Incidence Rates Of Use Research Articles

Cardiovascular disease incidence rates: a study using routinely collected health data

BackgroundThere is substantial evidence that systemic anticancer therapies and radiotherapy can increase the long-term risk of cardiovascular disease (CVD). Optimal management decisions for cancer patients therefore need to take into account the likely risks from a proposed treatment option, as well as its likely benefits. For CVD, the magnitude of the risk depends on the incidence of the disease in the general population to which the patient belongs, including variation with age and sex, as well as on the treatment option under consideration. The aim of this paper is to provide estimates of CVD incidence rates in the general population of England for use in cardio-oncology and in other relevant clinical, research and health policy contexts.MethodsWe studied a population-based representative cohort, consisting of 2,633,472 individuals, derived by electronic linkage of records from primary care with those of admitted-patient care in England during April 1, 2010, to April 1, 2015. From 38 individual CVDs available via the linked dataset we identified five relevant categories of CVD whose risk may be increased by cancer treatments: four of heart disease and one of stroke.ResultsWe calculated incidence rates by age-group and sex for all relevant CVD categories combined, for the four relevant categories of heart disease combined, and for the five relevant CVD categories separately. We present separate incidence rates for all 38 individual CVDs available via the linked dataset. We also illustrate how our data can be used to estimate absolute CVD risks in a range of people with Hodgkin lymphoma treated with chemotherapy and radiotherapy.ConclusionsOur results provide population-based CVD incidence rates for a variety of uses, including the estimation of absolute risks of CVD from cancer treatments, thus helping patients and clinicians to make appropriate individualized cancer treatment decisions.Graphical Graphical : Cardiovascular incidence rates for use in cardio-oncology and elsewhere: A presentation of age- and sex-specific cardiovascular disease (CVD) incidence rates for use in calculation of absolute cardiovascular risks of cancer treatments, and in other clinical, research and health policy contexts. Abbreviations– CVD: cardiovascular disease; y: years

Accounting for Immigrant Status when Calculating Cancer Incidence Rates for Bangkok

Objective:Cancer-registry data are crucial for definingcancer incidence rates for use in setting service priorities and monitoringservice effects. This applies in Thailand where cancer is the leading cause of death and service needs are high. The Bangkok Cancer Registry (population-based) was established in 1990to determine cancer incidence rates for Bangkok. This proved difficult, however, because the Bangkokpopulation (>8million) fluctuates with numbers of temporary visitors, many of whom visit Bangkok temporarily for services. If these visitors are mis-categorized as usual residents, cancer incidence rateswould be inflated. During 2013-2015, residential addresses on the Registry were cross-checked against official addresses on the National Civil Registration records of the Ministry of Interior. The effectsof this cross-checking on incidence rates are discussed.Methods:Residential addresses recorded on the Registry for cancer diagnoses in 2013-2015 were corrected using official Ministry data. Effects on numbers of recorded cancers and crude and directly age-standardized rates (World Population) were determined.Results:Of 44,813 cancer casesdiagnosed and recorded on the Registryduring 2013-2015, 36,327 (81.1%) had an official Bangkok address. When limiting analyses to these cases, the crude incidencefor all cancer sites combined reduced by 18.9% (19.7% for males and 18.3% for females). Corresponding reductions in age-standardized incidence rates were 20.0% for males and 18.8% for females. These reductions varied for common cancer sites: in males, from 14.8% for lung to 25.9% for colorectal cancer; and in females, from 12.9% for lung to 24.0% for cervical cancer.Conclusions:These differences are considered sufficient in magnitude to justifyroutine use of official residential data when calculating cancer incidence rates for Bangkok. If these rates are to be compared with comparable rates for other Asian citiesthat serve broader populations, equivalent methodologies for determining residential status would be needed for all cities.

Trends in the incidence of use of noninsulin glucose-lowering drugs between 2006 and 2013 in France.

