PDF(Pubmed)
Abstract：
UNASSIGNED: Gastric adenocarcinoma (GAC) is often diagnosed at advanced stages and portends a poor prognosis. We hypothesized that electronic health records (EHR) could be leveraged to identify individuals at highest risk for GAC from the population seeking routine care.
UNASSIGNED: This was a retrospective cohort study, with endpoint of GAC incidence as ascertained through linkage to an institutional tumor registry. We utilized 2010 to 2020 data from the Palo Alto Medical Foundation, a large multispecialty practice serving Northern California. The analytic cohort comprised individuals ages 40-75 receiving regular ambulatory care. Variables collected included demographic, medical, pharmaceutical, social, and familial data. Electronic phenotyping was based on rule-based methods.
UNASSIGNED: The cohort comprised 316,044 individuals and approximately 2 million person-years (p-y) of observation. 157 incident GACs occurred (incidence 7.9 per 100,000 p-y), of which 102 were non-cardia GACs (incidence 5.1 per 100,000 p-y). In multivariable analysis, male sex [HR: 2.2, 95% confidence interval (CI): 1.6-3.1], older age, Asian race (HR: 2.5, 95% CI: 1.7-3.7), Hispanic ethnicity (HR: 1.9, 95% CI: 1.1-3.3), atrophic gastritis (HR: 4.6, 95% CI: 2.2-9.3), and anemia (HR: 1.9, 95% CI: 1.3-2.6) were associated with GAC risk; use of NSAID was inversely associated (HR: 0.3, 95% CI: 0.2-0.5). Older age, Asian race, Hispanic ethnicity, atrophic gastritis, and anemia were associated with non-cardia GAC.
UNASSIGNED: Routine EHR data can stratify the general population for GAC risk.
UNASSIGNED: Such methods may help triage populations for targeted screening efforts, such as upper endoscopy.
UNASSIGNED: This was a retrospective cohort study, with endpoint of GAC incidence as ascertained through linkage to an institutional tumor registry. We utilized 2010 to 2020 data from the Palo Alto Medical Foundation, a large multispecialty practice serving Northern California. The analytic cohort comprised individuals ages 40-75 receiving regular ambulatory care. Variables collected included demographic, medical, pharmaceutical, social, and familial data. Electronic phenotyping was based on rule-based methods.
UNASSIGNED: The cohort comprised 316,044 individuals and approximately 2 million person-years (p-y) of observation. 157 incident GACs occurred (incidence 7.9 per 100,000 p-y), of which 102 were non-cardia GACs (incidence 5.1 per 100,000 p-y). In multivariable analysis, male sex [HR: 2.2, 95% confidence interval (CI): 1.6-3.1], older age, Asian race (HR: 2.5, 95% CI: 1.7-3.7), Hispanic ethnicity (HR: 1.9, 95% CI: 1.1-3.3), atrophic gastritis (HR: 4.6, 95% CI: 2.2-9.3), and anemia (HR: 1.9, 95% CI: 1.3-2.6) were associated with GAC risk; use of NSAID was inversely associated (HR: 0.3, 95% CI: 0.2-0.5). Older age, Asian race, Hispanic ethnicity, atrophic gastritis, and anemia were associated with non-cardia GAC.
UNASSIGNED: Routine EHR data can stratify the general population for GAC risk.
UNASSIGNED: Such methods may help triage populations for targeted screening efforts, such as upper endoscopy.
摘要：
背景：胃腺癌（GAC）通常诊断为晚期，预后不良。我们假设可以利用电子健康记录（EHR）从寻求常规护理的人群中识别出GAC风险最高的个体。
方法：这是一项回顾性队列研究，通过与机构肿瘤登记处的联系确定GAC发病率的终点。我们利用了帕洛阿尔托医学基金会2010-2020年的数据，服务于北加州的大型多专业实践。分析队列包括40-75岁接受定期门诊护理的个体。收集的变量包括人口统计，medical,Pharmaceutical,社会,和家族数据。电子表型基于基于规则的方法。
结果：该队列包括316,044名个体和约200万人年（p-y）的观察。发生157例GAC事件（每100,000年发生7.9例），其中102例为非贲门GAC(发病率5.1/100,000p-y)。在多变量分析中，男性（HR2.2，95%CI1.6-3.1），年龄较大,亚洲种族（HR2.5，95%CI1.7-3.7），西班牙裔种族（HR1.9，95%CI1.1-3.3），萎缩性胃炎（HR4.6，95%CI2.2-9.3），贫血(HR1.9,95%CI1.3-2.6)与GAC风险相关;非甾体类抗炎药的使用呈负相关(HR0.3,95%CI0.2-0.5).年纪大了,亚洲种族，西班牙裔种族，萎缩性胃炎,贫血与非贲门GAC相关。
结论：常规EHR数据可以对普通人群进行GAC风险分层。
结论：这些方法可能有助于对人群进行有针对性的筛查工作，比如上内窥镜。
方法：这是一项回顾性队列研究，通过与机构肿瘤登记处的联系确定GAC发病率的终点。我们利用了帕洛阿尔托医学基金会2010-2020年的数据，服务于北加州的大型多专业实践。分析队列包括40-75岁接受定期门诊护理的个体。收集的变量包括人口统计，medical,Pharmaceutical,社会,和家族数据。电子表型基于基于规则的方法。
结果：该队列包括316,044名个体和约200万人年（p-y）的观察。发生157例GAC事件（每100,000年发生7.9例），其中102例为非贲门GAC(发病率5.1/100,000p-y)。在多变量分析中，男性（HR2.2，95%CI1.6-3.1），年龄较大,亚洲种族（HR2.5，95%CI1.7-3.7），西班牙裔种族（HR1.9，95%CI1.1-3.3），萎缩性胃炎（HR4.6，95%CI2.2-9.3），贫血(HR1.9,95%CI1.3-2.6)与GAC风险相关;非甾体类抗炎药的使用呈负相关(HR0.3,95%CI0.2-0.5).年纪大了,亚洲种族，西班牙裔种族，萎缩性胃炎,贫血与非贲门GAC相关。
结论：常规EHR数据可以对普通人群进行GAC风险分层。
结论：这些方法可能有助于对人群进行有针对性的筛查工作，比如上内窥镜。
