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Linking the Paul Coverdell National Acute Stroke Program to commercial claims to establish a framework for real-world longitudinal stroke research

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Stroke & Vascular Neurology 2022年第2期7卷 114-123页

作者： Elisabetta Patorno Sebastian schneeweiss Mary G George Xin Tong Jessica M Franklin Ajinkya Pawar Helen Mogun Lidia M V R Moura Lee H Schwamm Division of Pharmacoepidemiology and Pharmacoeconomics Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA Division for Heart Disease and Stroke Prevention NCCDPHPCenters for Disease Control and PreventionAtlantaGeorgiaUSA Epilepsy and Neurophysiology Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Fireman Vascular Center and Stroke Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA

Background Non-interventional large-scale research on real-world patients who had a stroke requires the use of multiple data sources ensuring access to longitudinal data from large populations with clinically-detailed *** sought to establish a framework for longitudinal research on patients hospitalised with stroke by linking information-rich,deidentified inpatient data from the Paul Coverdell National Acute Stroke Program(PCNASP)to commercial and Medicare Advantage longitudinal claims *** All stroke admissions in PCNASP between 2008 and 2015 were evaluated for linkage to longitudinal claims from a commercial insurer using an algorithm based on six available common data fields(patient age,gender,admission date,discharge date,discharge diagnosis and state)and a hospital *** evaluated the linkage quality(via the percentage of unique records in the linked dataset)and the representativeness of the linked *** also described medical history,stroke severity and patterns of medication use among the PCNASP-claims linked *** The linkage produced uniqueness equal to 99.1%.We identified 5644 linked and 98896 unlinked patients who had an ischaemic stroke hospitalisation in claims *** patients were younger than unlinked(69.7 vs 72.5 years),but otherwise similar by medical history,prestroke medication use or lab *** severity was mild and most patients were discharged *** and discharge use of antihypertensive and statins in the PCNASP were greater than their use as measured by filled prescriptions in *** High-quality linkage between the PCNASP and commercial claims data is *** linkage identified differences between reported or recommended versus actual out-of-hospital medication utilisation,highlighting the importance of longitudinal data availability for research aimed to improve the care of patients who had a stroke.

关键词： linkage claims younger

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新型抗心律失常药物——氟卡胺

国外医学（心血管疾病分册） 1991年第3期18卷 159-160页

作者： schneeweiss A 桂永浩

近年来 IC 类抗心律失常药氟卡胺在儿科已广泛使用。该药减慢0相除极速度,但对复极过程影响很小。临床上主要用于室上性心律失常和室性心动过速及一部分室性早搏的病人。对 W-P-W 综合征有一定疗效,治疗房扑的效果较差。由于其低毒性,... 详细信息

近年来 IC 类抗心律失常药氟卡胺在儿科已广泛使用。该药减慢0相除极速度,但对复极过程影响很小。临床上主要用于室上性心律失常和室性心动过速及一部分室性早搏的病人。对 W-P-W 综合征有一定疗效,治疗房扑的效果较差。由于其低毒性,在儿童更受欢迎。

关键词：抗心律失常药氟卡胺

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血管紧张素转化酶抑制剂

国外医学（儿科学分册） 1989年第2期16卷 90-92页

作者： schneeweiss A. 林明

血管紧张素转化酶抑制剂(ACEI)能阻断血管紧张素Ⅰ转化为有升压作用的血管紧张素Ⅱ。此转化酶亦为激肽酶,负有清除血管扩张剂缓激肽的作用。 ACEI ACEI阻断血管紧张素Ⅱ的产生,导致了血管扩张。对高血压患者,其典型的血液动力学反应,包... 详细信息

血管紧张素转化酶抑制剂(ACEI)能阻断血管紧张素Ⅰ转化为有升压作用的血管紧张素Ⅱ。此转化酶亦为激肽酶,负有清除血管扩张剂缓激肽的作用。 ACEI ACEI阻断血管紧张素Ⅱ的产生,导致了血管扩张。对高血压患者,其典型的血液动力学反应,包括大循环血管阻力下降及大循环动脉压下降。充血性心力衰竭患者的大循环血管阻力和左心室充盈压力下降,心输出量增加,而心率常无变化或略为减慢。ACEI的效果可借助外源性血管紧张素Ⅰ对升压反应抑制的测定,或血浆肾素和转化酶活性的测定。

关键词： ACEI 血管扩张剂巯甲丙脯酸

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马克龙的改革难题法国人拒绝延迟退休

商业周刊（中文版） 2023年第1期 42-43页

作者： William Horobin Ania Nussbaum Zoe schneeweiss 杜然(译) 不详

埃马纽埃尔·马克龙(Emmanuel Macron)现在大可宣称,为了实现他的愿景,即建立一个就业机会丰富、对投资和商业有吸引力的开放经济,他带领法国完成长达10年转型的计划取得了重大进展。他的努力吸引了来自英国、饱受脱欧影响的银行家,他... 详细信息

