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Cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada.

https://arctichealth.org/en/permalink/ahliterature216297
Source
Epilepsia. 1995 Jan;36(1):29-36
Publication Type
Article
Date
Jan-1995
Author
P. Tennis
T B Cole
J F Annegers
J E Leestma
M. McNutt
A. Rajput
Author Affiliation
International Surveillance, Epidemiology, and Economic Research Division, Burroughs Wellcome Co, Research Triangle Park, NC 27709.
Source
Epilepsia. 1995 Jan;36(1):29-36
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Alcoholism - epidemiology
Anticonvulsants - therapeutic use
Cause of Death
Cohort Studies
Comorbidity
Death, Sudden - epidemiology
Drug Prescriptions - statistics & numerical data
Epilepsy - drug therapy - mortality
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Records as Topic - statistics & numerical data
Risk factors
Saskatchewan - epidemiology
Sex Factors
Abstract
To measure the incidence of sudden unexplained death in treated persons with epilepsy (SUDEP) and to identify risk factors for SUDEP, a cohort of 6,044 persons aged 15-49 years with more than four prescriptions for antiepileptic drugs (AEDs) was identified from the Saskatchewan Health prscription drug file. To exclude subjects whose sudden deaths (SUDs) might be misattributed to another chronic underlying disease, subjects with hospitalizations for cancer or heart problems were excluded. To exclude subjects without epilepsy, subjects with > 2-year AED treatment followed by AED-free time and subjects receiving
PubMed ID
8001505 View in PubMed
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Record linkage to conduct an epidemiologic study on the association of rheumatoid arthritis and lymphoma in the Province of Saskatchewan, Canada.

https://arctichealth.org/en/permalink/ahliterature220756
Source
J Clin Epidemiol. 1993 Jul;46(7):685-95
Publication Type
Article
Date
Jul-1993
Author
P. Tennis
E. Andrews
C. Bombardier
Y. Wang
L. Strand
R. West
H. Tilson
P. Doi
Author Affiliation
ESP Division, Burroughs Wellcome Co., Research Triangle Park, NC 27709.
Source
J Clin Epidemiol. 1993 Jul;46(7):685-95
Date
Jul-1993
Language
English
Publication Type
Article
Keywords
Arthritis, Rheumatoid - complications - drug therapy
Cohort Studies
Databases, Bibliographic
Epidemiologic Methods
Humans
Lymphoma - etiology
Medical Record Linkage
Reproducibility of Results
Retrospective Studies
Risk
Saskatchewan
Abstract
The objective of this effort was to assess the utility of the large automated database in Saskatchewan as a resource for pharmacoepidemiologic studies. To this end a study was undertaken to test the hypothesis that rheumatoid arthritis (RA) increases the risk of cancer, especially lymphoma. This was done by performing a retrospective cohort study based on record linkage data from Saskatchewan Health. From hospital discharge diagnoses in the hospital file an exposed group (RA) and two comparison groups matched to the RA group by age and sex were identified: (1) the RA group consisted of people with a discharge diagnosis of rheumatoid arthritis; (2) the osteoarthritis (OA) group consisted of people with OA discharge diagnoses; and (3) a comparison (CN) group consisted of hospitalized people with no discharge diagnoses of arthritis. Drug exposures were determined by linkage with the Prescription Drug File, cancer outcomes were determined by linkage with the Cancer Foundation file, and length of eligibility in the health plan and demographics information were determined by linkage with the registration file. The data were checked for quality of linkages across files and consistency with study definitions. Of 13,333 identified subjects, 2.8% were excluded because of apparent incorrect assignment to study group or age group or because of ineligibility in health plan during the study period. In order to decrease the possibility of misclassification of exposure (rheumatoid arthritis), hospital discharge diagnoses were used to exclude subjects with any inflammatory rheumatic diseases (IRD) from the CN (7.8%) and OA (8.3%) groups and subjects with IRD other than rheumatoid arthritis (4.6%) from the RA group. To decrease selection bias, those who had cancer within 1 year of enrollment (to exclude those in hospital because of symptoms of undiagnosed cancer) were excluded. Because RA subjects hospitalized by a rheumatologist were most likely to have valid rheumatoid arthritis diagnoses, each analysis was run twice: once with the entire RA group (N = 1210) and once with those in the RA group who were rheumatologist-hospitalized (N = 646). Logistic regression of incidence was used to control for age, sex, and use of individual disease-modifying anti-rheumatoid drugs (DMARDs). For the rheumatologist-hospitalized RA group compared to the CN group, a significant 4-fold greater risk for lymphoma/myeloma was detected when DMARD use was not controlled for, and a 3.4-fold increase in risk was detected even when use of individual DMARDs was controlled for.(ABSTRACT TRUNCATED AT 400 WORDS)
PubMed ID
8326357 View in PubMed
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Validity of rheumatoid arthritis diagnoses listed in the Saskatchewan Hospital Separations Database.

https://arctichealth.org/en/permalink/ahliterature220757
Source
J Clin Epidemiol. 1993 Jul;46(7):675-83
Publication Type
Article
Date
Jul-1993
Author
P. Tennis
C. Bombardier
E. Malcolm
W. Downey
Author Affiliation
Burroughs Wellcome Co, Research Triangle Park, NC 27709.
Source
J Clin Epidemiol. 1993 Jul;46(7):675-83
Date
Jul-1993
Language
English
Publication Type
Article
Keywords
Arthritis, Rheumatoid - diagnosis
Databases, Bibliographic - standards
Humans
Medical Records - standards
Osteoarthritis - diagnosis
Patient Discharge
Reproducibility of Results
Saskatchewan
Abstract
A Saskatchewan hospital separations database was compared to abstracted hospital records to determine the reliability of the database (i.e. accuracy with which the computer data reflect the charts from which they were coded) and the validity of classifying rheumatoid arthritis status with the database (i.e. the extent to which rheumatoid arthritis mentioned in the database reflected the condition of the patient). A sample of hospitalized subjects fell into three categories: 144 who never had a database diagnosis of any arthritis, 146 who had a database diagnosis of osteoarthritis, and 142 who had a database diagnosis of rheumatoid arthritis. These 432 people experienced 1717 hospitalizations eligible to match a hospital database listing by date, and 1618 matched. Of the remaining 99, 35 were relatively recent and probably had not yet been entered into the database, 39 were possibly entered incorrectly, and 25 could not be matched in any way. Of 150 hospitalizations with a database diagnosis of rheumatoid arthritis, this diagnosis was in the hospital record for 125. Chart documentation of rheumatoid arthritis status was greatest for subjects who, according to the database, were hospitalized by a rheumatologist: of 73 subjects in this category, abstractions showed 69.9% met > or = 5 American Rheumatism Association criteria, 15.1% met
PubMed ID
8326356 View in PubMed
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