Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: a cohort study of free-text electronic medical records

Welsh, C. E. , Duz, M., Parkin, T. D.H. and Marshall, J. F. (2017) Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: a cohort study of free-text electronic medical records. Preventive Veterinary Medicine, 136, pp. 11-18. (doi: 10.1016/j.prevetmed.2016.11.012)

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Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not initial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Parkin, Professor Tim and Marshall, Dr John and Welsh, Dr Claire
Authors: Welsh, C. E., Duz, M., Parkin, T. D.H., and Marshall, J. F.
College/School:College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Journal Name:Preventive Veterinary Medicine
Published Online:22 November 2016
Copyright Holders:Copyright © 2016 Elsevier B.V.
First Published:First published in Preventive Veterinary Medicine 136: 11-18
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
662061Multicentre Electronic Medical Record Analysis - A Powerful Tool for Investigating Equine DiseaseJohn MarshallAnimal Welfare Foundation (BVA-AWF)NHF_2014_1_JMVET - PATHOLOGY, PUBLIC H & DISEASE INV