Medical and Population Genetics Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Xavier Estivill
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Genomics and Disease, Bioinformatics and Genomics Programme Centre for Genomic Regulation Barcelona Spain
| | - Anne Farmer
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Angela Favaro
- Department of Neurosciences University of Padova Padova Italy
| | - Fernando Fernández‐Aranda
- Department of Psychiatry University Hospital of Bellvitge –IDIBELL and CIBERobn Barcelona Spain
- Department of Clinical Sciences, School of Medicine University of Barcelona Barcelona Spain
| | - Manfred M. Fichter
- Department of Psychiatry and Psychotherapy Ludwig‐Maximilians‐University Munich Germany
- Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich Munich Germany
| | - Krista Fischer
- Estonian Genome Center University of Tartu Tartu Estonia
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry University of Münster Münster Germany
| | - Lenka Foretova
- Department of Cancer, Epidemiology and Genetics Masaryk Memorial Cancer Institute Brno Czech Republic
| | - Andreas J. Forstner
- Department of Biomedicine University of Basel Basel Switzerland
- Centre for Human Genetics University of Marburg Marburg Germany
- Institute of Human Genetics School of Medicine & University Hospital Bonn, University of Bonn Bonn Germany
- Department of Psychiatry (UPK) University of Basel Basel Switzerland
| | - Monica Forzan
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | | | - Steven Gallinger
- Department of Surgery, Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Johanna Giuranna
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Fragiskos Gonidakis
- 1st Psychiatric Department National and Kapodistrian University of Athens, Medical School, Eginition Hospital Athens Greece
| | - Philip Gorwood
- Institute of Psychiatry and Neuroscience of Paris INSERM U1266 Paris France
- CMME (GHU Paris Psychiatrie et Neurosciences), Paris Descartes University Paris France
| | - Monica Gratacos Mayora
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post‐Acute Care, CHRU Montpellier University of Montpellier Montpellier France
| | - Yiran Guo
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
| | - Hakon Hakonarson
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Konstantinos Hatzikotoulas
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Institute of Translational Genomics, Helmholtz Zentrum München ‐ German Research Centre for Environmental Health Neuherberg Germany
| | - Joanna Hauser
- Department of Adult Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Sietske G. Helder
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- Zorg op Orde Delft The Netherlands
| | - Stefan Herms
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
| | - Beate Herpertz‐Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics Heidelberg University Hospital, Heidelberg University Heidelberg Germany
| | - Laura M. Huckins
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics Icahn School of Medicine at Mount Sinai New York New York USA
| | - James I. Hudson
- Biological Psychiatry Laboratory McLean Hospital/Harvard Medical School Boston Massachusetts USA
| | - Hartmut Imgart
- Eating Disorders Unit Parklandklinik Bad Wildungen Germany
| | - Hidetoshi Inoko
- Department of Molecular Life Science, Division of Basic Medical Science and Molecular Medicine, School of Medicine Tokai University Isehara Japan
| | - Vladimir Janout
- Faculty of Health Sciences Palacky University Olomouc Czech Republic
| | - Susana Jiménez‐Murcia
- Department of Psychiatry University Hospital of Bellvitge –IDIBELL and CIBERobn Barcelona Spain
- Department of Clinical Sciences, School of Medicine University of Barcelona Barcelona Spain
| | - Antonio Julià
- Rheumatology Research Group Vall d'Hebron Research Institute Barcelona Spain
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Deborah Kaminská
- Department of Psychiatry, First Faculty of Medicine Charles University Prague Czech Republic
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry Medical University of Vienna Vienna Austria
| | - Martien J.H. Kas
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
- Groningen Institute for Evolutionary Life Sciences University of Groningen Groningen The Netherlands
| | - James L. Kennedy
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | | | - Kirsty Kiezebrink
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition University of Aberdeen Aberdeen UK
| | - Youl‐Ri Kim
- Department of Psychiatry Seoul Paik Hospital, Inje University Seoul Korea
| | - Kelly L. Klump
- Department of Psychology Michigan State University East Lansing Michigan USA
| | | | - Maria C. La Via
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Stephanie Le Hellard
- Department of Clinical Science, Norwegian Centre for Mental Disorders Research (NORMENT) University of Bergen Bergen Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine Haukeland University Hospital Bergen Norway
- Department of Clinical Medicine, Laboratory Building Haukeland University Hospital Bergen Norway
| | - Robert D. Levitan
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Dong Li
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
| | - Lisa Lilenfeld
- The Chicago School of Professional Psychology, Washington DC Campus Washington District of Columbia USA
| | - Bochao Danae Lin
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention M Skłodowska‐Curie Cancer Center ‐ Oncology Center Warsaw Poland
| | - Jurjen Luykx
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
| | - Pierre J. Magistretti
- BESE Division King Abdullah University of Science and Technology Thuwal Saudi Arabia
- Department of Psychiatry University of Lausanne‐University Hospital of Lausanne (UNIL‐CHUV) Lausanne Switzerland
| | - Mario Maj
- Department of Psychiatry University of Campania "Luigi Vanvitelli" Naples Italy
| | - Katrin Mannik
- Estonian Genome Center University of Tartu Tartu Estonia
- Center for Integrative Genomics University of Lausanne Lausanne Switzerland
| | - Sara Marsal
- Rheumatology Research Group Vall d'Hebron Research Institute Barcelona Spain
| | - Christian R. Marshall
- Department of Paediatric Laboratory Medicine, Division of Genome Diagnostics The Hospital for Sick Children Toronto Ontario Canada
| | - Morten Mattingsdal
- NORMENT KG Jebsen Centre, Division of Mental Health and Addiction University of Oslo, Oslo University Hospital Oslo Norway
| | - Sara McDevitt
- Department of Psychiatry University College Cork Cork Ireland
- Eist Linn Adolescent Unit, Bessborough Health Service Executive South Cork Ireland
| | - Peter McGuffin
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Andres Metspalu
- Estonian Genome Center University of Tartu Tartu Estonia
- Institute of Molecular and Cell Biology University of Tartu Tartu Estonia
| | - Ingrid Meulenbelt
- Molecular Epidemiology Section (Department of Biomedical Datasciences) Leiden University Medical Centre Leiden The Netherlands
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine University of Geneva Geneva Switzerland
- Division of Child and Adolescent Psychiatry Geneva University Hospital Geneva Switzerland
| | - Karen Mitchell
- National Center for PTSD VA Boston Healthcare System Boston Massachusetts USA
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts USA
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Salerno Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence Florence Italy
| | - Marie Navratilova
- Department of Cancer, Epidemiology and Genetics Masaryk Memorial Cancer Institute Brno Czech Republic
| | - Ioanna Ntalla
- Department of Nutrition and Dietetics Harokopio University Athens Greece
| | | | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles Los Angeles California USA
- Department of Psychiatry, Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Leonid Padyukov
- Department of Medicine, Center for Molecular Medicine, Division of Rheumatology Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Aarno Palotie
- Program in Medical and Population Genetics Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
- Center for Human Genome Research Massachusetts General Hospital Boston Massachusetts USA
| | - Jacques Pantel
- Centre of Psychiatry and Neuroscience INSERM U894 Paris France
| | - Hana Papezova
- Department of Psychiatry, First Faculty of Medicine Charles University Prague Czech Republic
| | - Dalila Pinto
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics Icahn School of Medicine at Mount Sinai New York New York USA
| | - Raquel Rabionet
- Saint Joan de Déu Research Institute Saint Joan de Déu Barcelona Children's Hospital Barcelona Spain
- Institute of Biomedicine (IBUB) University of Barcelona Barcelona Spain
- Department of Genetics, Microbiology and Statistics University of Barcelona Barcelona Spain
| | - Anu Raevuori
- Department of Public Health University of Helsinki Helsinki Finland
| | - Nicolas Ramoz
- Institute of Psychiatry and Neuroscience of Paris INSERM U1266 Paris France
| | - Ted Reichborn‐Kjennerud
- Department of Mental Disorders Norwegian Institute of Public Health Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Valdo Ricca
- Department of Health Science University of Florence Florence Italy
| | - Samuli Ripatti
- Department of Biometry University of Helsinki Helsinki Finland
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Eating Disorders Research and Treatment Center Technische Universität Dresden Dresden Germany
| | - Marion Roberts
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Alessandro Rotondo
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies University of Pisa Pisa Italy
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Filip Rybakowski
- Department of Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Paolo Santonastaso
- Department of Neurosciences, Padua Neuroscience Center University of Padova Padova Italy
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences Jena University Hospital Jena Germany
| | - Stephen W. Scherer
- Department of Genetics and Genomic Biology The Hospital for Sick Children Toronto Ontario Canada
- McLaughlin Centre University of Toronto Toronto Ontario Canada
| | - Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | | | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy Medical University of Vienna Vienna Austria
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | - Lenka Slachtova
