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RISS 인기검색어
- 검색키워드
- 저자 : Tiina Laatikainen (검색결과 2 건)
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Elina Rautiainen,Olli-Pekka Ryynänen,Tiina Laatikainen,Pekka Kekolahti 대한의료정보학회 2020 Healthcare Informatics Research Vol.26 No.2
Objectives: To examine the direct effects of risk factors associated with the 5-year costs of care in persons with alcohol use disorder (AUD) and to examine whether remission decreases the costs of care. Methods: Based on Electronic Health Record data collected in the North Karelia region in Finland from 2012 to 2016, we built a non-causal augmented naïve Bayesian (ANB) network model to examine the directional relationship between 16 risk factors and the costs of care for a random cohort of 363 AUD patients. Jouffe’s proprietary likelihood matching algorithm and van der Weele’s disjunctive confounder criteria (DCC) were used to calculate the direct effects of the variables, and sensitivity analysis with tornado diagrams and analysis maximizing/minimizing the total cost of care were conducted. Results: The highest direct effect on the total cost of care was observed for a number of chronic conditions, indicating on average more than a €26,000 increase in the 5-year mean cost for individuals with multiple ICD-10 diagnoses compared to individuals with less than two chronic conditions. Remission had a decreasing effect on the total cost accumulation during the 5-year follow-up period; the percentage of the lowest cost quartile (42.9% vs. 23.9%) increased among remitters, and that of the highest cost quartile (10.71% vs. 26.27%) decreased compared with current drinkers. Conclusions: The ANB model with application of DCC identified that remission has a favorable causal effect on the total cost accumulation. A high number of chronic conditions was the main contributor to excess cost of care, indicating that comorbidity is an essential mediator of cost accumulation in AUD patients.
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Guicheng Zhang,Siew-Kim Khoo,Mika J Mäkelä,Pierre Candelaria,Catherine M Hayden,Leena von Hertzen,Tiina Laatikainen,Erkki Vartiainen,Jack Goldblatt,Tari Haahtela,Peter N LeSouëf1 대한천식알레르기학회 2014 Allergy, Asthma & Immunology Research Vol.6 No.4
Purpose: We investigated maternal genetic effects of four IL-4/IL-13 pathway genes as well as their interactions with the “Western or Easternlifestyles/environments” on IgE in Karelian children. Methods: This study included 609 children and their mothers. Total IgE levels in children andmothers were measured and 10 single nucleotide polymorphisms (SNPs) in IL-4, IL-4Ra, IL-13, and STAT6 were genotyped in mothers and their children. Results: The maternal G allele of IL-13 130 (rs20541) was significantly (P=0.001) associated with decreased IgE in children in the Karelianpopulation (Pooling Finnish and Russian children), as well as in Finnish (P=0.030) and Russian children (P=0.018). The IgE levels were significantly(P=0.001) higher in Russian children whose mothers were homozygous for the G allele of the IL-4Ra 50 (rs1805010) SNP than that in Russian childrenof mothers who were AG heterozygotes or AA homozygotes. After accounting for children’s genotypes, we observed interactive effects on children’sIgE for maternal IL-13 130 genotypes (P=0.014) and maternal IL-4Ra 50 genotypes (P=0.0003) with “Western or Eastern” lifestyles/environments. With the adjustment for multiple comparisons using a false discovery rate (FDR) of 0.05, the interactive effect of the maternal IL-4Ra 50 SNP wassignificant. Conclusion: Maternal genetic variants in IL-4/IL-13 pathway genes, such as IL-13 130 and IL-4Ra50, influenced IgE levels in schoolchildren that were independent of the children’s genetic effects. These effects differ in “Western or Eastern” environments.
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