Objective: Tumor registries in integrated healthcare systems (IHCS) have high precision for identifying incident cancer but often miss recently diagnosed cancers or those diagnosed outside of the IHCS. We developed an algorithm using the electronic medical record (EMR) to identify people with a history of cancer not captured in the tumor registry to identify adults, aged 40-65 years, with no history of cancer.
Materials And Methods: The algorithm was developed at Kaiser Permanente Colorado, and then applied to 7 other IHCS.
J Racial Ethn Health Disparities
December 2021
Background And Aims: Normal ranges of serum alanine aminotransferase (ALT) may vary by race. However, results from research studies are contradictory, and many of these studies have included only small numbers of African Americans. We investigated ALT values in patients without evidence of liver disease to determine whether normal ranges differ across race groups.
View Article and Find Full Text PDFPurpose: This study describes longitudinal trends in the use of prostate-specific antigen (PSA)-based testing in two geographically distinct healthcare systems following the 2011 US Preventive Services Task Force (USPSTF) recommendations against routine PSA screening.
Methods: We analyzed population-based health claims data from 253,139 men aged 40-80 who were enrolled at two US healthcare systems. We assessed trends in the percentage of eligible men receiving ≥ 1 PSA test per year by time period (2000-2008, 2009-2011, 2012-2014), age (40-54, 55-69, 70-80), and race (white, black, other, unknown), and conducted a joinpoint regression analysis.
Background: Epidemiologic studies of patients who present to dermatology clinics are necessary to identify the needs of patients.
Objective: To quantify and compare diagnoses according to race, ethnicity, and socioeconomic status (SES) at 6 general dermatology clinics from January 2013 to December 2016.
Methods: A retrospective cohort of new patients was established using an electronic medical record database.
Purpose: Malignant transformation to squamous cell carcinoma (SCC) arising within cutaneous epidermal cysts is a very rare phenomenon. We provide a series of new cases and an overview of the literature. We sought to define the prevalence of and characterize SCC arising within epidermal and pilar cysts.
View Article and Find Full Text PDFNeighbourhood-level crowding, a measure of the percentage of households with more than one person per room, may impact the severity of sleep-disordered breathing. This study examined the association of neighbourhood-level crowding with apnoea-hypopnoea index in a large clinical sample of diverse adults with sleep-disordered breathing. Sleep-disordered breathing severity was quantified as the apnoea-hypopnoea index calculated from overnight polysomnogram; analyses were restricted to those with apnoea-hypopnoea index ≥5.
View Article and Find Full Text PDFPurpose: A single nucleotide polymorphism, rs10486567, in JAZF1 has consistently been associated with increased risk of prostate cancer. The physical interaction of zinc finger proteins, such as JAZF1, with heavy metals may play a role in carcinogenesis. This study assessed potential gene-environment statistical interactions (G×E) between rs10486567 and heavy metals in prostate cancer.
View Article and Find Full Text PDFGoals: We evaluated whether prior infection with the hepatitis B virus (HBV) influences the development of pancreatic cancer or hepatocellular carcinoma (HCC).
Background: Prior infection with HBV may predispose patients to developing pancreatic cancer or HCC.
Study: We conducted a retrospective cohort study using administrative data from an integrated health care system.
Background: Black men have historically had higher blood lead levels than white men in the U.S. and have the highest incidence of prostate cancer in the world.
View Article and Find Full Text PDFObjective(s): To determine the influence of income on clinical outcomes in patients with surgical stages I to II endometrioid adenocarcinoma of the uterus.
Methods: We retrospectively analyzed the records of 660 women initially treated from 1985 to 2009. On the basis of income data obtained from the 2000 US census, patients were separated into various income groups (halves, tertiles, and quartiles) based on median household income, with most focus on the half income groups.
Background. Racial differences in breast cancer survival may be in part due to variation in patterns of care. To better understand factors influencing survival disparities, we evaluated patterns of receipt of adjuvant chemotherapy among 2,234 women with invasive, nonmetastatic breast cancer treated at the Henry Ford Health System (HFHS) from 1996 through 2005.
View Article and Find Full Text PDFHealth maintenance organization (HMO) administrative databases have been used as sampling frames for ascertaining nonmelanoma skin cancer (NMSC). However, because of the lack of tumor registry information on these cancers, these ascertainment methods have not been previously validated. NMSC cases arising from patients served by a staff model medical group and diagnosed between 1 January 2007 and 31 December 2008 were identified from claims data using three ascertainment strategies.
View Article and Find Full Text PDFObjective: To examine the association of serum 25-hydroxyvitamin D (25-OHD) with the risk of nonmelanoma skin cancer (NMSC), defined as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
Design: Cohort study.
Setting: Health maintenance organization.
Arch Otolaryngol Head Neck Surg
April 2010
Objective: To assess the role of secondhand smoke (SHS) in the etiology of chronic rhinosinusitis (CRS).
Design: Matched case-control study. Associations between SHS and CRS were evaluated by conditional logistic regression odds ratios.
Cancer registries usually exclude nonmelanoma skin cancers (NMSC), despite the large population affected. Health maintenance organization (HMO) and health system administrative databases could be used as sampling frames for ascertaining NMSC. NMSC patients diagnosed between January 1, 1988, and December 31, 2007, from such defined US populations were identified by using 3 algorithms: NMSC International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, NMSC treatment Current Procedural Terminology (CPT) codes, or both codes.
View Article and Find Full Text PDFBackground: Nonmelanoma skin cancer (NMSC) incidence in patients with vitiligo has not been studied.
Objective: We sought to quantify the incidence of NMSC in patients with vitiligo.
Methods: A cohort of 477 patients with vitiligo and no history of NMSC seen in an outpatient academic center between January 2001 and December 2006 was established.
Purpose: To investigate the association of the thiazolidinediones (TZDs), rosiglitazone, and pioglitazone, together and individually on the risk of cardiovascular outcomes and all-cause mortality, using time-updated propensity score adjusted analysis.
Methods: We conducted a retrospective cohort study in a large vertically integrated health system in southeast Michigan. Cohort inclusion criteria included adult patients with diabetes treated with oral medications and followed longitudinally within the health system between 1 January 2000 and 1 December 2006.
Background: Many allergic conditions occur more frequently in African American patients when compared with white patients; however, it is not known whether this represents genetic predisposition or disparate environmental exposures.
Objective: We sought to assess the relationship of self-reported race and genetic ancestry to allergic sensitization.
Methods: We included 601 women enrolled in a population-based cohort study whose self-reported race was African American or white.
Purpose: To determine whether group academic detailing with performance feedback increases recommended laboratory monitoring among outpatients dispensed medications.
Methods: Thirty-eight primary care practices in 3 states were randomized to group academic detailing with physician-level performance feedback (intervention) or a control group. Adjusted differences in creatinine and potassium testing between intervention and control group patients with a new or continuing dispensing for angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), diuretics, or digoxin were evaluated using generalized estimating equation approaches.
Context: Programs to track laboratory quality have reported aggregated specimen rejection rates ranging from 0.30% to 0.83%.
View Article and Find Full Text PDFBackground: Previous studies have shown differences in adherence to inhaled corticosteroids (ICSs) by race-ethnicity, yet little is known about factors that contribute to adherence within these groups. Environmental stressors, such as crime exposure, which has been associated with asthma morbidity, might also predict ICS adherence.
Objective: We sought to identify factors associated with ICS adherence among patients with asthma and among African American patients and white patients separately.