- Department of Pediatrics and Center of Applied Genomics, First Faculty of Medicine Charles University Prague Czech Republic
| | - P. Eline Slagboom
- Molecular Epidemiology Section (Department of Medical Statistics) Leiden University Medical Centre Leiden The Netherlands
| | - Margarita C.T. Slof‐Op't Landt
- Center for Eating Disorders Ursula Rivierduinen Leiden The Netherlands
- Department of Psychiatry Leiden University Medical Centre Leiden The Netherlands
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence Florence Italy
- IRCCS Fondazione Don Carlo Gnocchi Florence Italy
| | - Beata Świątkowska
- Department of Environmental Epidemiology Nofer Institute of Occupational Medicine Lodz Poland
| | - Jin P. Szatkiewicz
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | | | - Elena Tenconi
- Department of Neurosciences University of Padova Padova Italy
| | - Alfonso Tortorella
- Department of Psychiatry University of Naples SUN Naples Italy
- Department of Psychiatry University of Perugia Perugia Italy
| | - Federica Tozzi
- Brain Sciences Department Stremble Ventures Limassol Cyprus
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics "P. & A. Kyriakou" Children's Hospital, University of Athens Athens Greece
| | - Marta Tyszkiewicz‐Nwafor
- Department of Child and Adolescent Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Konstantinos Tziouvas
- Pediatric Intensive Care Unit "P. & A. Kyriakou" Children's Hospital, University of Athens Athens Greece
| | - Annemarie A. Elburg
- Center for Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
- Faculty of Social and Behavioral Sciences Utrecht University Utrecht The Netherlands
| | - Eric F. Furth
- Center for Eating Disorders Ursula Rivierduinen Leiden The Netherlands
- Department of Psychiatry Leiden University Medical Centre Leiden The Netherlands
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry Medical University of Vienna Vienna Austria
| | - Esther Walton
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Eleftheria Zeggini
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Institute of Translational Genomics, Helmholtz Zentrum München ‐ German Research Centre for Environmental Health Neuherberg Germany
| | - Stephanie Zerwas
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy University Medical Hospital Tuebingen Tuebingen Germany
| | - Andrew W. Bergen
- BioRealm, LLC Walnut California USA
- Oregon Research Institute Eugene Oregon USA
| | - Joseph M. Boden
- Christchurch Health and Development Study University of Otago Christchurch New Zealand
| | - Harry Brandt
- The Center for Eating Disorders at Sheppard Pratt Baltimore Maryland USA
| | - Steven Crawford
- The Center for Eating Disorders at Sheppard Pratt Baltimore Maryland USA
| | - Katherine A. Halmi
- Department of Psychiatry Weill Cornell Medical College New York New York USA
| | - L. John Horwood
- Christchurch Health and Development Study University of Otago Christchurch New Zealand
| | | | - Allan S. Kaplan
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Walter H. Kaye
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - James Mitchell
- Department of Psychiatry and Behavioral Science University of North Dakota School of Medicine and Health Sciences Fargo North Dakota USA
| | - Catherine M. Olsen
- Population Health Department QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - John F. Pearson
- Biostatistics and Computational Biology Unit University of Otago Christchurch New Zealand
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Science, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles Los Angeles California USA
- David Geffen School of Medicine University of California Los Angeles Los Angeles California USA
| | - Thomas Werge
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - David C. Whiteman
- Population Health Department QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - D. Blake Woodside
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Centre for Mental Health University Health Network Toronto Ontario Canada
- Program for Eating Disorders University Health Network Toronto Ontario Canada
| | - Jakob Grove
- Department of Biomedicine Aarhus University Aarhus Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- Centre for Integrative Sequencing, iSEQ Aarhus University Aarhus Denmark
- Bioinformatics Research Centre Aarhus University Aarhus Denmark
| | - Anjali K. Henders
- Institute for Molecular Bioscience University of Queensland Brisbane Queensland Australia
| | - Janne T. Larsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Richard Parker
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Liselotte V. Petersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Jennifer Jordan
- Department of Psychological Medicine University of Otago Christchurch New Zealand
- Canterbury District Health Board Christchurch New Zealand
| | - Martin A. Kennedy
- Department of Pathology and Biomedical Science University of Otago Christchurch New Zealand
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Claes Norring
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Renato Polimanti
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
| | - Jeanette N. McClintick
- Department of Biochemistry and Molecular Biology Indiana University School of Medicine Indianapolis Indiana USA
| | - Amy E. Adkins
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
| | - Fazil Aliev
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- Faculty of Business Karabuk University Karabuk Turkey
| | - Silviu‐Alin Bacanu
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Anthony Batzler
- Psychiatric Genomics and Pharmacogenomics Program Mayo Clinic Rochester Minnesota USA
| | - Sarah Bertelsen
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - Joanna M. Biernacka
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Tim B. Bigdeli
- Department of Psychiatry and Behavioral Sciences State University of New York Downstate Medical Center Brooklyn New York USA
| | - Li‐Shiun Chen
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | | | - Franziska Degenhardt
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | - Anna R. Docherty
- Department of Psychiatry University of Utah Salt Lake City Utah USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Jerome C. Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Louis Fox
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Laura M. Hack
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Annette M. Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Sarah M. Hartz
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Stefanie Heilmann‐Heimbach
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | | | - Per Hoffmann
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Institute of Human Genetics School of Medicine & University Hospital Bonn, University of Bonn Bonn Germany
- Human Genomics Research Group, Department of Biomedicine University of Basel Basel Switzerland
| | - Jouke‐Jan Hottenga
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Bettina Konte
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Jari Lahti
- Turku Institute for Advanced Studies University of Turku Turku Finland
| | | | - Dongbing Lai
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Lannie Ligthart
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Anu Loukola
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Brion S. Maher
- Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Hamdi Mbarek
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Cognitive Ageing and Cognitive Epidemiology University of Edinburgh Edinburgh UK
| | - Matthew B. McQueen
- Department of Integrative Physiology University of Colorado Boulder Boulder Colorado USA
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, Henri Begleiter Neurodynamics Laboratory SUNY Downstate Medical Center Brooklyn New York USA
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health Research Institute VU University Medical Center/GGz inGeest Amsterdam The Netherlands
| | - Teemu Palviainen
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Euijung Ryu
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
| | - Nancy L. Saccone
- Department of Genetics Washington University School of Medicine Saint Louis Missouri USA
| | - Jessica E. Salvatore
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Sandra Sanchez‐Roige
- Department of Psychiatry University of California San Diego La Jolla California USA
| | | | - Richard Sherva
- Department of Medicine (Biomedical Genetics) Boston University School of Medicine Boston Massachusetts USA
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Nathaniel Thomas
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
| | - Jen‐Chyong Wang
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - Bradley T. Webb
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Robbee Wedow
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Cambridge Massachusetts USA
- Department of Sociology Harvard University Cambridge Massachusetts USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Amanda G. Wills
- Department of Pharmacology University of Colorado School of Medicine Aurora Colorado USA
| | - Hang Zhou
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
| | - Jason D. Boardman
- Institute of Behavioral Science University of Colorado Boulder Colorado USA
- Department of Sociology University of Colorado Boulder Colorado USA
| | - Danfeng Chen
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Doo‐Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic Rochester Minnesota USA
| | - William E. Copeland
- Department of Psychiatry University of Vermont Medical Center Burlington Vermont USA
| | - Robert C. Culverhouse
- Department of Medicine, Division of Biostatistics Washington University School of Medicine Saint Louis Missouri USA
| | - Norbert Dahmen
- Department of Psychiatry University of Mainz Mainz Germany
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre University of New South Wales Sydney New South Wales Australia
| | - Benjamin W. Domingue
- Stanford University Graduate School of Education Stanford University Stanford California USA
| | - Mark A. Frye
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Wolfgang Gäebel
- Department of Psychiatry and Psychotherapy University of Düsseldorf Duesseldorf Germany
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh UK
| | - Marcus Ising
- Max‐Planck‐Institute of Psychiatry Munich Germany
| | - Margaret Keyes
