Gout and Gout-Related Comorbidities: Insight and Limitations from Population-Based Registers in Sweden
Abstract
:1. Introduction
2. Strengths
Strengths | Challenges and Limitations |
---|---|
Large study population | Misclassification |
Virtually complete follow-up | Missing data |
Data are prospectively collected | Underestimation of some medical conditions, i.e., alcohol abuse and obesity |
Data collection is independent of research questions | Difficult to study minorities and cultural differences |
Time- and cost-effective | Lack of specific phenotypic data, i.e., tophi |
Possibility to study multiple outcomes at the same time | Difficult to study patient’s adherence and over-the-counter drugs |
Possibility to study rare outcomes | |
Opportunity for pharmacological studies using real-world data | |
Possibility to study rare drug side effects | |
Opportunity for collaborative research |
Study | Outcome of Interest | Results |
---|---|---|
Incidence and prevalence of gout in Western Sweden [10] | Prevalence, trends in the incidence of gout, and ULT use in Western Sweden in the period 2002–2012. |
|
Prevalence and incidence of gout in southern Sweden from the socioeconomic perspective [27] | The prevalence and cumulative incidence of gout in southern Sweden with respect to socioeconomic status. |
|
Gout in immigrant groups: a cohort study in Sweden [28] | The association between country of birth and incidence of gout in different immigrant groups in Sweden. |
|
Trends in Gout Hospitalization in Sweden [29] | Hospitalization trend for gout in Western Sweden in the period 2002–2012. |
|
Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study [30] | The overall incidence of NL in gout cases and general population controls and risk factors for first-time NL in cases and controls separately. |
|
Comorbidity in gout at the time of first diagnosis: sex differences that may have implications for dosing of urate lowering therapy [15] | Comorbidities at the time of first diagnosis of gout compared with matched population controls, overall, and by sex. |
|
Factors associated with initiation and persistence of urate-lowering therapy [31] | The proportion of gout patients in the period 2011–2013 that received and persisted with ULT after gout diagnosis, as well as predictors for start and persistence with ULT. |
|
Work disability in gout: a population-based case-control study [32] | The extent and cost of work disability among patients with gout compared with matched population controls. |
|
Occupational exposure to inorganic dust and risk of gout: a population-based study [33] | The association between occupational exposure and inorganic dust and risk of gout. |
|
Association between perinatal factors and future risk for gout- a nested case-control study [34] | Maternal and perinatal factors that are associated with the future risk of being diagnosed with gout. |
|
Incident Gout: Risk of Death and Cause-Specific Mortality in Western Sweden: A Prospective, Controlled Inception Cohort Study [35] | Overall and cause-specific mortality in gout. |
|
Incident Gout and Risk of First-Time Acute Coronary Syndrome: a Prospective, Population-Based Cohort Study in Sweden [16] | The risk of first-time ACS in a large cohort of primary and secondary care patients with incident gout compared to the general population. |
|
Gout in Dalarna, Sweden- a population-based study of gout occurrence and compliance to treatment guidelines [36] | The incidence and prevalence of gout in Dalarna, as well as the use of allopurinol and compliance to treat-to-target recommendations before and after the publication of Swedish national guidelines in 2016. |
|
Swedish Databases | Start | Population Coverage | Limitations |
---|---|---|---|
National Patient Register | 1964 for inpatient care and 2001 for outpatient care | ≈100% coverage for inpatient care and ≈80% for outpatient care. | Primary care data not included. |
Prescribed Drug Register | 2005 | All dispensed prescriptions at Swedish pharmacies. | Over-the-counter drugs, drugs used in hospitals, or drugs that are prescribed but not collected by the patient are not included. |
Regional healthcare registers | Only partial inclusion of laboratory results. Data on smoking or BMI are lacking. | ||
| 2000 | Medical and administrative data for inpatient, outpatient, public and private primary care in the Västra Götaland region. | |
| 1998 | Medical and administrative data for inpatient, outpatient, public, and private primary care in the region of Skåne. | |
| 2000 for primary care and 2013 for inpatient and outpatient care | Medical and administrative data for inpatient, outpatient, public, and private primary care in the region of Dalarna. | |
National Registry for ACS-SwedHeart | 1995 | Information about risk factors, baseline characteristics, symptoms, in-hospital examinations, treatments, interventions, complications, discharge status, and secondary prevention up to 1-year follow-up for patients admitted with ACS. Coverage >90%. | |
LISA | 1990 | Data on health insurance, parental insurance, and unemployment at the individual level for all individuals aged >16 years who are registered in Sweden on 31 December each year. Data on education level for >98% of all individuals aged 25–64 years. | |
Cause-of-death Register | 1961 | Includes all deaths that occurred in Sweden, even deaths of persons not registered in Sweden. | |
The Swedish Military Conscription Register | 1969 | Data on physical and psychological health of approximately 2 million individuals between 1969 and 2018, with coverage of about 90% for men born between 1951 and 1988 (conscription 1969–2006). | Exclusion of individuals with certain pre-existing medical conditions, which means that the prevalence of certain diseases is underestimated in cohorts based on this register. |
Medical Birth Register | 1973 | All pregnancies leading to childbirth in Sweden since 1973. | Missing data, i.e., smoking during pregnancy. |
Cancer Register | 1958 | Data on cancer cases in Sweden. |
3. Limitations
4. Will Register-Based Research Change in the Future?
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Drivelegka, P.; Jacobsson, L.T.; Dehlin, M. Gout and Gout-Related Comorbidities: Insight and Limitations from Population-Based Registers in Sweden. Gout Urate Cryst. Depos. Dis. 2024, 2, 144-156. https://doi.org/10.3390/gucdd2020013
Drivelegka P, Jacobsson LT, Dehlin M. Gout and Gout-Related Comorbidities: Insight and Limitations from Population-Based Registers in Sweden. Gout, Urate, and Crystal Deposition Disease. 2024; 2(2):144-156. https://doi.org/10.3390/gucdd2020013
Chicago/Turabian StyleDrivelegka, Panagiota, Lennart TH Jacobsson, and Mats Dehlin. 2024. "Gout and Gout-Related Comorbidities: Insight and Limitations from Population-Based Registers in Sweden" Gout, Urate, and Crystal Deposition Disease 2, no. 2: 144-156. https://doi.org/10.3390/gucdd2020013