A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service
A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service
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DOI：
10.1016/s2589-7500(19)30012-3
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发表时间：
2019-06-01
影响因子：
30.8
通讯作者：
Hingorani, Aroon D.
中科院分区：
文献类型：
--
作者：
Kuan, Valerie;Denaxas, Spiros;Hingorani, Aroon D.
背景 为了有效地预防、检测和治疗影响人们生命周期的健康状况，医疗保健专业人员和研究人员需要了解哪些人群在哪些年龄段容易受到哪些健康状况的影响。因此，我们的目标是通过识别每十年生命中 50 种最常见的健康状况并估计首次诊断的中位年龄来绘制人类健康的进程。 方法我们针对涉及密集使用医疗保健资源的身心健康状况开发了表型分析算法和代码表。如果 1 岁以上的个人的初级保健和入院记录符合临床实践研究数据链设定的研究标准，并且他们已在英格兰的全科诊所注册，并在研究期间至少贡献了 1 年的符合标准的数据，则他们将被纳入研究。我们使用 CALIBRE 平台上的个人关联记录来计算 2010 年 4 月 1 日至 2015 年 3 月 31 日期间按 10 岁年龄组划分的这些疾病的性别标准化累积发病率。我们还根据患者的初级保健和二级保健记录得出了研究期间按年龄、性别和种族（黑人、白人、南亚人）分层的诊断时中位年龄和患病率估计值。结果 我们为 308 种疾病制定了病例定义表型。我们使用 2 784 138 名患者的记录来计算累积发病率，并使用 3 872 451 名患者的记录来计算这些疾病的经期患病率和诊断时的中位年龄。在生命的关键阶段首先出现的病症是：导致儿童入院的特应性病症和感染（
Background To effectively prevent, detect, and treat health conditions that affect people during their lifecourse, health-care professionals and researchers need to know which sections of the population are susceptible to which health conditions and at which ages. Hence, we aimed to map the course of human health by identifying the 50 most common health conditions in each decade of life and estimating the median age at first diagnosis.Methods We developed phenotyping algorithms and codelists for physical and mental health conditions that involve intensive use of health-care resources. Individuals older than 1 year were included in the study if their primary-care and hospital-admission records met research standards set by the Clinical Practice Research Datalink and they had been registered in a general practice in England contributing up-to-standard data for at least 1 year during the study period. We used linked records of individuals from the CALIBER platform to calculate the sex-standardised cumulative incidence for these conditions by 10-year age groups between April 1, 2010, and March 31, 2015. We also derived the median age at diagnosis and prevalence estimates stratified by age, sex, and ethnicity (black, white, south Asian) over the study period from the primary-care and secondary-care records of patients.Findings We developed case definitions for 308 disease phenotypes. We used records of 2 784 138 patients for the calculation of cumulative incidence and of 3 872 451 patients for the calculation of period prevalence and median age at diagnosis of these conditions. Conditions that first gained prominence at key stages of life were: atopic conditions and infections that led to hospital admission in children (