Astım için komorbiditelerin cinsiyete göre karşılaştırılması. Bir düğümün (dairenin) boyutu, çalışma döneminde (1 Nisan 2010 – 31 Mart 2015) durumun yaygınlığıyla orantılıdır. İki düğüm arasındaki çizgilerin genişliği, iki koşulun ne kadar ilişkili olduğunu gösterir. Kredi: Valerie Kuan, Spiros Denaxas, ve diğerleri / Lancet Dijital Sağlık
University College London (UCL) araştırmacıları tarafından yürütülen yeni bir çalışma, İngiltere’deki dört milyon hastadan alınan verileri kullanarak, aynı kişilerde ortak sağlık koşullarının nasıl bir arada ortaya çıktığına dair kalıpları belirledi.
İlerleyen yaşla birlikte milyonlarca insan, bazen multimorbidite olarak adlandırılan birden fazla koşulla yaşıyor. Ayrıca, bu şekilde etkilenen insanların oranının önümüzdeki yıllarda artması bekleniyor. Bununla birlikte, tıp eğitimi ve öğretimi, klinik yönergeler, sağlık hizmeti sunumu ve araştırmalar, her seferinde bir hastalığa odaklanmak için gelişmiştir.
Bu sorun tarafından tanınan[{” attribute=””>Academy of Medical Sciences and the UK Chief Medical Officer (CMO), which have set out a challenge of investigating which diseases co-occur in the same individuals and why.
In the new study, which was recently published in the journal Lancet Digital Health, the team used routine health records data to systematically identify patterns of clustering of 308 common mental and physical health conditions of men and women of different ages and with different ethnicities.
Some patterns found include: heart failure often co-occurred with hypertension, atrial fibrillation, osteoarthritis, stable angina, myocardial infarction, chronic kidney disease, type 2 diabetes, and chronic obstructive pulmonary disease.
Hypertension was most strongly associated with kidney disorders in those aged 20–29 years, but with dyslipidaemia, obesity, and type 2 diabetes in individuals aged 40 years and older.
Breast cancer was associated with different comorbidities in individuals from different ethnicities, asthma with different comorbidities between the sexes, and bipolar disorder with different comorbidities in younger ages compared with older ages.
The findings, the researchers say, provide the data and resources to help improve health and care planning for patients in England living with more than one condition.
Co-author Professor Aroon Hingorani (UCL Institute of Cardiovascular Science) said: “Information from minority ethnic groups and younger people has often been missing from studies of multimorbidity, but by using diverse electronic health records, we present a more inclusive and representative perspective of multimorbidity. This is one area where the NHS electronic health records and data science can generate important insights.”
Professor Spiros Denaxas (UCL Institute of Health Informatics) said: “Millions of people live with multiple diseases, yet our understanding of how and when these transpire is limited. This research project is the first step towards understanding how these diseases co-occur and identifying how to best treat them.”
The study includes accessible tools to help users visualize patterns of disease co-occurrence, including for diseases that cluster more commonly than expected by chance, providing an entry point to investigate common risk factors and treatments.
The findings should help patients better understand their illness, doctors better plan the management of patients with multimorbidity, healthcare providers optimize service delivery, policymakers plan resource allocation, and researchers to develop new or use existing medicines to treat several diseases together.
The data analyzed were from the Clinical Practice Research Datalink under license and managed securely via the UCL Data Safe Haven. All algorithms for defining the diseases are open source (and can be found here).
Reference: “Identifying and visualising multimorbidity and comorbidity patterns in patients in the English National Health Service: a population-based study” by Valerie Kuan, PhD; Prof Spiros Denaxas, PhD; Prof Praveetha Patalay, PhD; Prof Dorothea Nitsch, MD; Prof Rohini Mathur, PhD; Arturo Gonzalez-Izquierdo, PhD; Prof Reecha Sofat, PhD; Prof Linda Partridge, PhD; Amanda Roberts, BSc; Prof Ian C K Wong, PhD; Melanie Hingorani, FRCOphth; Prof Nishi Chaturvedi, MD; Prof Harry Hemingway, FMedSci and Prof Aroon D Hingorani, PhD on behalf of the Multimorbidity Mechanism and Therapeutic Research Collaborative (MMTRC), 29 November 2022, Lancet Digital Health.
DOI: 10.1016/S2589-7500(22)00187-X
The research was enabled by UK Research and Innovation’s Strategic Priority Fund, NIHR UCLH Biomedical Research Centre, Health Data Research (HDR) UK, Medical Research Council, the Department of Health and Social Care, Wellcome Trust, the British Heart Foundation, and The Alan Turing Institute, in collaboration with the Engineering and Physical Sciences Research Council.