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - John Kramer
- Department of Psychiatry University of Iowa Roy J and Lucille A Carver College of Medicine Iowa City Iowa USA
| | - Samuel Kuperman
- Department of Psychiatry University of Iowa Roy J and Lucille A Carver College of Medicine Iowa City Iowa USA
| | | | - Michael T. Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Wolfgang Maier
- Department of Psychiatry University of Bonn Bonn Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Satu Männistö
- Department of Public Health Solutions National Institute for Health and Welfare Helsinki Finland
| | - Bertram Müller‐Myhsok
- Department of Statistical Genetics Max‐Planck‐Institute of Psychiatry München Germany
| | - Alison D. Murray
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences & Nutrition University of Aberdeen Foresterhill Aberdeen UK
| | - John I. Nurnberger
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana USA
| | - Ulrich Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Herborn Germany
- Department of Psychiatry and Psychotherapy Vitos Hospital Herborn Herborn Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics University of Helsinki Helsinki Finland
| | | | - Monika Ridinger
- Department of Psychiatry and Psychotherapy University of Regensburg Psychiatric Health Care Aargau Regensburg Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy and Department of Addictive Behaviour and Addiction Medicine, Medical Faculty LVR‐Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Marc A. Schuckit
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - Michael Soyka
- Medical Park Chiemseeblick in Bernau‐Felden Ludwig‐Maximilians‐University Bernau am Chiemsee Germany
- Psychiatric Hospital, Ludwig‐Maximilians‐University Bernau am Chiemsee Germany
| | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Norbert Wodarz
- Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany
| | - Peter Zill
- Department of Psychiatry Psychiatric Hospital, Ludwig‐Maximilians‐University Munich Germany
| | - Daniel E. Adkins
- Department of Psychiatry University of Utah Salt Lake City Utah USA
- Department of Sociology University of Utah Salt Lake City Utah USA
| | - Dorret I. Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Laura J. Bierut
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Sandra A. Brown
- Department of Psychiatry University of California San Diego La Jolla California USA
- Department of Psychology University of California San Diego La Jolla California USA
| | - Kathleen K. Bucholz
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - E. Jane Costello
- Department of Psychiatry and Behavioral Sciences Duke University Medical Center Durham North Carolina USA
| | - Harriet Wit
- Department of Psychiatry and Behavioral Neuroscience University of Chicago Chicago Illinois USA
| | | | - Johan G. Eriksson
- Department of General Practice and Primary Health Care University of Helsinki Helsinki Finland
- National Institute for Health and Welfare Helsinki Finland
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics) Boston University School of Medicine Boston Massachusetts USA
- Department of Neurology Boston University School of Medicine Boston Massachusetts USA
- Department of Ophthalmology Boston University School of Medicine Boston Massachusetts USA
- Department of Epidemiology, School of Public Health Boston University Boston Massachusetts USA
- Department of Biostatistics, School of Public Health Boston University Boston Massachusetts USA
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Alison M. Goate
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - David Goldman
- Laboratory of Neurogenetics NIH/NIAAA Bethesda Maryland USA
- Office of the Clinical Director NIH/NIAAA Besthesda Maryland USA
| | - Richard A. Grucza
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Dana B. Hancock
- Center for Omics Discovery and Epidemiology, Behavioral Health Research Division RTI International Research Triangle Park North Carolina USA
| | - Kathleen Mullan Harris
- Department of Sociology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Carolina Population Center University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Victor Hesselbrock
- Department of Psychiatry University of Connecticut School of Medicine Farmington Connecticut USA
| | - John K. Hewitt
- Institute for Behavioral Genetics University of Colorado Boulder Boulder Colorado USA
| | | | - William G. Iacono
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Eric O. Johnson
- Center for Omics Discovery and Epidemiology, Behavioral Health Research Division RTI International Research Triangle Park North Carolina USA
- Fellow Program RTI International Research Triangle Park North Carolina USA
| | - Victor M. Karpyak
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Henry R. Kranzler
- Center for Studies of Addiction University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- VISN 4 MIRECC Crescenz VAMC Philadelphia Pennsylvania USA
| | - Kenneth Krauter
- Department of Molecular, Cellular, and Developmental Biology University of Colorado Boulder Boulder Colorado USA
| | - Penelope A. Lind
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Matt McGue
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research McMaster University/St. Joseph's Healthcare Hamilton Hamilton Ontario Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research McMaster University/St. Joseph's Healthcare Hamilton Hamilton Ontario Canada
| | - Pamela A.F. Madden
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Hermine H. Maes
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Elliot C. Nelson
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Markus M. Nöthen
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | - Abraham A. Palmer
- Department of Psychiatry University of California San Diego La Jolla California USA
- Institute for Genomic Medicine University of California San Diego La Jolla California USA
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC VU University and GGZinGeest Amsterdam The Netherlands
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, Henri Begleiter Neurodynamics Laboratory SUNY Downstate Medical Center Brooklyn New York USA
| | - John P. Rice
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Brien P. Riley
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Richard J. Rose
- Department of Psychological & Brain Sciences Indiana University Bloomington Bloomington Indiana USA
| | - Pei‐Hong Shen
- Laboratory of Neurogenetics NIH/NIAAA Bethesda Maryland USA
| | - Judy Silberg
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Michael C. Stallings
- Institute for Behavioral Genetics University of Colorado Boulder Boulder Colorado USA
| | - Ralph E. Tarter
- School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania USA
| | | | - Scott Vrieze
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Tamara L. Wall
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - John B. Whitfield
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health Yale University New Haven Connecticut USA
| | - Benjamin M. Neale
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Tracey D. Wade
- School of Psychology Flinders University Adelaide South Australia Australia
| | - Andrew C. Heath
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Grant W. Montgomery
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- Institute for Molecular Bioscience University of Queensland Brisbane Queensland Australia
- Queensland Brain Institute University of Queensland Brisbane Queensland Australia
| | | | - Patrick F. Sullivan
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Jaakko Kaprio
- Department of Public Health University of Helsinki Helsinki Finland
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Joel Gelernter
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
- Department of Genetics Yale School of Medicine New Haven Connecticut USA
- Department of Neuroscience Yale School of Medicine New Haven Connecticut USA
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology Indiana University School of Medicine Indianapolis Indiana USA
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Cynthia M. Bulik
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Nutrition University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Arpana Agrawal
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
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Li D, Ryu E, Saeidian AH, Youssefian L, Oliphant E, Terry SF, Tong PL, Uitto J, Haass NK, Li Q. GGCX mutations in a patient with overlapping pseudoxanthoma elasticum/cutis laxa-like phenotype. Br J Dermatol 2020; 184:1170-1174. [PMID: 33000479 DOI: 10.1111/bjd.19576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 12/15/2022]
Abstract
Pseudoxanthoma elasticum (PXE) is a multisystem disorder characterized by ectopic mineralization of connective tissues with primary manifestations in the skin, eyes and the cardiovascular system. The classic forms of PXE are caused by mutations in the ABCC6 gene encoding the ABCC6 protein, expressed primarily in the liver. Cutis laxa (CL) manifests with loose and sagging skin with loss of recoil. In 2009 we investigated a 19-year-old patient with overlapping cutaneous features of PXE and CL, together with alpha thalassaemia. Genetic analysis failed to identify pathogenic mutations in ABCC6. More recently we developed a gene-targeted panel of next-generation sequencing technology. This panel has 29 genes, 22 of which, including ABCC6 and GGCX, are associated with ectopic mineralization phenotypes. Mutation analysis in the patient identified two heterozygous GGCX mutations: c.200_201delTT in exon 2 and c.763G>A, p.V255M in exon 7. The GGCX gene encodes a γ-glutamyl carboxylase necessary for activation of blood coagulation factors in the liver. The p.V255M mutation was previously reported to result in reduced γ-glutamyl carboxylase activity in vitro, while the c.200_201delTT mutation is novel. Previous studies reported that mutations in GGCX cause overlapping PXE/CL skin phenotypes in association with or without multiple vitamin K-dependent coagulation factor deficiency. Our patient had loose redundant skin, moderate-to-severe angioid streaks and characteristic calcification of elastic structures in the mid dermis, consistent with PXE/CL overlap, but no coagulation abnormalities. Our studies expand the GGCX mutation landscape in patients with PXE-like phenotypes.
