Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States
Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States
复制标题
DOI：
10.1001/jamadermatol.2013.3049
复制
发表时间：
2013-07-01
期刊：
影响因子：
10.9
通讯作者：
Qureshi, Abrar A.
中科院分区：
文献类型：
--
作者：
Huang, Kathie P.;Mullangi, Samyukta;Qureshi, Abrar A.
目的评价麻萨诸塞州波士顿三级护理医院11年来斑秃患者的并存情况。设计一项横断面回顾研究。收集波士顿的三级护理医院，包括布里格姆妇女医院和马萨诸塞州综合医院。我们使用国际疾病分类，第九次修订代码704.01对研究患者数据库进行了全面搜索。我们随机选择了350名患者，并手动审查了他们的医疗记录，以训练和验证一个新的人工智能程序。然后，该程序使用自然语言处理来查看自由文本医疗记录，并确认AA的诊断。结果常见的并存疾病包括自身免疫诊断(甲状腺疾病14.6%，糖尿病11.1%，炎症性肠病6.3%，系统性红斑狼疮4.3%，类风湿性关节炎3.9%，牛皮癣和牛皮癣2.0%)，特应性(变应性鼻炎、哮喘和/或湿疹38.2%，接触性皮炎和其他湿疹35.9%)，和精神健康问题(25.5%的人有抑郁或焦虑)。高脂血症(24.5%)、高血压(21.9%)和胃食道反流病(17.3%)的患病率也很高。这一特征不同于牛皮癣和牛皮癣关节炎组的对比。结论和相关性我们发现，在波士顿学术医学中心的AA患者中，合并疾病的患病率很高。照顾再生障碍性贫血患者的医生应该考虑筛查合并症。
OBJECTIVE To evaluate the prevalence of comorbid conditions among patients with alopecia areata (AA) seen at tertiary care hospitals in Boston, Massachusetts, during an 11-year period.DESIGN Retrospective cross-sectional study.SETTING Tertiary care hospitals in Boston, including Brigham and Women's Hospital and Massachusetts General Hospital.PARTICIPANTS We identified 3568 individuals with AA seen in the Partners health care system in Boston between January 1, 2000, and January 1, 2011. We performed comprehensive searches of the Research Patient Data Repository using International Classification of Diseases, Ninth Revision code 704.01. We randomly selected 350 patients and manually reviewed their medical records to train and validate a novel artificial intelligence program. This program then used natural language processing to review free-text medical records and confirm a diagnosis of AA. To confirm the algorithm, we manually reviewed a subset of records and found 93.9% validity.MAIN OUTCOMES AND MEASURES The prevalence of comorbid conditions was assessed.RESULTS Common comorbid conditions included autoimmune diagnoses (thyroid disease in 14.6%, diabetes mellitus in 11.1%, inflammatory bowel disease in 6.3%, systemic lupus erythematosus in 4.3%, rheumatoid arthritis in 3.9%, and psoriasis and psoriatic arthritis in 2.0%), atopy (allergic rhinitis, asthma, and/or eczema in 38.2% and contact dermatitis and other eczema in 35.9%), and mental health problems (depression or anxiety in 25.5%). We also found high prevalences of hyperlipidemia (24.5%), hypertension (21.9%), and gastroesophageal reflux disease (17.3%). This profile was different from that seen in a comparison psoriasis and psoriatic arthritis group.CONCLUSIONS AND RELEVANCE We found a high prevalence of comorbid conditions among individuals with AA presenting to academic medical centers in Boston. Physicians caring for patients with AA should consider screening for comorbid conditions.