1.Signal Detection of Adverse Drug Reactions through LASSO Logistic Regression Using an Electronic Health Records Database:A Case-Control Study
Hiroshi HAYASHI ; Tatsuo HIRAMATSU ; Daisuke KOIDE ; Katsuya TANAKA ; Kazuhiko OHE
Japanese Journal of Pharmacoepidemiology 2017;21(2):51-62
Objective:The objective of this study was to apply Least Absolute Shrinkage and Selection Operator (LASSO)logistic regression to detection of adverse drug reaction (ADR) signals using an electronic health records database as a comprehensive and quantitative method to supplement the current pharmacovigilance activities in Japan.
Design:case-control study
Methods:We analyzed data from 40767 inpatients using a single-institution hospital database and identified two ADRs, suspected pancreatitis and thrombocytopenia, using abnormal laboratory test results. LASSO logistic regression analysis was applied to detect ADR signals with adjustment for age, sex, comorbidities and medical procedures. The positive predictive value (PPV) was calculated using reference standard of known drug-ADR associations based on drug product labels.
Results:The number of case group was 6735 for suspected pancreatitis and 11561 for thrombocytopenia. The number of ADR signals detected using LASSO logistic regression was 27 for suspected pancreatitis and 40 for thrombocytopenia. The calculated PPV was 3.7% for suspected pancreatitis and 55.0% for thrombocytopenia.
Conclusion:LASSO logistic regression analysis efficiently detects ADR signals by adjusting for confounding factors such as comorbidities and medical procedures. The false positive signals may contain unknown signals and further signal assessment will be needed.
2.Report of health survey conducted during 1982 by the mutual welfare association of the Fukushima Pref. Agricultural Co-operative.
Mieko Tanaka ; Mitsuko Shiraishi ; Yoichi Yoshida ; Masaki Namatame ; Iwao Komuro ; Sadao Haga ; Jiro Tachibana ; Ryoichi Endo ; Shigeharu Kikuta ; Katsuya Akanuma
Journal of the Japanese Association of Rural Medicine 1984;33(2):218-223
Our examination was performed on 1, 541 men and 3, 803 women. Reviewed were blood pressure, obesity, anemia, fatty tissue (lipide), liver function, urine-suger and protein, urobilinogen, and their abnormalities.
(1) High blood pressure was found in 53.7 % of the men and 68.3 % of the women, with higher rates found in the middle to older age groups of both men and women.
(2) Obesity, by the Minowa method, was found to be over 20 %, with the higher rate being in women. The tendency to obesity in men was found to decrease with age. In females, abnormalities of blood pressure, total cholesterol, triglyceride, thickness of subcutaneous fatty tissue (of the upper arm and shoulder blade areas) were discovered to be greater in proportion to obesity.
(3) Abnormalities in GPT were seen as 15.3 % in men and 7.3 % in women. According to age group in men: Those in their 30's, 21 %, in the 40's, 27.2 %, 50's, 12.7%, 60's, 9.1 %.
A study on the effects of alcholic beverage consumption will be included in the 1983 survey.
3.Radiotherapy for locally recurrent rectal cancer treated with surgery alone as the initial treatment.
Hidekazu TANAKA ; Takahiro YAMAGUCHI ; Kae HACHIYA ; Sunaho OKADA ; Masashi KITAHARA ; Katsuya MATSUYAMA ; Masayuki MATSUO
Radiation Oncology Journal 2017;35(1):71-77
PURPOSE: Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. MATERIALS AND METHODS: Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0–3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. RESULTS: Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (≥75 Gy10) than for the lower BED group (<75 Gy10). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. CONCLUSION: For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than 75 Gy10, if the dose to the organ at risk is within acceptable levels.
Appointments and Schedules
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Humans
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Radiotherapy*
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Radiotherapy, Conformal
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Rectal Neoplasms*
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Recurrence
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Retrospective Studies
4.Efficacy of Adenine in the Treatment of Leukopenia and Neutropenia Associated with an Overdose of Antipsychotics or Discontinuation of Lithium Carbonate Administration: Three Case Studies.
