Incidence, prevalence, mortality and health-service use among people with systemic sclerosis (scleroderma) in the UK Clinical Practice Research Datalink

Date of Approval
Application Number
16_190
Technical Summary

Objectives:
i) To estimate the incidence, prevalence, mortality
ii) Describe health service usage before and after diagnosis and
iii) Describe leading causes of death in systemic sclerosis in the UK using the CPRD and linked HES and ONS mortality data.

Methods and data analysis:
i) We will identify all cases of systemic sclerosis in the CPRD 1995-2014, and estimate incidence and prevalence using the whole CPRD as the denominator population. We will investigate the effects of the a priori confounders age, sex and socio-economic status on incidence using multi-variable Poisson regression, and on prevalence using logistic regression.
ii) In the HES-linked CPRD 1997-2014 we will describe general practice, inpatient and outpatient healthcare usage before and after diagnosis for all incident cases of systemic sclerosis and matched controls.
iii) Finally, in the HES-linked CPRD 1997-2014, we will estimate overall mortality rates using Kaplan-Meier methods, and investigate the effects of age, sex, socio-economic status and year of diagnosis on mortality using multi-variable Cox regression. We will estimate cause-specific mortality rates for people with systemic sclerosis and matched controls and using the cumulative incidence function.

Health Outcomes to be Measured

Incidence Study Diagnosis with systemic sclerosis Healthcare usage Study Number of GP appointments Hospital appointments Number and length of hospital and intensive care admissions Mortality Study Date of death Causes of death

Collaborators

Matthew Grainge - Chief Investigator - University of Nottingham
Fiona Pearce - Corresponding Applicant - University of Nottingham
Abhishek Abhishek - Collaborator - University of Nottingham
Jeremy Royle - Collaborator - Nottingham University Hospitals
Peter Lanyon - Collaborator - Nottingham University Hospitals

Linkages

HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation