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The First National Prevalence Estimation of Gastroparesis in the United States Using a Large-scale Retrospective Database

The First National Prevalence Estimation of Gastroparesis in the United States Using a... LETTER TO THE EDITOR The First National community and cannot be extrapolated to period will affect the ability to detect a the wider US general population due disease and influence temporal trends. Prevalence Estimation to the lack of diversity in economic, The impact of different lookback win- geographic, and demographic characteri- dows should be thoroughly assessed to of Gastroparesis in the 2,3 stics. This new observational study ensure the robustness of the findings. Last, mitigated the gap in disease occurrence Syed and colleagues correctly pointed out United States Using a knowledge using real-world evidence from that differences in study populations pre- a large representative sample of the United vent meaningful direct comparisons with Large-scale States general population. The traditional previous prevalence estimation of gastro- Retrospective method of prevalence and incidence paresis. This study has unique strengths, assessment involves complex sampling including a large covered population and Database strategies in national surveys such as the diversity in patient demographics; how- National Health and Nutrition Examina- ever, more studies with rigorous method- tion Survey (NHANES) and has proven ology in additional populations are to be expensive, time-consuming, and necessary to further understand the To the Editor: unable to capture changing dynamics of epidemiology of gastroparesis. 1 4 Syed et al recently published an a population. Meanwhile, as part of Yizhou Ye, PhD* observational study using real-world the medical practice for administrative Dimitri Bennett, MD*† data to study patients with gastro- purposes, secondary databases that are *Department of Epidemiology, Takeda paresis in a national population in the frequently updated over a wide population Pharmaceutical Company Limited United States. We read with interest and readily accessible at a low cost have Cambridge, MA this paper and would like to congratulate provided new data sources for epidemiol- †Center for Clinical Epidemiology and the authors on publishing this very first ogists and other researchers. It is also well- Biostatistics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA epidemiologic study using a large-scale recognized that secondary databases are secondary database to estimate the preva- not collected for research purposes, often lence of gastroparesis in the United States. constrained by sociologic and economic REFERENCES The study used Explorys, an electronic limitations, and are censored. Therefore, 1. Syed AR, Wolfe MM, Calles-Escandon medical records database with ICD-9 all secondary database researches should J. Epidemiology and diagnosis of gastro- codes indexed diagnoses, to estimate the implement a rigorous methodology, pro- paresis in the United States: a popula- proportion of study population with gas- vide adequate documentation of methods tion-based study. J Clin Gastroenterol. and results, and adequately address the troparesis. The unique strength of the 2019. [Epub ahead of print]. limitations to ensure quality and integrity. 2. Jung HK, Choung RS, Locke GR III, study was that the database has a wide et al. The incidence, prevalence, and In this study, to the authors’ credit, they coverage of over 43 million patients from outcomes of patients with gastroparesis noted the retrospective nature of the study over 340 hospitals in 22 different health in Olmsted County, Minnesota, from and addressed potential misclassification care systems in the United States and 1996 to 2006. Gastroenterology. 2009;136: allowed an estimation of gastroparesis due to documentation errors. 1225–1233. prevalence at the national level. The results On the basis of the findings of this 3. Choung RS, Locke GR III, Schleck CD, showed that out of a total of 43,827,910 study,wehaveafewsuggestions for et al. Risk of gastroparesis in subjects medical records, 69,950 (0.16%) have a future research. First, the study of preva- with type 1 and 2 diabetes in the general diagnosis of gastroparesis recorded. The lence usually seeks to understand “the population. Am J Gastroenterol. 2012;107: 82–88. authors also observed concurrent gastro- proportion of the population of the dis- 4. Rassen JA, Bartels DB, Schneeweiss S, paresis in 4.59% medical records with type ease at the specified time.” This study et al. Measuring prevalence and incidence I diabetes mellitus, 1.31% medical records reported the proportion of medical of chronic conditions in claims and with type II diabetes mellitus, and 0.05% records which is associated with preva- electronic health record databases. Clin medical records with no history of any lence. The additional patient-level analysis Epidemiol. 2019;11:1–15. potential etiologies of gastroparesis. would provide a clearer view of the bur- 5. Rothman KJ, Greenland S, Lash TL. As the authors correctly pointed den of gastroparesis in the population. Modern Epidemiology. Philadelphia, PA: out, previous literature on the prevalence Second, in left and right-censored longi- Wolters Kluwer Health/Lippincott Williams of gastroparesis was limited to a single tudinal databases, the length of lookback & Wilkins; 2008. Y.Y. and D.B. are employees of Takeda Pharmaceutical Company Limited. Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution- Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/MCG.0000000000001279 106 www.jcge.com J Clin Gastroenterol Volume 54, Number 1, January 2020 This paper can be cited using the date of access and the unique DOI number which can be found in the footnotes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Gastroenterology Pubmed Central

The First National Prevalence Estimation of Gastroparesis in the United States Using a Large-scale Retrospective Database