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Affiliation(s)
- D Li
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - E Ryu
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - A H Saeidian
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA.,Genetics, Genomics and Cancer Biology PhD Program, Thomas Jefferson University, Philadelphia, PA, USA
| | - L Youssefian
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - E Oliphant
- PXE International, Inc, Washington, DC, 20008, USA
| | - S F Terry
- PXE International, Inc, Washington, DC, 20008, USA
| | - P L Tong
- Discipline of Dermatology, University of Sydney, Camperdown, NSW, Australia.,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - J Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - N K Haass
- Discipline of Dermatology, University of Sydney, Camperdown, NSW, Australia.,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Q Li
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and PXE International Center of Excellence in Research and Clinical Care, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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30
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Li Y, Nair P, Lu XH, Wen Z, Wang Y, Dehaghi AAK, Miao Y, Liu W, Ordog T, Biernacka JM, Ryu E, Olson JE, Frye MA, Liu A, Guo L, Marelli A, Ahuja Y, Davila-Velderrain J, Kellis M. Inferring multimodal latent topics from electronic health records. Nat Commun 2020; 11:2536. [PMID: 32439869 PMCID: PMC7242436 DOI: 10.1038/s41467-020-16378-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
Electronic health records (EHR) are rich heterogeneous collections of patient health information, whose broad adoption provides clinicians and researchers unprecedented opportunities for health informatics, disease-risk prediction, actionable clinical recommendations, and precision medicine. However, EHRs present several modeling challenges, including highly sparse data matrices, noisy irregular clinical notes, arbitrary biases in billing code assignment, diagnosis-driven lab tests, and heterogeneous data types. To address these challenges, we present MixEHR, a multi-view Bayesian topic model. We demonstrate MixEHR on MIMIC-III, Mayo Clinic Bipolar Disorder, and Quebec Congenital Heart Disease EHR datasets. Qualitatively, MixEHR disease topics reveal meaningful combinations of clinical features across heterogeneous data types. Quantitatively, we observe superior prediction accuracy of diagnostic codes and lab test imputations compared to the state-of-art methods. We leverage the inferred patient topic mixtures to classify target diseases and predict mortality of patients in critical conditions. In all comparison, MixEHR confers competitive performance and reveals meaningful disease-related topics.
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Affiliation(s)
- Yue Li
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada.
| | - Pratheeksha Nair
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | - Xing Han Lu
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | - Zhi Wen
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | - Yuening Wang
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | | | - Yan Miao
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | - Weiqi Liu
- School of Computer Science and McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, H3A0E9, Canada
| | - Tamas Ordog
- Department of Physiology and Biomedical Engineering and Division of Gastroenterology and Hepatology, Department of Medicine, and Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aihua Liu
- McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Montreal, QC H4A 3J1, Quebec, Canada
| | - Liming Guo
- McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Montreal, QC H4A 3J1, Quebec, Canada
| | - Ariane Marelli
- McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Montreal, QC H4A 3J1, Quebec, Canada
| | - Yuri Ahuja
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, 32 Vassar St, Cambridge, MA, 02139, USA
| | - Jose Davila-Velderrain
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, 32 Vassar St, Cambridge, MA, 02139, USA
| | - Manolis Kellis
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, 32 Vassar St, Cambridge, MA, 02139, USA.
- The Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA, 02142, USA.
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31
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Seol HY, Wi CI, Ryu E, King KS, Divekar RD, Juhn YJ. A diagnostic codes-based algorithm improves accuracy for identification of childhood asthma in archival data sets. J Asthma 2020; 58:1077-1086. [PMID: 32315558 DOI: 10.1080/02770903.2020.1759624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE While a single but truncated ICD code (493) had been widely used for identifying asthma in asthma care and research, it significantly under-identifies asthma. We aimed to develop and validate a diagnostic codes-based algorithm for identifying asthmatics using Predetermined Asthma Criteria (PAC) as the reference. METHODS This is a retrospective cross-sectional study which utilized two different coding systems, the Hospital Adaptation of the International Classification of Diseases, Eighth Revision (H-ICDA) and the International Classification of Diseases, Ninth Revision (ICD-9). The algorithm was developed using two population-based asthma study cohorts, and validated in a validation cohort, a random sample of the 1976-2007 Olmsted County Birth Cohort. Performance of the diagnostic codes-based algorithm for ascertaining asthma status against manual chart review for PAC (gold standard) was assessed by determining both criterion and construct validity. RESULTS Among eligible 267 subjects of the validation cohort, 50% were male, 70% white, and the median age at last follow-up was 17 (interquartile range, 8.7-24.4) years. Asthma prevalence by PAC through manual chart review was 34%. Sensitivity and specificity of the codes-based algorithm for identifying asthma were 82% and 98% respectively. Associations of asthma-related risk factors with asthma status ascertained by the code-based algorithm were similar to those by the manual review. CONCLUSIONS The diagnostic codes-based algorithm for identifying asthmatics improves accuracy of identification of asthma and can be a useful tool for large scale studies in a setting without automated chart review capabilities.
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Affiliation(s)
- Hee Yun Seol
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Katherine S King
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Rohit D Divekar
- Division of Allergic Disease, Mayo Clinic, Rochester, Minnesota, USA
| | - Young J Juhn
- Department of Pediatric and Adolescent Medicine/Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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32
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Patten CA, Juhn YJ, Ryu E, Wi CI, King KS, Bublitz JT, Pignolo RJ. Rural-urban health disparities for mood disorders and obesity in a midwestern community. J Clin Transl Sci 2020; 4:408-415. [PMID: 33244429 PMCID: PMC7681122 DOI: 10.1017/cts.2020.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/26/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Prior studies indicate greater disease burden for obesity among rural compared with urban residents but no differences for mood disorder based on geographic location. Recent attention has focused on the need to examine regional rural-urban disparities in disease burden. We focused on mood disorders and obesity prevalence within three southeastern Minnesota counties served by the Mayo Clinic Center for Translational Science Award, in Rochester, Minnesota, as these were top priorities identified in community health needs assessments. METHODS Cross-sectional study to assess the association of rural-urban locality on 5-year (2009-2014) prevalence of mood disorder and obesity obtained using the Rochester Epidemiological Project medical records linkage system, among subjects residing in three mixed rural-urban counties on April 1, 2014. Multivariable analyses adjusted for demographics, socioeconomic status using an individual housing-based measure, and counties. RESULTS The study cohort (percent rural location) included 91,202 (15%) for Olmsted, 10,197 (51%) in Dodge, and 10,184 (57%) in Wabasha counties. On multivariate analysis, 5-year prevalence of mood disorders and obesity was significantly greater for urban compared with rural residents, after adjusting for confounders; odds ratios (95% confidence intervals): 1.21 (1.17-1.26), P < 0.001, and 1.05 (1.01-1.10), P = 0.016, respectively. Observed effects were not modified in additional models adjusted for health care utilization (HCU; ≥1 general medical examination visit and flu vaccination). CONCLUSIONS Rural-urban health disparities for burden of mood disorders and obesity are independent of socioeconomic status and HCU in a Midwestern community. It is important to assess potential regional heterogeneity of rural-urban disparities on health outcomes.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Young J. Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Katherine S. King
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Josh T. Bublitz
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
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33
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Pan AY, Ryu E, Geske JR, Zhou XY, McElroy SL, Cicek MS, Frye MA, Biernacka JM, Andreazza AC. The impact of sample processing on inflammatory markers in serum: Lessons learned. World J Biol Psychiatry 2020; 21:230-237. [PMID: 31749403 DOI: 10.1080/15622975.2019.1696474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To investigate the effect of sample handling on inflammatory cytokines in serum and highlight challenges with using samples pre-collected from biobanks for biomarker research.Methods: Cytokine concentrations (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, and IFNγ) were measured in serum samples of 205 patients with bipoldar disorder (BD) from the Mayo Clinic Bipolar Disorder Biobank and 205 non-psychiatric controls from the Mayo Clinic Biobank. As cytokine concentrations varied by recruitment site, post-hoc models were used to test the effect of clinical variables and pre-processing time on cytokines. To evaluate the effect of pre-processing time experimentally, cytokines were assayed in serum and plasma from 6 healthy volunteers processed at different time points.Results: Cytokine levels were significantly higher in the BD group. However, both cytokine levels and pre-processing times differed by recruitment site, and post-hoc analyses revealed that pre-processing time was significantly associated with several cytokines. An experiment using samples from healthy volunteers confirmed that concentrations for most cytokines increased with longer pre-processing times.Conclusions: Delays in processing influence cytokine concentrations in blood samples. Given the increasing use of biobanks in research, this study highlights the need to carefully evaluate sample collection and handling methods when designing biomarker studies.
