Abstract:
:When healthcare professionals have the choice between several drug treatments for their patients, they often experience considerable decision uncertainty because many decisions simply have no single "best" choice. The challenges are manifold and include that guideline recommendations focus on randomized controlled trials whose populations do not necessarily correspond to specific patients in everyday treatment. Further reasons may be insufficient evidence on outcomes, lack of direct comparison of distinct options, and the need to individually balance benefits and risks. All these situations will occur in routine care, its outcomes will be mirrored in routine data, and could thus be used to guide decisions. We propose a concept to facilitate decision-making by exploiting this wealth of information. Our working example for illustration assumes that the response to a particular (drug) treatment can substantially differ between individual patients depending on their characteristics (heterogeneous treatment effects, HTE), and that decisions will be more precise if they are based on real-world evidence of HTE considering this information. However, such methods must account for confounding by indication and effect measure modification, eg, by adequately using machine learning methods or parametric regressions to estimate individual responses to pharmacological treatments. The better a model assesses the underlying HTE, the more accurate are predicted probabilities of treatment response. After probabilities for treatment-related benefit and harm have been calculated, decision rules can be applied and patient preferences can be considered to provide individual recommendations. Emulated trials in observational data are a straightforward technique to predict the effects of such decision rules when applied in routine care. Prediction-based decision rules from routine data have the potential to efficiently supplement clinical guidelines and support healthcare professionals in creating personalized treatment plans using decision support tools.
journal_name
Clin Epidemioljournal_title
Clinical epidemiologyauthors
Meid AD,Ruff C,Wirbka L,Stoll F,Seidling HM,Groll A,Haefeli WEdoi
10.2147/CLEP.S274466subject
Has Abstractpub_date
2020-11-02 00:00:00pages
1223-1234issn
1179-1349pii
274466journal_volume
12pub_type
杂志文章abstract:AIM OF DATABASE:The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. STUDY POPULATION:The DHFR includes inpatients and outpatients (≥18 years) with incident HF. Reporting to the DHFR is mandatory for the Danish hospital departme...
journal_title:Clinical epidemiology
pub_type: 杂志文章,评审
doi:10.2147/CLEP.S99504
更新日期:2016-10-25 00:00:00
abstract:BACKGROUND:A number of population-based studies have demonstrated lower cancer survival in elderly patients than among middle-aged or younger patients. Also, data quality in cancer registries has been shown to be associated with age. The objective of this study was to examine the recent age-specific cancer survival tre...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S87699
更新日期:2015-07-29 00:00:00
abstract:PURPOSE:Rotavirus (RV) is a leading cause of severe gastroenteritis (GE) in children across the world. As there is a lack of epidemiological data for RV gastroenteritis (RVGE) in Saudi Arabia, this hospital-based study was designed to estimate the disease burden of RVGE and assess the prevalent RV types in Saudi childr...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S69502
更新日期:2015-02-11 00:00:00
abstract:BACKGROUND:Severe infection resulting in sepsis is recognized as a leading cause of morbidity and mortality worldwide. The purpose of this study is to use longitudinal, population-based data to report national-level hospital metrics, providing a current assessment of the status of sepsis hospitalizations in Canadian ch...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S72282
更新日期:2014-12-05 00:00:00
abstract:Background:The Swedish Quality Register for Inflammatory Bowel Disease (SWIBREG) contains clinical data for the study of inflammatory bowel disease (IBD). The Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) cohort was recently established for the study of gastrointestinal histopathology. We aim...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S265404
更新日期:2020-10-09 00:00:00
abstract:Purpose:Former studies have suggested that women with Crohn's disease (CD) and ulcerative colitis (UC) have a decreased chance of a live born child after assisted reproductive technology (ART) treatment. It is debated whether corticosteroids before ART may improve outcomes, either by decreasing inflammatory bowel disea...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S234996
更新日期:2020-03-23 00:00:00
abstract:BACKGROUND:To date there has not been any nationwide age-standardized incidence data reported for prostate cancer in Nigeria. We examined and integrated diverse trends in the age-specific incidence of prostate cancer into a comprehensive trend for Nigeria, and examined how best the existing data could generate a countr...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S23536
更新日期:2012-01-01 00:00:00
abstract:AIM OF DATABASE:The aim of the Danish Anaesthesia Database (DAD) is the nationwide collection of data on all patients undergoing anesthesia. Collected data are used for quality assurance, quality development, and serve as a basis for research projects. STUDY POPULATION:The DAD was founded in 2004 as a part of Danish C...
