Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease

Chang, Shyue‐Luen; Huang, Yau‐Li; Lee, Mei‐Ching; Hu, Sindy; Hsiao, Yen-Chang; Chang, Su-Wei; Chang, Chee Jen; Chen, Pei Chun

doi:10.1001/jama.2018.0246

Cited by 145 publications

(126 citation statements)

References 27 publications

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“…The CGRD used unique hospital medication and procedure codes which could be mapped to WHO Anatomical Therapeutic Chemical codes and ICD‐9 procedure codes, respectively. The diagnosis codes including diabetes, heart failure, ischemic stroke, and varicose veins of the lower extremities in CGRD have been validated …”

Section: Methodsmentioning

confidence: 99%

“…The diagnosis codes including diabetes, heart failure, ischemic stroke, and varicose veins of the lower extremities in CGRD have been validated. [4][5][6] We selected a nationwide population-based database, Taiwan's NHIRD, which is derived from the National Health Insurance (NHI) program as the comparator to evaluate the capacity and representativeness of the CGRD. The NHI was established in 1995 to deliver universal coverage for the entire population in Taiwan.…”

Section: Data Sourcementioning

confidence: 99%

“…The NHIRD is one of the most well-known nationwide databases with representative and rich variables for clinical, epidemiological, and policy research with more than 3000 studies published to date, in many high-impact medical journals. 6,[17][18][19][20][21] However, like all studies using administrative claims databases, misclassifications from uncertain measurement of the exposures and/or outcomes (eg, diagnosis) have been a major concern. In contrast, EMR data are originated for health care purposes and thus provide better measurement of exposures and outcomes than claims data; moreover, researchers can always also refer to additional data for confirmation, such as laboratory data (eg, blood glucose for diabetes) or pathological reports (eg, electrocardiogram for atrial fibrillation) from EMR data.…”

Section: Future Opportunities Of Cgrdmentioning

confidence: 99%

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The Chang Gung Research Database—A multi‐institutional electronic medical records database for real‐world epidemiological studies in Taiwan

Shao

Chan

Yang

et al. 2019

Pharmacoepidemiology and Drug

228

222

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Purpose The Chang Gung Research Database (CGRD), the largest multi‐institutional electronic medical records (EMR) collection in Taiwan, provides good access for researchers to efficiently use the standardized patient‐level data. This study evaluates the capacity and representativeness of the CGRD to promote secondary use of EMR data for clinical research with more accurate estimates. Methods The National Health Insurance Research Database (NHIRD) which covers over 99.9% of the Taiwanese population served as the comparator in this study. We compare the data components of the CGRD with the NHIRD, including records for health care facilities, patients, diagnoses, drugs, and procedures. Using the chi‐square test, we compared the distributions of age categories and sex of patients, and the rates of their health conditions between NHIRD and CGRD based on the year 2015. Results The CGRD contains more clinical information such as pathological and laboratory results than the NHIRD. The CGRD includes 6.1% of outpatients and 10.2% of hospitalized patients from the NHIRD. We found the CGRD includes more elderly outpatients (23.5% vs 12.5%) and pediatric inpatients (19.7% vs 14.4%) compared with the NHIRD. We found patients' sex distributions were similar between CGRD and NHIRD, but coverage rates of severe conditions, such as cancer, were higher than other health conditions in CGRD. Conclusions The CGRD could serve as the basis for accurate estimates in medical studies. However, researchers should pay special attention to selection biases since patients' characteristics from CGRD differ from those of the national database.

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Section: Methodsmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Section: Future Opportunities Of Cgrdmentioning

confidence: 99%

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The Chang Gung Research Database—A multi‐institutional electronic medical records database for real‐world epidemiological studies in Taiwan

Shao

Chan

Yang

et al. 2019

Pharmacoepidemiology and Drug

228

222

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show abstract

“…The information from this national health insurance scheme is recorded in the NHIRD, including the patients’ demographic data, diagnostic codes, medication claims, and treatment and procedure codes. Numerous studies have been published in recent years using this database . Approval for the current study was obtained from the ethics committee of our hospital [KMUHIRB‐SV(I)‐20170055, 8 September 2017].…”

Section: Methodsmentioning

confidence: 99%

“…Numerous studies have been published in recent years using this database. [28][29][30] Approval for the current study was obtained from the ethics committee of our hospital [KMUHIRB-SV(I)-20170055, 8 September 2017].…”

Section: Source Of Datamentioning

confidence: 99%

Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study

Yuan

Chen

et al. 2019

Acad Dermatol Venereol

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Background Psoriasis is known to confer a higher risk of cardiovascular and cerebrovascular diseases. However, very few studies have investigated whether the development of depression in psoriasis patients may further increase this vascular risk. Objective We investigated the risk of ischaemic heart disease and cerebrovascular disease in Taiwanese psoriasis patients with and without depression. Methods A nationwide population‐based retrospective cohort study was performed using the National Health Insurance Research Database. We included 604 psoriasis patients with depression, who were matched to 2416 psoriasis patients without depression (1 : 4 ratio). Relative risks (RR) with 95% confidence intervals (CI) were determined using the Cox proportional hazards regression model, with adjustment for demographic characteristics and comorbidities. Results Compared with psoriasis patients without depression, psoriasis patients with depression had greater risk of developing incident ischaemic heart disease (19.5% vs. 8.3%, adjusted RR 1.98, 95% CI 1.57–2.49), cerebrovascular disease (15.6% vs. 5.9%, adjusted RR 2.29, 95% CI 1.76–2.98), and either ischaemic heart disease or cerebrovascular disease (28.3% vs. 12.5%, adjusted RR 1.94, 95% CI 1.60–2.35). Subgroup analysis showed that in psoriasis patients with depression, a higher risk of incident ischaemic heart disease or cerebrovascular disease was present in age groups 30–100 years, in both males and females, and in both lower and higher income categories. Conclusion Depression is an independent risk factor for incident ischaemic heart disease and cerebrovascular disease in patients with psoriasis. Therefore, clinicians need to be vigilant for the increased vascular risk in psoriasis patients with depression.

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Varicose Veins and Deep Venous Thrombosis

Tiwari

Lester

Tang

2018

JAMA

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In addition, it has been demonstrated that any type of surgery significantly increases DVT risk. 4 This risk increases quickly on the day of surgery and remains elevated for the next few weeks into the postoperative period. The relative risk of DVT within 6 weeks of day surgery is approximately 10 times higher than in patients without surgery. Therefore further information is needed on the confounding factors of not only venous but also any day surgical procedures that the patient cohort may have had that may account for the high incidence of DVT in patients with varicose veins.

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Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease

Cited by 145 publications

References 27 publications

The Chang Gung Research Database—A multi‐institutional electronic medical records database for real‐world epidemiological studies in Taiwan

The Chang Gung Research Database—A multi‐institutional electronic medical records database for real‐world epidemiological studies in Taiwan

Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study

Varicose Veins and Deep Venous Thrombosis

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