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Affiliation(s)
- Alexander Y Pan
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jennifer R Geske
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Xinyang Y Zhou
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | | | - Mine S Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ana C Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.,Center of Addiction and Mental Health, Toronto, Canada
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Seol HY, Rolfes MC, Chung W, Sohn S, Ryu E, Park MA, Kita H, Ono J, Croghan I, Armasu SM, Castro-Rodriguez JA, Weston JD, Liu H, Juhn Y. Expert artificial intelligence-based natural language processing characterises childhood asthma. BMJ Open Respir Res 2020; 7:7/1/e000524. [PMID: 33371009 PMCID: PMC7011897 DOI: 10.1136/bmjresp-2019-000524] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/04/2020] [Accepted: 01/10/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The lack of effective, consistent, reproducible and efficient asthma ascertainment methods results in inconsistent asthma cohorts and study results for clinical trials or other studies. We aimed to assess whether application of expert artificial intelligence (AI)-based natural language processing (NLP) algorithms for two existing asthma criteria to electronic health records of a paediatric population systematically identifies childhood asthma and its subgroups with distinctive characteristics. METHODS Using the 1997-2007 Olmsted County Birth Cohort, we applied validated NLP algorithms for Predetermined Asthma Criteria (NLP-PAC) as well as Asthma Predictive Index (NLP-API). We categorised subjects into four groups (both criteria positive (NLP-PAC+/NLP-API+); PAC positive only (NLP-PAC+ only); API positive only (NLP-API+ only); and both criteria negative (NLP-PAC-/NLP-API-)) and characterised them. Results were replicated in unsupervised cluster analysis for asthmatics and a random sample of 300 children using laboratory and pulmonary function tests (PFTs). RESULTS Of the 8196 subjects (51% male, 80% white), we identified 1614 (20%), NLP-PAC+/NLP-API+; 954 (12%), NLP-PAC+ only; 105 (1%), NLP-API+ only; and 5523 (67%), NLP-PAC-/NLP-API-. Asthmatic children classified as NLP-PAC+/NLP-API+ showed earlier onset asthma, more Th2-high profile, poorer lung function, higher asthma exacerbation and higher risk of asthma-associated comorbidities compared with other groups. These results were consistent with those based on unsupervised cluster analysis and lab and PFT data of a random sample of study subjects. CONCLUSION Expert AI-based NLP algorithms for two asthma criteria systematically identify childhood asthma with distinctive characteristics. This approach may improve precision, reproducibility, consistency and efficiency of large-scale clinical studies for asthma and enable population management.
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Affiliation(s)
- Hee Yun Seol
- Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA,Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Mary C Rolfes
- Mayo Clinic Alix School of Medicine, Rocheser, Minnesota, USA
| | - Wi Chung
- Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sunghwan Sohn
- Digital Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Euijung Ryu
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Miguel A Park
- Allergic Diseases, Mayo Clinic, Rochester, MN, United States
| | - Hirohito Kita
- Allergic Diseases, Mayo Clinic, Rochester, MN, United States
| | - Junya Ono
- Research and Development Unit, Shino-Test Corporation, Sagamihara, Japan
| | - Ivana Croghan
- Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Sebastian M Armasu
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | | | - Jill D Weston
- Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hongfang Liu
- Digital Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Young Juhn
- Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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35
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Hathcock MA, Kirt C, Ryu E, Bublitz J, Gupta R, Wang L, Thibodeau SN, Larson NL, Cicek MS, Cerhan JR, Olson JE. Characteristics Associated With Recruitment and Re-contact in Mayo Clinic Biobank. Front Public Health 2020; 8:9. [PMID: 32117849 PMCID: PMC7010638 DOI: 10.3389/fpubh.2020.00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To better understand the characteristics associated with a participant's willingness to consent to the Mayo Clinic Biobank (MCB) and examine factors associated with willingness to participate in follow-up studies embedded within MCB that require re-contact and participant approval. Participants and Methods: Consent rates were compared across patient demographics to the MCB. Rates of participation to follow-up studies were also compared across demographics and request types. Results: Among 272,102 Mayo Clinic patients invited to the MCB, 48,314 (19%) consented across the three recruitment sites within 90 days of initial invitation. A significant age by gender interaction was identified, showing young males consent at a lower rate than young females and older males consent at a higher rate than older females. Over the recruitment time frame of 2009-2015, there was a significant decrease in consent rates (decline of 2.5%/year). Of the 57,041 consented MCB participants, 33,487 participants (59%) have been invited to participate in follow-up studies via re-contact. Follow-up studies of the MCB may require participants to provide additional samples, complete questionnaires, and/or release their identity to a research team. MCB participants have been invited to enroll in a median of two studies (IQR: 1-3). Seventy-one percent of participants consented to at least one follow-up study, with individual follow-up study consent rates ranging from 14 to 87% depending on study type, with a median consent rate of 61% (IQR: 47-70%). Studies requesting return of a questionnaire had the highest participation rates. White participants, older participants, and participants with some college or a degree were significantly more likely to participate to follow-up studies, while there was no association with gender. Conclusion: Consent rates among younger and non-white patients were lower than in older, white patients. However, we also found that participation rates among those already enrolled in the biobank were much higher than those seen in new recruitment efforts, external to an existing biobank. We thus demonstrate an important way that biobanks can advance precision medicine goals: through provision of populations from which studies can draw participants for future studies.
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Affiliation(s)
- Matthew A Hathcock
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Christine Kirt
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Josh Bublitz
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Ruchi Gupta
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Liwei Wang
- Division of Digital Health Sciences, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Nicole L Larson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Mine S Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Janet E Olson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
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Kwon J, Ryu E, Wi CI, Seol H, King K, Yoon J, Park M, Sohn S, Liu H, Juhn Y. Association of Asthma Prognosis with Risk of Asthma-Associated Infectious and Inflammatory Multimorbidities (AIMs) in Children with Asthma. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wi CI, Gent J, King K, Bublitz J, Ryu E, Sorrentino K, Plano J, Porcher J, Wheeler P, Juhn Y. Variation of Residential Levels of Nitrogen Dioxide in a Mixed Rural-Urban Setting and its Implication in Childhood Asthma. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoon J, Ryu E, Wi CI, Kwon J, King K, Park M, Sohn S, Liu H, Juhn Y. Assessment of asthma outcomes among children with and without a timely physician diagnosis of asthma. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ryan CS, Juhn YJ, Kaur H, Wi CI, Ryu E, King KS, Lachance DH. Long-term incidence of glioma in Olmsted County, Minnesota, and disparities in postglioma survival rate: a population-based study. Neurooncol Pract 2019; 7:288-298. [PMID: 32537178 DOI: 10.1093/nop/npz065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background We assessed glioma incidence and disparities in postglioma survival rate in the Olmsted County, Minnesota, population. Methods This population-based study assessed the incidence of pathologically confirmed primary gliomas between January 1, 1995, and December 31, 2014. Age- and sex-adjusted incidence rates per 100 000 person-years were calculated and standardized to the US white 2010 population. We compared incidence trends of glioma during our study period with previously published Olmsted County data from 1950 to 1990. We assessed postglioma survival rates among individuals with different socioeconomic status (SES), which was measured by a validated individual HOUsing-based SES index (HOUSES). Results We identified 135 incident glioma cases (93% white) with 20 pediatric (50% female) and 115 adult cases (44% female). Overall incidence rate during our study period, 5.51 per 100 000 person-years (95% CI: 4.56-6.46), showed no significant changes and was similar to that seen in 1950 to 1990, 5.5 per 100 000 person-years. The incidence of pediatric (age < 20 years) glioma was 2.49 (95% CI: 1.40-3.58), whereas adult glioma incidence was 6.47 (95% CI: 5.26-7.67). Among those with grade II to IV gliomas, individuals with lower SES (< median HOUSES) had significantly lower 5-year survival rates compared to those with higher SES, adjusted hazard ratio 1.61 (95% CI: 1.01-2.85). Conclusion In a well-defined North American population, long-term glioma incidence appears stable since 1950. Significant socioeconomic disparities exist for postglioma survival.
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Affiliation(s)
- Conor S Ryan
- Department of Neurology, Mayo Clinic, Rochester, MN
| | - Young J Juhn
- Department of Pediatrics, Mayo Clinic, Rochester, MN
| | - Harsheen Kaur
- Department of Pediatrics, Mayo Clinic, Rochester, MN
| | - Chung-Il Wi
- Department of Pediatrics, Mayo Clinic, Rochester, MN
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Katherine S King
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Olson JE, Ryu E, Hathcock MA, Gupta R, Bublitz JT, Takahashi PY, Bielinski SJ, St Sauver JL, Meagher K, Sharp RR, Thibodeau SN, Cicek M, Cerhan JR. Characteristics and utilisation of the Mayo Clinic Biobank, a clinic-based prospective collection in the USA: cohort profile. BMJ Open 2019; 9:e032707. [PMID: 31699749 PMCID: PMC6858142 DOI: 10.1136/bmjopen-2019-032707] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The Mayo Clinic Biobank was established to provide a large group of patients from which comparison groups (ie, controls) could be selected for case-control studies, to create a prospective cohort with sufficient power for common outcomes and to support electronic health record (EHR) studies. PARTICIPANTS A total of 56 862 participants enrolled (21% response rate) into the Mayo Clinic Biobank from Rochester, Minnesota (77%, n=43 836), Jacksonville, Florida (18%, n=10 368) and La Crosse, Wisconsin (5%, n=2658). Participants were all Mayo Clinic patients, 18 years of age or older and US residents. FINDINGS TO DATE Overall, 43% of participants were 65 years of age or older and female participants were more frequent (59%) than males at all sites. Most participants resided in the Upper Midwest regions of the USA (Minnesota, Iowa, Illinois or Wisconsin), Florida or Georgia. Self-reported race among Biobank participants was 90% white. Here we provide examples of the types of studies that have successfully utilised the resource, including (1) investigations of the population itself, (2) provision of controls for case-control studies, (3) genotype-driven research, (4) EHR-based research and (5) prospective recruitment to other studies. Over 270 projects have been approved to date to access Biobank data and/or samples; over 200 000 sample aliquots have been approved for distribution. FUTURE PLANS The data and samples in the Mayo Clinic Biobank can be used for various types of epidemiological and clinical studies, especially in the setting of case-control studies for which the Biobank samples serve as control samples. We are planning cohort studies with additional follow-up and acquisition of genetic information on a large scale.