journal_title:Clinical epidemiology
pub_type: 杂志文章,评审
doi:10.2147/CLEP.S99517
更新日期:2016-10-25 00:00:00
abstract:BACKGROUND:A number of studies have shown poorer survival among cancer patients with comorbidity. Several mechanisms may underlie this finding. In this review we summarize the current literature on the association between patient comorbidity and cancer prognosis. Prognostic factors examined include tumor biology, diagn...
journal_title:Clinical epidemiology
pub_type: 杂志文章,评审
doi:10.2147/CLEP.S47150
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:The Department of Hematology, Zealand University Hospital, Denmark, and the National Institute of Public Health, University of Southern Denmark, created the first nationwide, population-based, and the most comprehensive cross-sectional health-related quality of life (HRQoL) survey of patients with myeloprolif...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S117587
更新日期:2017-03-02 00:00:00
abstract:Purpose:Anemia is prevalent in patients with chronic kidney disease (CKD), but the longitudinal risk of anemia in patients with newly identified CKD is unknown. We therefore examined the risks of experiencing anemia in persons with newly identified CKD. Patients and Methods:This cohort study included adult patients wi...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S259648
更新日期:2020-09-11 00:00:00
abstract:Purpose:To validate the use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the Taiwan National Health Insurance (NHI) Outpatient Claims Dataset. Methods:We conducted ...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S236823
更新日期:2020-02-20 00:00:00
abstract:Purpose:To establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR). Patients and Methods:Based on discharge summaries and brain imaging reports, we estimated the positive predictive value (PPV) of a first-ever diagnosis code...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S267583
更新日期:2020-12-01 00:00:00
abstract::Routinely-collected health data (RCD) are now used for a wide range of studies, including observational studies, comparative effectiveness research, diagnostics, studies of adverse effects, and predictive analytics. At the same time, limitations inherent in using data collected without specific a priori research quest...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S110528
更新日期:2016-10-19 00:00:00
abstract:BACKGROUND:National prescription databases are important tools in pharmacoepidemiological studies investigating potential long-term adverse events after drug use. Palivizumab is a biological pharmaceutical used as passive prophylaxis against severe infection with respiratory syncytial virus in high-risk children. OBJE...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S73355
更新日期:2015-05-08 00:00:00
abstract::Sjögren's syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of exocrine glands. It can present as an entity by itself, primary Sjögren's syndrome (pSS), or in addition to another autoimmune disease, secondary Sjögren's syndrome (sSS). pSS has a strong female propensity and is ...
