Cohort Profile: The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)

Gange, Stephen J.; Kitahata, Mari M.; Saag, Michael S.; Bangsberg, David R.; Bosch, Ronald J.; Brooks, John T.; Calzavara, Liviana; Deeks, Steven G.; Eron, Joseph J.; Gebo, Kelly A.; Gill, M. John; Haas, David W.; Hogg, Robert S.; Horberg, Michael A.; Jacobson, Lisa P.; Justice, Amy C.; Kirk, Gregory D.; Klein, Marina B.; Martin, Jeffrey N.; McKaig, Rosemary G.; Rodrı́guez, Benigno; Rourke, Sean B.; Sterling, Timothy R.; Freeman, Aimee; Moore, Richard D.

doi:10.1093/ije/dyl286

Cited by 181 publications

(169 citation statements)

References 12 publications

Supporting

Mentioning

166

Contrasting

Unclassified

Order By: Relevance

“…The NA-ACCORD is the largest collaboration of longitudinal HIV cohort studies in North America and has compiled data from >100 clinical sites in the United States and Canada [12,29]. Briefly, at scheduled intervals, participating HIV cohorts submit data regarding enrolled participants' demographic characteristics, vital status, prescribed antiretrovirals, clinical diagnoses, and dates and results of laboratory tests including HIV load and CD4 + T-cell count.…”

Section: Study Populationmentioning

confidence: 99%

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

et al. 2016

View full text Add to dashboard Cite

(See the editorial commentary by Furrer on pages 830-1.)Background. There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in care in the United States and Canada.Methods. We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 2000-2010. After excluding 16 737 (21%) with any AIDS-defining clinical events documented before NA-ACCORD enrollment, we analyzed incident OIs among the remaining 63 541 persons, most of whom received antiretroviral therapy during the observation. We calculated incidence rates per 100 person-years of observation (hereafter, "person-years") with 95% confidence intervals (CIs) for the first occurrence of any OI and select individual OIs during 2000-2003, 2004-2007, and 2008-2010.Results. A total of 63 541 persons contributed 261 573 person-years, of whom 5836 (9%) developed at least 1 OI. The incidence rate of any first OI decreased over the 3 observation periods, with 3.0 cases, 2.4 cases, and 1.5 cases per 100 person-years of observation during 2000-2003, 2004-2007, and 2008-2010, respectively (P trend <.001); the rates of most individual OIs decreased as well. During 2008-2010, the leading OIs included Pneumocystis jiroveci pneumonia, esophageal candidiasis, and disseminated Mycobacterium avium complex or Mycobacterium kansasii infection.Conclusions. For HIV-infected persons in care during 2000-2010, rates of first OI were relatively low and generally declined over this time.

show abstract

Section: Study Populationmentioning

confidence: 99%

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) is a large demographically, clinically, and geographically diverse collaboration which has been collecting data from multi-and single-site interval and clinical cohort studies in the United States and Canada since 2006 (20). According to the Institute of Medicine, the NA-ACCORD has demonstrated a constituent patient population that comprises a large proportion of and is demographically similar to persons living with HIV/AIDS in the United States, and it has been recognized as one of the data systems adequate to assess and quantify quality-of-care measures (including retention in clinical care) that will serve as benchmarks for progress under the National HIV/AIDS Strategy and the Affordable Care Act (9).…”

Section: Population and Study Designmentioning

confidence: 99%

“…According to the Institute of Medicine, the NA-ACCORD has demonstrated a constituent patient population that comprises a large proportion of and is demographically similar to persons living with HIV/AIDS in the United States, and it has been recognized as one of the data systems adequate to assess and quantify quality-of-care measures (including retention in clinical care) that will serve as benchmarks for progress under the National HIV/AIDS Strategy and the Affordable Care Act (9). Further details on the NA-ACCORD collaboration have been published previously (20).…”

Section: Population and Study Designmentioning

confidence: 99%

Laboratory Measures as Proxies for Primary Care Encounters: Implications for Quantifying Clinical Retention Among HIV-Infected Adults in North America

Rebeiro¹,

Althoff²,

Lau³

et al. 2015

Am. J. Epidemiol.