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Affiliation(s)
- Janet E Olson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Euijung Ryu
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew A Hathcock
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ruchi Gupta
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Joshua T Bublitz
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul Y Takahashi
- Division of Primary Care Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L St Sauver
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Karen Meagher
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard R Sharp
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mine Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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Abstract
OBJECTIVES Literature suggests an inconsistent, but largely inverse, association between asthma and risk of glioma, which is primarily due to methodological inconsistency in sampling frame and ascertainment of asthma. The objective of the study was to clarify the association between asthma and risk of glioma by minimising methodological biases (eg, recall and detection bias). DESIGN A population-based case-control study. SETTING General population in Olmsted County, Minnesota, USA. PARTICIPANTS All eligible biopsy-proven incident glioma cases (1995-2014) and two sets of controls among residents matched to age and sex (first set: community controls without glioma; second set: MRI-negative controls from the same community). METHODS The predetermined asthma criteria via medical record review were applied to ascertain asthma status of cases and controls. History of asthma prior to index date was compared between glioma cases and their matched controls using conditional logistic regression models. Propensity score for asthma status was adjusted for multivariate analysis. RESULTS We enrolled 135 glioma cases (median age at index date: 53 years) and 270 controls. Of the cases, 21 had a history of asthma (16%), compared with 36 of MRI controls (27%) (OR (95% CI) 0.48 (0.26 to 0.91), p=0.03). With MRI controls, an inverse association between asthma and risk of glioma persisted after adjusting for the propensity score for asthma status, but did not reach statistical significance probably due to the lack of statistical power (OR (95% CI) 0.48 (0.21 to 1.09); p=0.08). Based on comparison of characteristics of controls and cases, community controls seem to be more susceptible to a detection bias. CONCLUSIONS While differential detection might account for the association between asthma and risk of glioma, asthma may potentially pose a protective effect on risk of glioma. Our study results need to be replicated by a larger study.
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Affiliation(s)
- Harsheen Kaur
- Pediatric Neurology, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Conor S Ryan
- Child and Adolescent Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Youn Ho Sheen
- Pediatrics, CHA Gangnam Medical Center, Seoul, Korea
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hee Yun Seol
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Chung-Il Wi
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sunghwan Sohn
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Katherine S King
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Euijung Ryu
- Health Science Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Young Juhn
- Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Abstract
OBJECTIVE Two pertussis outbreaks occurred in Olmsted County, Minnesota, during 2004-2005 and 2012 (5-10 times higher than other years), with significantly higher incidence than for the State. We aimed to assess whether there were similar spatio-temporal patterns between the two outbreaks. SETTING Olmsted County, Minnesota, USA PARTICIPANTS: We conducted a population-based retrospective cohort study of all Olmsted County residents during the 2004-2005 and 2012 outbreaks, including laboratory-positive pertussis cases. PRIMARY OUTCOME MEASURE For each outbreak, we estimated (1) age-specific incidence rate using laboratory-positive pertussis cases (numerator) and the Rochester Epidemiology Project Census (denominator), a medical record-linkage system for virtually all Olmsted County residents, and (2) pertussis case density using kernel density estimation to identify areas with high case density. To account for population size, we calculated relative difference of observed density and expected density based on age-specific incidence. RESULTS We identified 157 and 195 geocoded cases in 2004-2005 and 2012, respectively. Incidence was the highest among adolescents (ages 11 to <14 years) for both outbreaks (9.6 and 7.9 per 1000). The 2004-2005 pertussis outbreak had higher incidence in winter (52% of cases) versus summer in 2012 (53%). We identified a consistent area with higher incidence at the beginning (ie, first quartile) of two outbreaks, but it was inconsistent for later quartiles. The relative difference maps for the two outbreaks suggest a greater role of neighbourhood population size in 2012 compared with 2004-2005. CONCLUSIONS Comparing spatio-temporal patterns between two pertussis outbreaks identified a consistent geographical area with higher incidence of pertussis at the beginning of outbreaks in this community. This finding can be tested in future outbreaks, and, if confirmed, can be used for identifying epidemiological risk factors clustered in such areas for geographically targeted intervention.
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Affiliation(s)
- Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Philip H Wheeler
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Harsheen Kaur
- Department of Pediatrics, Univeristy of New Mexico, Albuquerque, New Mexico, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Dohyeong Kim
- Geospatial Health Research Group, School of Economic, Political and Policy Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Young Juhn
- Department of Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Li D, Ryu E, Saeidian A, Youssefian L, Duvall E, Oliphant E, Terry S, Haass N, Uitto J, Li Q. 403 GGCX mutations in a patient with co-existent overlapping PXE/CL phenotype and thalassemia minor. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stahl EA, Breen G, Forstner AJ, McQuillin A, Ripke S, Trubetskoy V, Mattheisen M, Wang Y, Coleman JRI, Gaspar HA, de Leeuw CA, Steinberg S, Pavlides JMW, Trzaskowski M, Byrne EM, Pers TH, Holmans PA, Richards AL, Abbott L, Agerbo E, Akil H, Albani D, Alliey-Rodriguez N, Als TD, Anjorin A, Antilla V, Awasthi S, Badner JA, Bækvad-Hansen M, Barchas JD, Bass N, Bauer M, Belliveau R, Bergen SE, Pedersen CB, Bøen E, Boks MP, Boocock J, Budde M, Bunney W, Burmeister M, Bybjerg-Grauholm J, Byerley W, Casas M, Cerrato F, Cervantes P, Chambert K, Charney AW, Chen D, Churchhouse C, Clarke TK, Coryell W, Craig DW, Cruceanu C, Curtis D, Czerski PM, Dale AM, de Jong S, Degenhardt F, Del-Favero J, DePaulo JR, Djurovic S, Dobbyn AL, Dumont A, Elvsåshagen T, Escott-Price V, Fan CC, Fischer SB, Flickinger M, Foroud TM, Forty L, Frank J, Fraser C, Freimer NB, Frisén L, Gade K, Gage D, Garnham J, Giambartolomei C, Pedersen MG, Goldstein J, Gordon SD, Gordon-Smith K, Green EK, Green MJ, Greenwood TA, Grove J, Guan W, Guzman-Parra J, Hamshere ML, Hautzinger M, Heilbronner U, Herms S, Hipolito M, Hoffmann P, Holland D, Huckins L, Jamain S, Johnson JS, Juréus A, Kandaswamy R, Karlsson R, Kennedy JL, Kittel-Schneider S, Knowles JA, Kogevinas M, Koller AC, Kupka R, Lavebratt C, Lawrence J, Lawson WB, Leber M, Lee PH, Levy SE, Li JZ, Liu C, Lucae S, Maaser A, MacIntyre DJ, Mahon PB, Maier W, Martinsson L, McCarroll S, McGuffin P, McInnis MG, McKay JD, Medeiros H, Medland SE, Meng F, Milani L, Montgomery GW, Morris DW, Mühleisen TW, Mullins N, Nguyen H, Nievergelt CM, Adolfsson AN, Nwulia EA, O'Donovan C, Loohuis LMO, Ori APS, Oruc L, Ösby U, Perlis RH, Perry A, Pfennig A, Potash JB, Purcell SM, Regeer EJ, Reif A, Reinbold CS, Rice JP, Rivas F, Rivera M, Roussos P, Ruderfer DM, Ryu E, Sánchez-Mora C, Schatzberg AF, Scheftner WA, Schork NJ, Shannon Weickert C, Shehktman T, Shilling PD, Sigurdsson E, Slaney C, Smeland OB, Sobell JL, Søholm Hansen C, Spijker AT, St Clair D, Steffens M, Strauss JS, Streit F, Strohmaier J, Szelinger S, Thompson RC, Thorgeirsson TE, Treutlein J, Vedder H, Wang W, Watson SJ, Weickert TW, Witt SH, Xi S, Xu W, Young AH, Zandi P, Zhang P, Zöllner S, Adolfsson R, Agartz I, Alda M, Backlund L, Baune BT, Bellivier F, Berrettini WH, Biernacka JM, Blackwood DHR, Boehnke M, Børglum AD, Corvin A, Craddock N, Daly MJ, Dannlowski U, Esko T, Etain B, Frye M, Fullerton JM, Gershon ES, Gill M, Goes F, Grigoroiu-Serbanescu M, Hauser J, Hougaard DM, Hultman CM, Jones I, Jones LA, Kahn RS, Kirov G, Landén M, Leboyer M, Lewis CM, Li QS, Lissowska J, Martin NG, Mayoral F, McElroy SL, McIntosh AM, McMahon FJ, Melle I, Metspalu A, Mitchell PB, Morken G, Mors O, Mortensen PB, Müller-Myhsok B, Myers RM, Neale BM, Nimgaonkar V, Nordentoft M, Nöthen MM, O'Donovan MC, Oedegaard KJ, Owen MJ, Paciga SA, Pato C, Pato MT, Posthuma D, Ramos-Quiroga JA, Ribasés M, Rietschel M, Rouleau GA, Schalling M, Schofield PR, Schulze TG, Serretti A, Smoller JW, Stefansson H, Stefansson K, Stordal E, Sullivan PF, Turecki G, Vaaler AE, Vieta E, Vincent JB, Werge T, Nurnberger JI, Wray NR, Di Florio A, Edenberg HJ, Cichon S, Ophoff RA, Scott LJ, Andreassen OA, Kelsoe J, Sklar P. Genome-wide association study identifies 30 loci associated with bipolar disorder. Nat Genet 2019; 51:793-803. [PMID: 31043756 PMCID: PMC6956732 DOI: 10.1038/s41588-019-0397-8] [Citation(s) in RCA: 879] [Impact Index Per Article: 175.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
Abstract
Bipolar disorder is a highly heritable psychiatric disorder. We performed a genome-wide association study (GWAS) including 20,352 cases and 31,358 controls of European descent, with follow-up analysis of 822 variants with P < 1 × 10-4 in an additional 9,412 cases and 137,760 controls. Eight of the 19 variants that were genome-wide significant (P < 5 × 10-8) in the discovery GWAS were not genome-wide significant in the combined analysis, consistent with small effect sizes and limited power but also with genetic heterogeneity. In the combined analysis, 30 loci were genome-wide significant, including 20 newly identified loci. The significant loci contain genes encoding ion channels, neurotransmitter transporters and synaptic components. Pathway analysis revealed nine significantly enriched gene sets, including regulation of insulin secretion and endocannabinoid signaling. Bipolar I disorder is strongly genetically correlated with schizophrenia, driven by psychosis, whereas bipolar II disorder is more strongly correlated with major depressive disorder. These findings address key clinical questions and provide potential biological mechanisms for bipolar disorder.
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Affiliation(s)
- Eli A Stahl
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.
| | - Gerome Breen
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Andreas J Forstner
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Stephan Ripke
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany
| | - Manuel Mattheisen
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Yunpeng Wang
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jonathan R I Coleman
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Héléna A Gaspar