journal_title:Clinical epidemiology
pub_type: 杂志文章,评审
doi:10.2147/CLEP.S47399
更新日期:2014-07-30 00:00:00
abstract:Purpose:Obesity is an established risk factor for venous thromboembolism (VTE), while studies on physical inactivity and VTE risk show conflicting results. We examined whether physical activity modified the association between obesity and VTE. Patients and Methods:We conducted a population-based cohort study by combin...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S275079
更新日期:2020-12-08 00:00:00
abstract:Background:Cost-effective primary prevention of cardiovascular disease (CVD) relies on accuracy of risk assessment. Current risk scores require clinical and laboratory measures, are expensive and are often difficult to apply in the population setting. Objective:This study sought to estimate CVD risk from individuals' ...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S219708
更新日期:2020-01-14 00:00:00
abstract:Purpose:Sharing of detailed individual-level data continues to pose challenges in multi-center studies. This issue can be addressed in part by using analytic methods that require only summary-level information to perform the desired multivariable-adjusted analysis. We examined the feasibility and empirical validity of ...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S178163
更新日期:2018-11-27 00:00:00
abstract:BACKGROUND:The study objective was to compare the Newcastle-Ottawa Scale (NOS) and the RTI item bank (RTI-IB) and estimate interrater agreement using the RTI-IB within a systematic review on the cardiovascular safety of glucose-lowering drugs. METHODS:We tailored both tools and added four questions to the RTI-IB. Two ...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S66677
更新日期:2014-10-10 00:00:00
abstract:Background and aims:Canada's large geographic area and low population density pose challenges in access to specialized health care for remote and rural residents. We compared health services use, surgical rate, and specialist gastroenterologist care in rural and urban inflammatory bowel disease (IBD) patients in Canada...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S178056
更新日期:2018-11-08 00:00:00
abstract:Background:Congenital red blood cell (RBC) disorders, such as hemoglobinopathies, are frequent worldwide but with large geographical variation. Growing migration has increased the number of patients with RBC disorders in formerly low prevalence countries, eg, Denmark. However, accurate prevalences are unknown. Methods...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S250251
更新日期:2020-05-21 00:00:00
abstract:Background:Participation in cervical cancer screening varies by socioeconomic status. The aims were to assess if offering human papilloma virus (HPV) self-sampling kits has an effect on screening participation among various socioeconomic groups and to determine if two invitation strategies for offering self-sampling in...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S164826
更新日期:2018-08-23 00:00:00
abstract:Background:Individuals with a family history of Parkinson's disease (PD) appear to have a higher risk of developing PD and other neuropsychiatric diseases. However, estimates of the relative risks (RRs) of PD and the roles of genetic and environmental factors in PD susceptibility are unclear. The aim of this study was ...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S164330
更新日期:2018-05-30 00:00:00
abstract:OBJECTIVE:Invasive bladder cancer (IBC) is a common urological malignancy accounting for 4%-5% of all cancers in Denmark. Our aim was to examine possible changes in short- and long-term survival of patients with IBC during 1998-2009. STUDY DESIGN AND SETTING:Data on all patients (N = 4032) with an incident diagnosis o...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S20615
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (pHPT) is associated with an increased risk of developing breast cancer, but little is known about the underlying factors. The aim of this study was to compare women with a history of pHPT and a reference population in terms of standard factors predictive of prognosis and response...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S17298
更新日期:2011-03-25 00:00:00
abstract:Aim:The EPICHRONIC (EPIdemiology of CHRONIC diseases) project investigated the possibility of developing common procedures for French and Spanish electronic health care databases to enable large-scale pharmacoepidemiological studies on chronic diseases. A feasibility study assessed the prevalence of type 2 diabetes mel...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S151890
更新日期:2018-07-27 00:00:00
abstract:Background:The presence of comorbid medical conditions can significantly affect a cancer patient's treatment options, quality of life, and survival. However, these important data are often lacking from population-based cancer registries. Leveraging routine linkage to hospital discharge data, a comorbidity score was cal...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S146395
更新日期:2017-11-20 00:00:00
abstract:Objective:To investigate the impact of moderate wine consumption on the risk of prostate cancer (PCa). We focused on the differential effect of moderate consumption of red versus white wine. Design:This study was a meta-analysis that includes data from case-control and cohort studies. Materials and methods:A systemat...
journal_title:Clinical epidemiology
pub_type: 杂志文章,评审
doi:10.2147/CLEP.S163668
更新日期:2018-04-17 00:00:00
abstract::Background: The Swedish National Patient Registry (NPR) is a nationwide registry that is used extensively for epidemiological research. Using the NPR, we recently found a recurrent pregnancy loss (RPL) incidence of 650/100,000 (0.65%) pregnant women in Sweden. It is of great importance that the quality of the coding i...
journal_title:Clinical epidemiology
pub_type: 杂志文章
doi:10.2147/CLEP.S199206
更新日期:2019-05-08 00:00:00