Dementia Phenotypes in Primary Care, Hospital, and National Mortality Registries
Dementia Phenotypes in Primary Care, Hospital, and National Mortality Registries: a Cohort Study in Linked Electronic Health Records
Most patients with dementia in the UK use their local hospitals and general (family) practices throughout their illness. Linked electronic health records from primary care, hospital and death certificates records therefore provide useful information about the diagnosis and prognosis of patients who develop dementia.
In this study we will assess the validity of dementia diagnoses in linked primary care, hospital and death records, by examining the timing of important health transitions in patients with recorded dementia, and we will estimate the lifetime risk of recorded dementia in different age and sex groups
調査の概要
詳細な説明
Dementia is a clinical syndrome with insidious onset that is difficult to diagnose in its earliest stages. Presentation to healthcare depends not only upon the rates of disease progression, but also on social support, recognition by clinicians, and patients' and carers' fear of diagnosis. Maintaining complete follow up in cohorts of patient with dementia is difficult, because patients with dementia are frequently lost to follow up.
Most patients with dementia in the UK use their local hospitals and general (family) practices throughout their illness. Linked electronic health records from primary care, hospital and death certificates records should therefore provide useful information about the diagnosis and prognosis of patients who develop dementia with minimal loss to follow-up rates and improved completeness of diagnosis.
Demonstrating that patients with recorded dementia have an earlier onset of typical symptoms, functional impairment and death than patients in the general population would support the veracity of diagnosed dementia recorded in electronic health records and its use as an outcome or exposure in cohort studies and for evaluating policy. Previous studies have found that dementia is poorly recorded in routine clinical practice in comparison to face-to-face studies, although this varies by setting and region. However, ascertainment may be improved by examining linked, longitudinal resources. Comparing the lifetime risk of dementia calculated from linked electronic health records with lifetime risks from other sources will also be a useful information to support the use of linked electronic health records in dementia research.
Electronic health records contain information on important health transitions in patients with dementia: from the earliest stage of the illness (depression, anxiety, memory complaints); the development of cognitive impairment that manifest as loss of capacity or missed appointments; and significant functional impairment, with admission to nursing homes or hospital admission. In this study, we will assess the validity of dementia diagnoses in linked primary care, hospital and death records, by examining the timing of important health transitions in patients with recorded dementia, and estimate the lifetime risk of recorded dementia in different age and sex groups.
研究の種類
入学 (予想される)
連絡先と場所
研究場所
-
-
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London、イギリス
- London Farr Institute of Health Informatics
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patients aged 18 years and over
- Registered with a participating general practice during the study period
- Minimum one year of records prior to study entry meeting CPRD data quality criteria
- Followed on or after 1 January 1997
Exclusion Criteria:
- Patients without recorded gender
- Less than 1 year of follow-up between study entry and date of administrative censoring
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
---|---|
Dementia
Patients with a recorded diagnosis of dementia in primary or secondary care
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This study is based on the retrospective analysis of linked electronic health records.
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Non-dementia
Patients without a recorded diagnosis of dementia in primary or secondary care
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This study is based on the retrospective analysis of linked electronic health records.
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Proportion of patients with dementia diagnosis (any type) in primary care that also are recorded in secondary care
時間枠:10 years
|
10 years
|
|
Factors associated with dementia diagnosis (any type) recording in mortality data only
時間枠:10 years
|
These will be estimated from multivariable logistic regression models
|
10 years
|
Symptoms associated with subsequent diagnosis of dementia
時間枠:10 years
|
These will be estimated from multivariable logistic regression models
|
10 years
|
Lifetime risk of dementia (any type)
時間枠:10 years
|
10 years
|
|
Lifetime risk of mortality associated with dementia (any time)
時間枠:10 years
|
10 years
|
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Factors associated with dementia diagnosis (any type) recording in secondary care only
時間枠:10 years
|
These will be estimated from multivariable logistic regression models
|
10 years
|
Factors associated with dementia diagnosis (any type) recording in primary care only
時間枠:10 years
|
These will be estimated from multivariable logistic regression models
|
10 years
|
Proportion of patients with dementia diagnosis (any type) in primary care that also are recorded in mortality data
時間枠:10 years
|
10 years
|
|
Proportion of patients with dementia diagnosis (any type) in secondary care that also are recorded in mortality data
時間枠:10 years
|
10 years
|
二次結果の測定
結果測定 |
時間枠 |
---|---|
Proportion of patients with Alzheimer's disease in primary care that are also diagnosed in secondary care
時間枠:10 years
|
10 years
|
Proportion of patients with vascular dementia in primary care that are also diagnosed in secondary care
時間枠:10 years
|
10 years
|
Lifetime risk of Alzheimer's disease
時間枠:10 years
|
10 years
|
Lifetime risk of vascular dementia
時間枠:10 years
|
10 years
|
Lifetime risk of mortality associated with Alzheimer's disease
時間枠:10 years
|
10 years
|
Proportion of patients with Alzheimer's disease in primary care that are also diagnosed in mortality data
時間枠:10 years
|
10 years
|
Proportion of patients with Alzheimer's disease in secondary care that are also recorded in mortality data
時間枠:10 years
|
10 years
|
Proportion of patients with vascular dementia in primary care that are also recorded in secondary care
時間枠:10 years
|
10 years
|
Proportion of patients with vascular dementia in secondary care that are also recorded in mortality data
時間枠:10 years
|
10 years
|
協力者と研究者
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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