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Christiaan A de Leeuw
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | | | - Maciej Trzaskowski
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Enda M Byrne
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Tune H Pers
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA
| | - Peter A Holmans
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Alexander L Richards
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Liam Abbott
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Esben Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Huda Akil
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Diego Albani
- Department of Neuroscience, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Ney Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Thomas D Als
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Adebayo Anjorin
- Department of Psychiatry, Berkshire Healthcare NHS Foundation Trust, Bracknell, UK
| | - Verneri Antilla
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany
| | - Judith A Badner
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - Marie Bækvad-Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Jack D Barchas
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Nicholas Bass
- Division of Psychiatry, University College London, London, UK
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Richard Belliveau
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Bøcker Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Erlend Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Marco P Boks
- Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - James Boocock
- Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
| | - William Bunney
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Margit Burmeister
- Molecular & Behavioral Neuroscience Institute and Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Jonas Bybjerg-Grauholm
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - William Byerley
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Miquel Casas
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Felecia Cerrato
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Pablo Cervantes
- Department of Psychiatry, Mood Disorders Program, McGill University Health Center, Montreal, Quebec, Canada
| | - Kimberly Chambert
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Danfeng Chen
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Claire Churchhouse
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland
| | - William Coryell
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Cristiana Cruceanu
- Department of Psychiatry, Mood Disorders Program, McGill University Health Center, Montreal, Quebec, Canada
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - David Curtis
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - Piotr M Czerski
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Anders M Dale
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Simone de Jong
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Jurgen Del-Favero
- Applied Molecular Genomics Unit, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Amanda L Dobbyn
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashley Dumont
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Torbjørn Elvsåshagen
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
| | - Valentina Escott-Price
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Sascha B Fischer
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Matthew Flickinger
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Tatiana M Foroud
- Department of Medical & Molecular Genetics, Indiana University, Indianapolis, IN, USA
| | - Liz Forty
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christine Fraser
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Nelson B Freimer
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Louise Frisén
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Child and Adolescent Psychiatry Research Center, Stockholm, Sweden
| | - Katrin Gade
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Diane Gage
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claudia Giambartolomei
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marianne Giørtz Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jaqueline Goldstein
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Scott D Gordon
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Elaine K Green
- School of Biomedical Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Jakob Grove
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Weihua Guan
- Biostatistics, University of Minnesota System, Minneapolis, MN, USA
| | - José Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | - Marian L Hamshere
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Martin Hautzinger
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Maria Hipolito
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Per Hoffmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Dominic Holland
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Laura Huckins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stéphane Jamain
- Psychiatrie Translationnelle, Inserm U955, Créteil, France
- Faculté de Médecine, Université Paris Est, Créteil, France
| | - Jessica S Johnson
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anders Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Radhika Kandaswamy
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Onatario, Canada
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - James A Knowles
- Cell Biology, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | | | - Anna C Koller
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Ralph Kupka
- Psychiatry, Altrecht, Utrecht, the Netherlands
- Psychiatry, GGZ inGeest, Amsterdam, the Netherlands
- Psychiatry, VU Medisch Centrum, Amsterdam, the Netherlands
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jacob Lawrence
- Department of, rth East London NHS Foundation Trust, Ilford, UK
| | - William B Lawson
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Markus Leber
- Department of Neurodegenerative Diseases and Geropsychiatry, University Hospital Bonn, Bonn, Germany
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Shawn E Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Jun Z Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Chunyu Liu
- Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | | | - Anna Maaser
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Donald J MacIntyre
- Mental Health, NHS 24, Glasgow, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Lina Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Steve McCarroll
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Peter McGuffin
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - James D McKay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - Helena Medeiros
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - Sarah E Medland
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Fan Meng
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Lili Milani
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Derek W Morris
- Discipline of Biochemistry, Neuroimaging and Cognitive Genomics (NICOG) Centre, National University of Ireland, Galway, Galway, Ireland
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Thomas W Mühleisen
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Niamh Mullins
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Hoang Nguyen
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Research/Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | | | - Evaristus A Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Loes M Olde Loohuis
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anil P S Ori
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lilijana Oruc
- Department of Clinical Psychiatry, Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Urban Ösby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Roy H Perlis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Clinical Research, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Perry
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shaun M Purcell
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Eline J Regeer
- Outpatient Clinic for Bipolar Disorder, Altrecht, Utrecht, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Céline S Reinbold
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - John P Rice
- Department of Psychiatry, Washington University in Saint Louis, Saint Louis, MO, USA
| | - Fabio Rivas
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | - Margarita Rivera
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
| | - Panos Roussos
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Douglas M Ruderfer
- Medicine, Psychiatry, Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Cristina Sánchez-Mora
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alan F Schatzberg
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Tatyana Shehktman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Engilbert Sigurdsson
- Faculty of Medicine, Department of Psychiatry, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Claire Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Olav B Smeland
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - Janet L Sobell
- Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christine Søholm Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | | | - David St Clair
- Institute for Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Michael Steffens
- Research Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - John S Strauss
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Onatario, Canada
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Robert C Thompson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Helmut Vedder
- Department of Psychiatry, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - Weiqing Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stanley J Watson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simon Xi
- Computational Sciences Center of Emphasis, Pfizer Global Research and Development, Cambridge, MA, USA
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Onatario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Zandi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peng Zhang
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sebastian Zöllner
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine and Diakonhjemmet Hospital, University of Oslo, Oslo, Norway
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Lena Backlund
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Munster, Munster, Germany
| | - Frank Bellivier
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- Paris Bipolar and TRD Expert Centres, FondaMental Foundation, Paris, France
- UMR-S1144 Team 1: Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France
- Department of Psychiatry, Université Paris Diderot, Paris, France
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Michael Boehnke
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Anders D Børglum
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Nicholas Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Mark J Daly
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Udo Dannlowski
- Department of Psychiatry, University of Munster, Munster, Germany
| | - Tõnu Esko
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
| | - Bruno Etain