Ye, Yizhou; Bennett, Dimitri
Journal of Clinical Gastroenterology , Volume 54 (1) – Nov 7, 2019
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References (5)

Publisher
Pubmed Central
Copyright
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.
ISSN
0192-0790
eISSN
1539-2031
DOI
10.1097/MCG.0000000000001279
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Abstract

LETTER TO THE EDITOR The First National community and cannot be extrapolated to period will affect the ability to detect a the wider US general population due disease and influence temporal trends. Prevalence Estimation to the lack of diversity in economic, The impact of different lookback win- geographic, and demographic characteri- dows should be thoroughly assessed to of Gastroparesis in the 2,3 stics. This new observational study ensure the robustness of the findings. Last, mitigated the gap in disease occurrence Syed and colleagues correctly pointed out United States Using a knowledge using real-world evidence from that differences in study populations pre- a large representative sample of the United vent meaningful direct comparisons with Large-scale States general population. The traditional previous prevalence estimation of gastro- Retrospective method of prevalence and incidence paresis. This study has unique strengths, assessment involves complex sampling including a large covered population and Database strategies in national surveys such as the diversity in patient demographics; how- National Health and Nutrition Examina- ever, more studies with rigorous method- tion Survey (NHANES) and has proven ology in additional populations are to be expensive, time-consuming, and necessary to further understand the To the Editor: unable to capture changing dynamics of epidemiology of gastroparesis. 1 4 Syed et al recently published an a population. Meanwhile, as part of Yizhou Ye, PhD* observational study using real-world the medical practice for administrative Dimitri Bennett, MD*† data to study patients with gastro- purposes, secondary databases that are *Department of Epidemiology, Takeda paresis in a national population in the frequently updated over a wide population Pharmaceutical Company Limited United States. We read with interest and readily accessible at a low cost have Cambridge, MA this paper and would like to congratulate provided new data sources for epidemiol- †Center for Clinical Epidemiology and the authors on publishing this very first ogists and other researchers. It is also well- Biostatistics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA epidemiologic study using a large-scale recognized that secondary databases are secondary database to estimate the preva- not collected for research purposes, often lence of gastroparesis in the United States. constrained by sociologic and economic REFERENCES The study used Explorys, an electronic limitations, and are censored. Therefore, 1. Syed AR, Wolfe MM, Calles-Escandon medical records database with ICD-9 all secondary database researches should J. Epidemiology and diagnosis of gastro- codes indexed diagnoses, to estimate the implement a rigorous methodology, pro- paresis in the United States: a popula- proportion of study population with gas- vide adequate documentation of methods tion-based study. J Clin Gastroenterol. and results, and adequately address the troparesis. The unique strength of the 2019. [Epub ahead of print]. limitations to ensure quality and integrity. 2. Jung HK, Choung RS, Locke GR III, study was that the database has a wide et al. The incidence, prevalence, and In this study, to the authors’ credit, they coverage of over 43 million patients from outcomes of patients with gastroparesis noted the retrospective nature of the study over 340 hospitals in 22 different health in Olmsted County, Minnesota, from and addressed potential misclassification care systems in the United States and 1996 to 2006. Gastroenterology. 2009;136: allowed an estimation of gastroparesis due to documentation errors. 1225–1233. prevalence at the national level. The results On the basis of the findings of this 3. Choung RS, Locke GR III, Schleck CD, showed that out of a total of 43,827,910 study,wehaveafewsuggestions for et al. Risk of gastroparesis in subjects medical records, 69,950 (0.16%) have a future research. First, the study of preva- with type 1 and 2 diabetes in the general diagnosis of gastroparesis recorded. The lence usually seeks to understand “the population. Am J Gastroenterol. 2012;107: 82–88. authors also observed concurrent gastro- proportion of the population of the dis- 4. Rassen JA, Bartels DB, Schneeweiss S, paresis in 4.59% medical records with type ease at the specified time.” This study et al. Measuring prevalence and incidence I diabetes mellitus, 1.31% medical records reported the proportion of medical of chronic conditions in claims and with type II diabetes mellitus, and 0.05% records which is associated with preva- electronic health record databases. Clin medical records with no history of any lence. The additional patient-level analysis Epidemiol. 2019;11:1–15. potential etiologies of gastroparesis. would provide a clearer view of the bur- 5. Rothman KJ, Greenland S, Lash TL. As the authors correctly pointed den of gastroparesis in the population. Modern Epidemiology. Philadelphia, PA: out, previous literature on the prevalence Second, in left and right-censored longi- Wolters Kluwer Health/Lippincott Williams of gastroparesis was limited to a single tudinal databases, the length of lookback & Wilkins; 2008. Y.Y. and D.B. are employees of Takeda Pharmaceutical Company Limited. Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution- Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/MCG.0000000000001279 106 www.jcge.com J Clin Gastroenterol Volume 54, Number 1, January 2020 This paper can be cited using the date of access and the unique DOI number which can be found in the footnotes.

Journal

Journal of Clinical Gastroenterology – Pubmed Central

Published: Nov 7, 2019

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