Takashi TOMITA ; Hidekazu GOTO ; Kenji SUMIYA ; Tadashi YOSHIDA ; Katsuya TANAKA ; Yukinao KOHDA
Clinical Psychopharmacology and Neuroscience 2016;14(4):391-395
Because adenine is effective for managing cases of radiation-induced and drug-induced leukopenia, it may be effective in cases of antipsychotic-induced leukopenia and neutropenia. Here, we report our experience with patients with leukopenia and neutropenia caused by an antipsychotic overdose or discontinuation of lithium carbonate, in whom adenine administration ameliorated the white blood cell and neutrophil counts. The progress of patients suggests that adenine is effective in cases of leukopenia and neutropenia associated with lithium carbonate discontinuation and an antipsychotic overdose.
Adenine*
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Antipsychotic Agents*
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Humans
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Leukocytes
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Leukopenia*
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Lithium Carbonate*
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Lithium*
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Neutropenia*
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Neutrophils
5.Chronic Kidney Disease As a Risk Factor of Stroke
Kenji KIKUCHI ; Kazuo SUZUKI ; Hisashi KOJIMA ; Katsuya FUTAWATARI ; Kenji MURAISHI ; Yoshitaka SUDA ; Junkoh SASAKI ; Susumu FUSHIMI ; Yasunari OTAWARA ; Toshirou OOTSUKA ; Hidehiko ENDO ; Makie TANAKA ; Naoko SUZUKI ; Kimiyo TAKAHASHI ; Yuko KIKUCHI ; Kozue IKEDA ; Mutsumi NITTA ; Mikiko FUJIWARA ; Miyuki NANBU ; Akiko TAKAHASHI ; Shousaku OGASAWARA
Journal of the Japanese Association of Rural Medicine 2014;63(4):596-605
Chronic kidney disease (CKD) has recently been reported to be an independent risk factor for stroke. However, a detailed analysis was yet to be conducted according to stroke subtype. We attempted to determine the risk factors for stroke using data from the “specific health checkup” for metabolic syndrome conducted by the 9 hospitals affiliated with the Akita Prefectural Federation of Agricultural Cooperatives, and evaluate and determine the risk factors for stroke. There were 401 patients who had undergone metabolic syndrome checkups from 2007 and 2010 and suffered from stroke afterwards within 3 years after the screening. The controls were all 69,407 subjects who were screened during the same period. The predictors examined were sex, age, blood pressure, BMI, cholesterol values (HDL・LDL), history of diabetes mellitus, presence of atrial fibrillation, CKD, and drinking and smoking habits. Analysis was conducted using logistic regression. The risk factors for stroke as a whole were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking history. For cerebral infarction, the risk factors were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking habit. The risk factors for cerebral hemorrhage were age, blood pressure, and CKD. For subarachnoid hemorrhage, the risk factors were female sex, age, blood pressure, low HDLemia, and CKD. In conclusion, CKD is an independent risk factor for the 3 subtypes of stroke, and in particular plays an important role as a higher risk factor for cerebral hemorrhage. Smoking cessation and controls of blood pressure, diabetes and atrial fibrillation are the important measures for stroke prevention. In addition, the further intervention should also be targeted to those with the result of CKD revealed by specific health checkups.
6.Signal Detection of Adverse Drug Reactions through LASSO Logistic Regression Using an Electronic Health Records Database:A Case-Control Study
Hiroshi HAYASHI ; Tatsuo HIRAMATSU ; Daisuke KOIDE ; Katsuya TANAKA ; Kazuhiko OHE
Japanese Journal of Pharmacoepidemiology 2017;21(2):51-62
Objective:The objective of this study was to apply Least Absolute Shrinkage and Selection Operator (LASSO)logistic regression to detection of adverse drug reaction (ADR) signals using an electronic health records database as a comprehensive and quantitative method to supplement the current pharmacovigilance activities in Japan.Design:case-control studyMethods:We analyzed data from 40767 inpatients using a single-institution hospital database and identified two ADRs, suspected pancreatitis and thrombocytopenia, using abnormal laboratory test results. LASSO logistic regression analysis was applied to detect ADR signals with adjustment for age, sex, comorbidities and medical procedures. The positive predictive value (PPV) was calculated using reference standard of known drug-ADR associations based on drug product labels.Results:The number of case group was 6735 for suspected pancreatitis and 11561 for thrombocytopenia. The number of ADR signals detected using LASSO logistic regression was 27 for suspected pancreatitis and 40 for thrombocytopenia. The calculated PPV was 3.7% for suspected pancreatitis and 55.0% for thrombocytopenia.Conclusion:LASSO logistic regression analysis efficiently detects ADR signals by adjusting for confounding factors such as comorbidities and medical procedures. The false positive signals may contain unknown signals and further signal assessment will be needed.