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- UMR-S1144 Team 1: Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France
- Department of Psychiatry, Université Paris Diderot, Paris, France
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mark Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Fernando Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Joanna Hauser
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - David M Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Lisa A Jones
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - George Kirov
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Marion Leboyer
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- INSERM, Paris, France
| | - Cathryn M Lewis
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | - Qingqin S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, LLC, Titusville, NJ, USA
| | - Jolanta Lissowska
- Cancer Epidemiology and Prevention, M. Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | | | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Francis J McMahon
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Ingrid Melle
- Division of Mental Health and Addiction and Institute of Clinical Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Gunnar Morken
- Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
| | - Ole Mors
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Preben Bo Mortensen
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bertram Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Benjamin M Neale
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - Merete Nordentoft
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Michael C O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Ketil J Oedegaard
- Division of Psychiatry, Haukeland Universitetssjukehus, Bergen, Norway
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Sara A Paciga
- Human Genetics and Computational Biomedicine, Pfizer Global Research and Development, Groton, CT, USA
| | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
- College of Medicine Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - Michele T Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - Josep Antoni Ramos-Quiroga
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ribasés
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
- Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - Kari Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, Department of Psychiatry, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Eystein Stordal
- Department of Psychiatry, Hospital Namsos, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Arne E Vaaler
- Department of Psychiatry, Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - John B Vincent
- Centre for Addiction and Mental Health, Toronto, Onatario, Canada
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Institute of Biological Psychiatry, MHC Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Naomi R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Arianna Di Florio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Howard J Edenberg
- Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Roel A Ophoff
- Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
- Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Laura J Scott
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - John Kelsoe
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Pamela Sklar
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Huang J, Ryu E, Youssefian L, Saeidian A, Duvall E, Oliphant E, Terry S, Uitto J, Li Q. 406 An in vitro splicing assay reveals the pathogenicity of intronic variants in ABCC6, the gene at fault in pseudoxanthoma elasticum. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bjur KA, Wi CI, Ryu E, Crow SS, King KS, Juhn YJ. Epidemiology of Children With Multiple Complex Chronic Conditions in a Mixed Urban-Rural US Community. Hosp Pediatr 2019; 9:281-290. [PMID: 30923070 PMCID: PMC6434974 DOI: 10.1542/hpeds.2018-0091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Children with multiple complex chronic conditions (MCCs) represent a small fraction of our communities but a disproportionate amount of health care cost and mortality. Because the temporal trends of children with MCCs within a geographically well-defined US pediatric population has not been previously assessed, health care planning and policy for this vulnerable population is limited. METHODS In this population-based, repeated cross-sectional study, we identified and enrolled all eligible children residing in Olmsted County, Minnesota, through the Rochester Epidemiology Project, a medical record linkage system of Olmsted County residents. The pediatric complex chronic conditions classification system version 2 was used to identify children with MCCs. Five-year period prevalence and incidence rates were calculated during the study period (1999-2014) and characterized by age, sex, ethnicity, and socioeconomic status (SES) by using the housing-based index of socioeconomic status, a validated individual housing-based SES index. Age-, sex-, and ethnicity-adjusted prevalence and incidence rates were calculated, adjusting to the 2010 US total pediatric population. RESULTS Five-year prevalence and incidence rates of children with MCCs in Olmsted County increased from 1200 to 1938 per 100 000 persons and from 256 to 335 per 100 000 person-years, respectively, during the study period. MCCs tend to be slightly more prevalent among children with a lower SES and with a racial minority background. CONCLUSIONS Both 5-year prevalence and incidence rates of children with MCCs have significantly increased over time, and health disparities are present among these children. The clinical and financial outcomes of children with MCCs need to be assessed for formulating suitable health care planning given limited resources.
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Sheen YH, Kizilbash S, Ryoo E, Wi CI, Park M, Abraham RS, Ryu E, Divekar R, Juhn Y. Relationship between asthma status and antibody response pattern to 23-valent pneumococcal vaccination. J Asthma 2019; 57:381-390. [PMID: 30784333 DOI: 10.1080/02770903.2019.1575394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Asthma poses an increased risk for serious pneumococcal disease, but little is known about the influence of asthma status on the 23-valent serotype-specific pneumococcal antibody response. We examined differences in antibody titers between pre- and post-vaccination with 23-valent pneumococcal polysaccharide vaccine (PPSV-23) in relation to asthma status. Methods: Asthma status was retrospectively ascertained by the Predetermined Asthma Criteria in an existing vaccine cohort through comprehensive medical record review. Twenty-three serotype-specific pneumococcal antibody titers measured at baseline and 4-6 weeks post-vaccination were analyzed. Vaccine responses to PPSV-23 were calculated from pre- to post-vaccine titers for each of the serotypes. Results: Of the 64 eligible and enrolled subjects, 18 (28%) had asthma. Controls (i.e., subjects without asthma) demonstrated a statistically significant fold change response compared to their baseline for all serotypes, while those with asthma did not mount a significant response to serotypes 7F, 22F, and 23F. The overall vaccine response as measured by fold change over baseline was lower in subjects with asthma than controls. Conclusions: Poorer humoral immune responses to PPSV-23 as measured by fold change were more likely to be observed in subjects with asthma compared to controls. We recommend the consideration of asthma status when interpreting vaccine response for immune competence workup through larger studies. Further studies are warranted to replicate these findings.
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Affiliation(s)
- Youn H Sheen
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, CHA University School of Medicine, Seoul, Korea
| | - Sarah Kizilbash
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, School of Medicine, University of Minnesota, Twin Cities, MN, USA
| | - Eell Ryoo
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Gil Hospital, Gachon University, Incheon, Korea
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Miguel Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN, USA
| | - Roshini S Abraham
- Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Department of Health Sciences and Research, Mayo Clinic, Rochester, MN, USA
| | - Rohit Divekar
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN, USA
| | - Young Juhn
- Department of Pediatric and Adolescent Medicine/Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Schulmann A, Ryu E, Goncalves V, Rollins B, Christiansen M, Frye MA, Biernacka J, Vawter MP. Novel Complex Interactions between Mitochondrial and Nuclear DNA in Schizophrenia and Bipolar Disorder. Mol Neuropsychiatry 2019; 5:13-27. [PMID: 31019915 DOI: 10.1159/000495658] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/20/2018] [Indexed: 12/21/2022]
Abstract
Mitochondrial dysfunction has been associated with schizophrenia (SZ) and bipolar disorder (BD). This review examines recent publications and novel associations between mitochondrial genes and SZ and BD. Associations of nuclear-encoded mitochondrial variants with SZ were found using gene- and pathway-based approaches. Two control region mitochondrial DNA (mtDNA) SNPs, T16519C and T195C, both showed an association with SZ and BD. A review of 4 studies of A15218G located in the cytochrome B oxidase gene (CYTB, SZ = 11,311, control = 35,735) shows a moderate association with SZ (p = 2.15E-03). Another mtDNA allele A12308G was nominally associated with psychosis in BD type I subjects and SZ. The first published study testing the epistatic interaction between nuclear-encoded and mitochondria-encoded genes demonstrated evidence for potential interactions between mtDNA and the nuclear genome for BD. A similar analysis for the risk of SZ revealed significant joint effects (34 nuclear-mitochondria SNP pairs with joint effect p ≤ 5E-07) and significant enrichment of projection neurons. The mitochondria-encoded gene CYTB was found in both the epistatic interactions for SZ and BD and the single SNP association of SZ. Future efforts considering population stratification and polygenic risk scores will test the role of mitochondrial variants in psychiatric disorders.
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Affiliation(s)
- Anton Schulmann
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, Virginia, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Vanessa Goncalves
- Molecular Brain Science Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Brandi Rollins
- Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, California, USA
| | - Michael Christiansen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.,Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joanna Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Marquis P Vawter
- Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, California, USA
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Divekar R, Wi CI, Ryu E, Juhn YJ. Lower socioeconomic status predicts lower pneumococcal antibody titers among young adults with asthma. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Mosnaim G, Wi CI, Wheeler PH, Ryu E, King KS, Park MA, Juhn YJ. Geospatial Analysis for Assessing the Impact of High Traffic Volume on Asthma Exacerbations in a Mixed Rural-Urban US Community. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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