3 Citations (Scopus)

Abstract

Background and objective: Patients who visit emergency department (ED) may have symptoms of occult cancers. Methods: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses. Results: There were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95% confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer. Conclusions: The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalComputer Methods and Programs in Biomedicine
Volume115
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Taiwan
Gastrointestinal Tract
Hospital Emergency Service
Early Diagnosis
Blood
Health insurance
Population
Neoplasms
Endoscopy
Hemoglobin
Bilirubin
Screening
Blood Transfusion
Ultrasonics
Health
Guaiac
X rays
Occult Blood
Control Groups
Informatics

Keywords

  • Cancer
  • Diagnosis
  • Emergency department
  • Predictor

ASJC Scopus subject areas

  • Computer Science Applications
  • Software
  • Health Informatics
  • Medicine(all)

Cite this

@article{18b25797507e463b926f495b39f61f4c,
title = "Emergency department utilization can indicate early diagnosis of digestive tract cancers: A population-based study in Taiwan",
abstract = "Background and objective: Patients who visit emergency department (ED) may have symptoms of occult cancers. Methods: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses. Results: There were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95{\%} confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer. Conclusions: The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.",
keywords = "Cancer, Diagnosis, Emergency department, Predictor",
author = "Carlos Lam and Kuan, {Ching Feng} and James Miser and Hsieh, {Kun Yi} and Fang, {Yu Ann} and Yu-Chuan Li and Chin-Wung Hsu and Ray-Jade Chen and Chang-I Chen",
year = "2014",
doi = "10.1016/j.cmpb.2014.04.002",
language = "English",
volume = "115",
pages = "103--109",
journal = "Computer Methods and Programs in Biomedicine",
issn = "0169-2607",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

TY - JOUR

T1 - Emergency department utilization can indicate early diagnosis of digestive tract cancers

T2 - A population-based study in Taiwan

AU - Lam, Carlos

AU - Kuan, Ching Feng

AU - Miser, James

AU - Hsieh, Kun Yi

AU - Fang, Yu Ann

AU - Li, Yu-Chuan

AU - Hsu, Chin-Wung

AU - Chen, Ray-Jade

AU - Chen, Chang-I

PY - 2014

Y1 - 2014

N2 - Background and objective: Patients who visit emergency department (ED) may have symptoms of occult cancers. Methods: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses. Results: There were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95% confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer. Conclusions: The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.

AB - Background and objective: Patients who visit emergency department (ED) may have symptoms of occult cancers. Methods: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses. Results: There were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95% confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer. Conclusions: The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.

KW - Cancer

KW - Diagnosis

KW - Emergency department

KW - Predictor

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U2 - 10.1016/j.cmpb.2014.04.002

DO - 10.1016/j.cmpb.2014.04.002

M3 - Article

VL - 115

SP - 103

EP - 109

JO - Computer Methods and Programs in Biomedicine

JF - Computer Methods and Programs in Biomedicine

SN - 0169-2607

IS - 3

ER -