This study aimed at describing trends in the incidence of use of noninsulin glucose-lowering drugs (NIGLDs) between 2006 and 2013 in France. Repeated cross-sectional studies on NIGLD new users were performed annually from 2006 to 2013 within the Echantillon Généraliste des Bénéficiaires (EGB) database, a 1/97th representative sample of the population covered by the French healthcare insurance system. NIGLD included metformin, sulfonylureas, α-glucosidase inhibitors, thiazolidinediones, dipeptidylpeptidase-4 (DPP-4) inhibitors, glinides and glucagon-like peptide-1 analogues. New users were defined as patients with no delivery of any NIGLD (first-line new users) or no delivery of a NIGLD of the same class (add-on/switch new users) in the preceding year. Incidence rates of use and corresponding 95% confidence intervals (95% CI) were estimated per 1000 persons. Among the 507 043 persons included in the EGB in 2006, 2036 were identified as NIGLD first-line new users and 2192 as add-on/switch new users, which corresponded to an incidence of use of 4.0‰ (95%CI 3.8-4.2) and 4.3‰ (4.1-4.5), respectively. First-line incidence increased to 5.3‰ (5.1-5.5) in 2010 and then decreased to 4.2‰ (4.0-4.4) in 2013; add-on/switch incidence increased to 8.0‰ (7.8-8.2) in 2010 and then decreased to 5.3‰ (5.1-5.5) in 2013. This reduction was mainly related to DPP-4 inhibitors, whose use as add-on/switch NIGLDs was roughly halved between 2010 and 2013. Concomitantly, the use of sulfonylureas and glinides increased. In conclusion, after reaching a peak in 2010, the incidence of use of NIGLDs has markedly decreased in France. Since then, prescribers seem to have reverted to older and well-known therapies.

Born in the USA: Estimated annual incidence rates for use of cannabis in the 21st century United States

Born in the USA: Estimated annual incidence rates for use of cannabis in the 21st century United States

Meta-Analysis of the Use of Rescue Antiemetics Following PONV Prophylactic Failure with 5-HT3Antagonist/Dexamethasone Versus Single-Agent Therapies

To assess the use of rescue antiemetic medication following 5-HT3 receptor antagonist (5-HT3RA) plus dexamethasone therapy versus monotherapy with a 5-HT3RA for prophylaxis of postoperative nausea and vomiting (PONV). Reports of randomized, controlled trials were identified via a MEDLINE search (1966-September 2005) using the key terms ondansetron, dolasetron, tropisetron, granisetron, 5-HT3, PONV, vomiting, emesis, and nausea. Randomized, controlled trials of adult populations that had treatment arms comparing 5-HT3RA/dexamethasone combination therapy with 5-HT3RA or dexamethasone monotherapies versus placebo or 5-HT3RA versus dexamethasone or placebo were selected for analysis. Another criterion was that a proportion of patients required rescue medication 48 hours or less following surgery. Odds ratios (ORs) with 95% confidence interval were calculated to determine incidence rates for use of rescue medications within early (0-6 h), late (6-24 h), and overall (0-24 or 48 h) postoperative periods. Overall effect sizes were calculated by pooling ORs within fixed and random effects models. Prophylaxis with 5-HT3RA/dexamethasone was associated with lower use of rescue antiemetics than 5-HT3RA (OR(pooled) = 0.48; 95% CI 0.29 to 0.77) or dexamethasone (OR(pooled) = 0.26; 95% CI 0.12-0.57) monotherapy during the overall postoperative period. Insufficient data were available to assess rescue use during early or late postoperative periods. It appears that patients at high risk of PONV who are treated prophylactically with combination 5-HT3RA/dexamethasone therapy are overall less likely to require rescue medication than if treated with 5-HT3RAs or dexamethasone alone. Additional large prospective studies are needed to determine the optimal regimen and timing of administration of prophylactic antiemetic therapy for different surgical populations.