Population risk factor estimates for abdominal aortic aneurysm from electronic medical records: a case control study.
Population risk factor estimates for abdominal aortic aneurysm from electronic medical records: a case control study.
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DOI：
10.1186/1471-2261-14-174
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发表时间：
2014-12-04
影响因子：
2.1
通讯作者：
Carey DJ
中科院分区：
文献类型：
--
作者：
Smelser DT;Tromp G;Elmore JR;Kuivaniemi H;Franklin DP;Kirchner HL;Carey DJ
以腹主动脉瘤（AAA）为模型，该病例对照研究使用电子病历（EMR）数据评估已知的风险因素并确定新的关联。研究人群包括来自宾夕法尼亚州中部和东北部Geisinger卫生系统EMR的AAA病例（n = 888）和对照组（n = 10，523）。我们从EMR中提取了2004年1月至2009年12月这些患者的所有临床和诊断数据。从这个样本集中，使用自举复制程序随机生成2,500次迭代的数据集，每次有500例病例和2000例对照。危险因素效应量的估计值通过逐步logistic回归和bootstrap聚合获得。使用迭代中包含的数量和P值对变量进行排序。良性肿瘤诊断与AAA呈负相关，这是一个新发现。同样，2型糖尿病、舒张压、体重和髓系肿瘤与AAA呈负相关。外周动脉疾病、吸烟、年龄、冠状动脉狭窄、收缩压、年龄、身高、男性、肺部疾病和高血压与AAA风险增加相关。本研究回顾性地利用EMR数据对复杂疾病的风险因素进行评估。AAA的已知风险因素在程度和方向上重复。发现了一种新的良性肿瘤阴性相关性。EMR使研究人员能够快速，廉价地使用临床数据来扩大队列规模，并获得AAA以及其他复杂疾病的更好风险估计。
Using abdominal aortic aneurysm (AAA) as a model, this case–control study used electronic medical record (EMR) data to assess known risk factors and identify new associations. The study population consisted of cases with AAA (n =888) and controls (n =10,523) from the Geisinger Health System EMR in Central and Northeastern Pennsylvania. We extracted all clinical and diagnostic data for these patients from January 2004 to December 2009 from the EMR. From this sample set, bootstrap replication procedures were used to randomly generate 2,500 iterations of data sets, each with 500 cases and 2000 controls. Estimates of risk factor effect sizes were obtained by stepwise logistic regression followed by bootstrap aggregation. Variables were ranked using the number of inclusions in iterations and P values. The benign neoplasm diagnosis was negatively associated with AAA, a novel finding. Similarly, type 2 diabetes, diastolic blood pressure, weight and myelogenous neoplasms were negatively associated with AAA. Peripheral artery disease, smoking, age, coronary stenosis, systolic blood pressure, age, height, male sex, pulmonary disease and hypertension were associated with an increased risk for AAA. This study utilized EMR data, retrospectively, for risk factor assessment of a complex disease. Known risk factors for AAA were replicated in magnitude and direction. A novel negative association of benign neoplasms was identified. EMRs allow researchers to rapidly and inexpensively use clinical data to expand cohort size and derive better risk estimates for AAA as well as other complex diseases.
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影响因子：
4.3
作者：
Baumgartner, Iris;Hirsch, Alan T.;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.
影响因子：
1.8
作者：
Austin, PC;Tu, JV
通讯作者：
Tu, JV
影响因子：
9
作者：
Brown, LC;Powell, JT
通讯作者：
Powell, JT
影响因子：
9.8
作者：
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通讯作者：
Samani, Nilesh J.
DOI：
10.1016/j.ejvs.2005.10.007
发表时间：
2006-03-01
影响因子：
5.7
作者：
de Céniga, MV;Gómez, R;Barba, A
通讯作者：
Barba, A