| アブストラクト | OBJECTIVES: We aimed to design and test a method to extract information on antithrombotic therapy from anonymised free-text notes in the Clinical Practice Research Datalink (CPRD). SETTING: General practice database representative of the UK. PARTICIPANTS: All patients undergoing total hip replacement (THR, n=25,898) or total knee replacement (TKR, n=22,231) between January 2008 and October 2012 were included. Antithrombotic drug use related to THR or TKR was identified using anonymised free text and prescription data. PRIMARY AND SECONDARY OUTCOME MEASURES: Internal validity of our newly designed method was determined by calculating positive predictive values (PPVs) of hits for predefined keywords in a random sample of anonymised free-text notes. In order to determine potential detection bias, total joint replacement (TJR) patient characteristics were compared as per their status of exposure to antithrombotics. RESULTS: PPVs ranging between 97% and 99% for new oral anticoagulants (NOAC) or low-molecular weight heparins (LMWH) exposure related to TJR were obtained with our method. Our search strategy increased detection rates by 57%, yielding a total proportion of 18.5% of all THR and 18.6% of all TKR surgeries. Identified users of NOACs and LMWHs were largely similar with regards to age, sex, lifestyle, disease and drug history compared to patients without identified drug use. CONCLUSIONS: We have developed a useful method to identify additional exposure to NOACs or LMWHs with TJR surgery. |
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| 投稿者 | Nielen, Johannes Th; van den Bemt, Bart J F; Boonen, Annelies; Dagnelie, Pieter C; Emans, Pieter J; Veldhorst, Nicole; Lalmohamed, Arief; van Staa, Tjeerd-Pieter; de Vries, Frank |
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| 組織名 | Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University,;Utrecht, The Netherlands Department of Epidemiology, CAPHRI School for Public;Health and Primary Care, Maastricht University, Maastricht, The Netherlands.;Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands;Department of Pharmacy, Radboud University Medical Center, Nijmegen, The;Netherlands.;Department of Internal Medicine, Division of Rheumatology, Maastricht University;Medical Centre, Maastricht, The Netherlands.;Department of Epidemiology, CAPHRI School for Public Health and Primary Care, and;CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The;Department of Orthopaedics, Maastricht University Medical Center, Maastricht, The;Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Center, Maastricht, The Netherlands.;Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The;Utrecht, The Netherlands.;Utrecht, The Netherlands Department of Clinical Pharmacy and Toxicology,;Maastricht University Medical Center, Maastricht, The Netherlands. |
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