View full text Add to dashboard Cite

Because of limitations in the availability of data on primary care encounters, patient retention in human immunodeficiency virus (HIV) care is often estimated using laboratory measurement dates as proxies for clinical encounters, leading to possible outcome misclassification. This study included 83,041 HIV-infected adults from 14 clinical cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) who had ≥1 HIV primary care encounters during 2000-2010, contributing 468,816 person-years of follow-up. Encounter-based retention (R EB ) was defined as ≥2 encounters in a calendar year, ≥90 days apart. Laboratory-based retention (R LB ) was defined similarly, using the dates of CD4-positive cell counts or HIV-1 RNA measurements. Percentage of agreement and the κ statistic were used to characterize agreement between R LB and R EB . Logistic regression with generalized estimating equations and stabilized inverse-probability-of-selection weights was used to elucidate temporal trends and the discriminatory power of R LB as a predictor of R EB , accounting for age, sex, race/ethnicity, primary HIV risk factor, and cohort site as potential confounders. Both R EB and R LB increased from 2000 to 2010 (from 67% to 78% and from 65% to 77%, respectively), though R EB was higher than R LB throughout (P < 0.01). R LB agreed well with R EB (80%-86% agreement; κ = 0.55-0.62, P < 0.01) and had a strong, imperfect ability to discriminate between persons retained and not retained in care by R EB (C statistic: C = 0.81, P < 0.05). As a proxy for R EB , R LB had a sensitivity and specificity of 84% and 77%, respectively, with misclassification error of 18%. clinical encounters; clinical retention; HIV; laboratory measurements; measurement error; misclassification; proxies Abbreviations: AIDS, acquired immunodeficiency syndrome; CI, confidence interval; HIV, human immunodeficiency virus; HIV-1, HIV type 1; IDU, injection drug user; IPW, inverse-probability-of-selection weights; NA-ACCORD, North American AIDS Cohort Collaboration on Research and Design; ROC, receiver operating characteristic; ROR, ratio of odds ratios.Access to health care and its utilization for clinical monitoring in both healthy populations (for preventive care) and unhealthy populations (for treatment) are vital components of improving health outcomes. The reliable and ongoing use of clinical services by patients as part of disease management, or retention in care, is one such indicator of health-care utilization. Epidemiologic tools have long been recognized as being both available and useful for evaluation of evidence and formulation of policies for health services (1). With healthcare reform (e.g., the Affordable Care Act) removing barriers to linkage to care in the United States, an understanding of how people seek health care and are retained in care is likely to become increasingly valuable (2, 3). These questions speak to identifying disparities in our health-care system and may have a large impact on patient outcomes.The study of...

show abstract

“…Este tipo de estudios permite abordar objetivos amplios, por períodos prolongados de seguimiento y evaluar resultados de la aplicación de programas de intervención en "el mundo real" 1 . Los principales estudios de cohorte provienen de Europa y Estados Unidos de América, con reportes de 10.000 o más pacientes en seguimiento desde antes del año 2000, tales como la cohorte Suiza, la "ATHENA Cohort" de Países Bajos, la cohorte Aquitaine en Francia y la ICONA en Italia y, especialmente a través de agrupaciones de cohortes como EuroSIDA, NA-Accord o ART-CC, con un gran número de pacientes [2][3][4] . Estos estudios han entregado información relevante sobre eficacia y mortalidad a largo plazo, factores bio-demográficos asociados a efectividad y toxicidad, incidencia de enfermedades marcadoras y no definitorias de SIDA, recuperación inmunológica y toxicidades específicas, entre otras.…”

Section: Introductionunclassified

Evolución de las características epidemiológicas y clínicas de pacientes adultos del programa nacional al inicio de la terapia anti-retroviral en la Cohorte Chilena de SIDA, 2001-2015

Beltrán

Zitko

Wolff

et al. 2016

Rev. chil. infectol.

View full text Add to dashboard Cite

200 cells/mm3. Discussion: Despite the limitations of observational studies present report describes the characteristics and evolution of the epidemics in Chile in the last 15 years. The infection occurs at younger ages in men, whereas in women there is an increase over 50 years old. Despite advances in treatment access have reduced late presentation to therapy, important challenges remain to achieve more timely initiation of antiretroviral therapy in accordance with WHO 90-90-90 goals.]]>

show abstract

Cohort Profile: The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)

Cited by 181 publications

References 12 publications

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

Laboratory Measures as Proxies for Primary Care Encounters: Implications for Quantifying Clinical Retention Among HIV-Infected Adults in North America

Evolución de las características epidemiológicas y clínicas de pacientes adultos del programa nacional al inicio de la terapia anti-retroviral en la Cohorte Chilena de SIDA, 2001-2015

Contact Info

Product

Resources

About