埃马纽埃尔·马克龙(Emmanuel Macron)现在大可宣称,为了实现他的愿景,即建立一个就业机会丰富、对投资和商业有吸引力的开放经济,他带领法国完成长达10年转型的计划取得了重大进展。他的努力吸引了来自英国、饱受脱欧影响的银行家,他们帮助创建了数十家价值数十亿美元的科技初创企业,甚至促进了该国长期低迷的制造业就业出现了一定程度的上升。

关键词：延迟退休初创企业制造业就业就业机会长期低迷埃马纽埃尔银行家改革难题

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反复住院预示社区心力衰竭人群的死亡率

世界核心医学期刊文摘（心脏病学分册） 2007年第12期3卷 12-13页

作者： Setoguchi S. Stevenson L.W. schneeweiss S. 马超 Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital Boston MA United StatesDr.

背景:识别具有高死亡风险的患者对于适当处置患者和卫生保健资源至关重要。因心力衰竭(HF)反复住院对死亡率的影响尚未在大样本的社区HF人群中进行研究。本研究旨在依据患者因HF住院次数确定其生存特点。方法:通过卫生保健利用数据库,识... 详细信息

背景:识别具有高死亡风险的患者对于适当处置患者和卫生保健资源至关重要。因心力衰竭(HF)反复住院对死亡率的影响尚未在大样本的社区HF人群中进行研究。本研究旨在依据患者因HF住院次数确定其生存特点。方法:通过卫生保健利用数据库,识别2000—2004年英属哥伦比亚所有居民中首次因HF住院的患者队列。

关键词：心力衰竭反复住院死亡率

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药物治疗帕金森病患者与突发难治性嗜睡

世界核心医学期刊文摘（神经病学分册） 2005年第12期1卷 10-11页

作者： Avorn J. schneeweiss S. Sudarsky L.R. 高中宝 Dr.Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital 1620 Tremont St Boston MA 02120 United States

Background: Episodes of sudden uncontrollable somnolence have been reported in patients with Parkinson disease (PD) receiving dopamine agonists, including pramipexole and ropinirole, but controversy persists concerning their nature, severity, and frequency. Abstract:Objectives: To quantify the risk of sudden uncontrollable somnolence in patients taking specific PD medications and to define its predictors. Methods: We contacted 929 patients with PD and administered a 45-to 60-minute interview addressing medication use, adverse events, and the patient’s clinical status in the preceding 6 months. Their physicians completed record reviews detailing their clinical histories and drug regimens. The outcome of interest in this case-control study was an episode of somnolence that was uncontrollable, severe, and inappropriate, such as while driving or engaged in social activity. For multiple events, the first was chosen as the index event. For each case, we sampled control time from all respondents who had no event as of the index time for that case. Multiple logistic regression was used to adjust for potential confounders. Results: Episodes of uncontrollable somnolence were reported by 22%of all respondents. After controlling for age, sex, PD duration and severity, frailty, and other medication use, we found that patients receiving a dopamine agonist (pramipexole, ropinirole, or pergolide) were nearly 3-fold as likely to have episodes of sudden uncontrollable somnolence (odds ratio, 2.8; 95%confidence interval, 1.8-4.2) compared with all other PD medication users. Similar risks were seen for the 3 agents, pramipexole, ropinirole, and pergolide, each compared with levodopa alone (odds ratio, 2.2, 1.8, and 2.1, respectively), with a clear dose-response relationship for each. No increase in risk was seen with any other drugs studied. Conclusions: Dopamine agonists widely used for the management of PD significantly increase the risk of sudden uncontrollable somnolence in a dose-

关键词：帕金森病药物治疗普拉克索左旋多巴罗匹尼罗激动剂临床病史病历回顾临床状态社交活动

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他汀类药物亲脂性和发生心力衰竭风险的关系

中华高血压杂志 2020年第8期28卷 784-784页

作者：周卫(译) 叶鹏(校) Imran T Wong A schneeweiss S Desai RJ 不详

比较使用亲水性和亲脂性他汀类药物患者发生心力衰竭的风险。方法:利用美国(2005-2014年)商业健康保险计划的申报数据,研究者确定了开始使用亲水性或亲脂性他汀类药物的患者。在他汀类药物开始使用后1年,对主要观察指标心力衰竭进行随... 详细信息

比较使用亲水性和亲脂性他汀类药物患者发生心力衰竭的风险。方法:利用美国(2005-2014年)商业健康保险计划的申报数据,研究者确定了开始使用亲水性或亲脂性他汀类药物的患者。在他汀类药物开始使用后1年,对主要观察指标心力衰竭进行随访。将心力衰竭1个住院诊断或者2个门诊诊断编码和使用袢利尿剂作为主要观察指标。倾向得分法用于评估混杂因素。

关键词：商业健康保险观察指标混杂因素心力衰竭他汀类药物袢利尿剂住院诊断亲脂性