The epidemiology of psoriatic arthritis in the UK: a health intelligence analysis of UK Primary Care Electronic Health Records 1991–2020
The epidemiology of psoriatic arthritis in the UK: a health intelligence analysis of UK Primary Care Electronic Health Records 1991–2020
Objectives: epidemiological estimates of psoriatic arthritis (PsA) underpin the provision of healthcare, research, and the work of government, charities and patient organizations. Methodological problems impacting prior estimates include small sample sizes, incomplete case ascertainment, and representativeness. We developed a statistical modelling strategy to provide contemporary prevalence and incidence estimates of PsA from 1991 to 2020 in the UK.
Methods: data from Clinical Practice Research Datalink (CPRD) were used to identify cases of PsA between 1st January 1991 and 31st December 2020. To optimize ascertainment, we identified cases of Definite PsA (≥1 Read code for PsA) and Probable PsA (satisfied a bespoke algorithm). Standardized annual rates were calculated using Bayesian multilevel regression with post-stratification to account for systematic differences between CPRD data and the UK population, based on age, sex, socioeconomic status and region of residence.
Results: a vtotal of 26293 recorded PsA cases (all definitions) were identified within the study window (77.9% Definite PsA). Between 1991 and 2020 the standardized prevalence of PsA increased twelve-fold from 0.03 to 0.37. The standardized incidence of PsA per 100,000 person years increased from 8.97 in 1991 to 15.08 in 2020, an almost 2-fold increase. Over time, rates were similar between the sexes, and across socioeconomic status. Rates were strongly associated with age, and consistently highest in Northern Ireland.
Conclusion: the prevalence and incidence of PsA recorded in primary care has increased over the last three decades. The modelling strategy presented can be used to provide contemporary prevalence estimates for musculoskeletal disease using routinely collected primary care data.
Druce, Katie L.
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Yimer, Belay Birlie
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Humphreys, Jennifer
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Njuki, Lucy N.
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Bourke, Darryl
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Li, Michael
fee10aba-7a5e-468b-a1fc-f04638c97afd
Ellis, Benjamin
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Zhang, Yuanyuan
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Bravo, Ramiro
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Hyrich, Kimme L.
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Verstappen, Suzanne M.M.
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Dixon, William G.
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McBeth, John
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2 November 2023
Druce, Katie L.
02f51c2c-e166-4a3a-a059-34f4629652f1
Yimer, Belay Birlie
35af844b-99da-44ae-959a-edfe713eb3c3
Humphreys, Jennifer
48f32fc2-709c-4955-9b12-e9ba2b66a479
Njuki, Lucy N.
4615f4fb-b163-4e57-a47b-9c903171c50b
Bourke, Darryl
12acc9f6-d44b-4a05-94f4-b1492cea7cbc
Li, Michael
fee10aba-7a5e-468b-a1fc-f04638c97afd
Ellis, Benjamin
4c3c7499-02d7-48f3-96f7-ec86f6940eb0
Zhang, Yuanyuan
5ccfad72-adee-49aa-a708-f9fdcdbab54e
Bravo, Ramiro
618d47fa-ff1f-42e4-80d4-12bf865e0b9b
Hyrich, Kimme L.
bf2bc52a-6d8a-4ca3-9266-8e471155fad9
Verstappen, Suzanne M.M.
34d9aaa3-c50d-4a7f-8d81-b3d61e66f393
Dixon, William G.
8fcb2256-4094-4f58-9777-4248ad245166
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61
Druce, Katie L., Yimer, Belay Birlie, Humphreys, Jennifer, Njuki, Lucy N., Bourke, Darryl, Li, Michael, Ellis, Benjamin, Zhang, Yuanyuan, Bravo, Ramiro, Hyrich, Kimme L., Verstappen, Suzanne M.M., Dixon, William G. and McBeth, John
(2023)
The epidemiology of psoriatic arthritis in the UK: a health intelligence analysis of UK Primary Care Electronic Health Records 1991–2020.
Rheumatology.
(doi:10.1093/rheumatology/kead586).
Abstract
Objectives: epidemiological estimates of psoriatic arthritis (PsA) underpin the provision of healthcare, research, and the work of government, charities and patient organizations. Methodological problems impacting prior estimates include small sample sizes, incomplete case ascertainment, and representativeness. We developed a statistical modelling strategy to provide contemporary prevalence and incidence estimates of PsA from 1991 to 2020 in the UK.
Methods: data from Clinical Practice Research Datalink (CPRD) were used to identify cases of PsA between 1st January 1991 and 31st December 2020. To optimize ascertainment, we identified cases of Definite PsA (≥1 Read code for PsA) and Probable PsA (satisfied a bespoke algorithm). Standardized annual rates were calculated using Bayesian multilevel regression with post-stratification to account for systematic differences between CPRD data and the UK population, based on age, sex, socioeconomic status and region of residence.
Results: a vtotal of 26293 recorded PsA cases (all definitions) were identified within the study window (77.9% Definite PsA). Between 1991 and 2020 the standardized prevalence of PsA increased twelve-fold from 0.03 to 0.37. The standardized incidence of PsA per 100,000 person years increased from 8.97 in 1991 to 15.08 in 2020, an almost 2-fold increase. Over time, rates were similar between the sexes, and across socioeconomic status. Rates were strongly associated with age, and consistently highest in Northern Ireland.
Conclusion: the prevalence and incidence of PsA recorded in primary care has increased over the last three decades. The modelling strategy presented can be used to provide contemporary prevalence estimates for musculoskeletal disease using routinely collected primary care data.
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kead586
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Accepted/In Press date: 14 October 2023
Published date: 2 November 2023
Identifiers
Local EPrints ID: 492280
URI: http://eprints.soton.ac.uk/id/eprint/492280
ISSN: 1462-0324
PURE UUID: 28d76270-6118-4f3a-aaf1-307a3f8a7e9f
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Date deposited: 23 Jul 2024 16:57
Last modified: 24 Jul 2024 02:11
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Contributors
Author:
Katie L. Druce
Author:
Belay Birlie Yimer
Author:
Jennifer Humphreys
Author:
Lucy N. Njuki
Author:
Darryl Bourke
Author:
Michael Li
Author:
Benjamin Ellis
Author:
Yuanyuan Zhang
Author:
Ramiro Bravo
Author:
Kimme L. Hyrich
Author:
Suzanne M.M. Verstappen
Author:
William G. Dixon
Author:
John McBeth
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