Dataset Information

A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States.

ABSTRACT: INTRODUCTION:Schizophrenia is a condition that places a significant burden on individuals with the condition, their family, and society. A large proportion of those treated for schizophrenia do not experience treatment response and are referred to as having "treatment-resistant schizophrenia" (TRS). Expert opinion has long held that the prevalence of TRS among individuals with schizophrenia is 30%, but the basis of this estimate is unclear. This article presents a model developed for estimating the prevalence of TRS in the United States 2014. METHODS:An incidence-prevalence-mortality model was developed to estimate the prevalence of TRS in the United States. The model was populated with data from public health agencies and published literature. Prevalence in 2014 was modelled using a Markov cohort simulation for each birth cohort between 1930 to 2014. RESULTS:Using different scenarios for baseline incidence, relative risks of mortality, it was estimated that approximately 22% of individuals with schizophrenia would be considered treatment-resistant in 2014. DISCUSSION:The results suggests that prevalence of TRS may be somewhat lower than the 30% often reported, however this is highly dependent on the definition of treatment resistance. Methods such as this may help answer epidemiological and health policy questions as well as test the influence of key underlying assumptions.

SUBMITTER: Morup MF

PROVIDER: S-EPMC7272089 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States.

Mørup Michael Frank MF Kymes Steven M SM Oudin Åström Daniel D

PloS one 20200604 6

<h4>Introduction</h4>Schizophrenia is a condition that places a significant burden on individuals with the condition, their family, and society. A large proportion of those treated for schizophrenia do not experience treatment response and are referred to as having "treatment-resistant schizophrenia" (TRS). Expert opinion has long held that the prevalence of TRS among individuals with schizophrenia is 30%, but the basis of this estimate is unclear. This article presents a model developed for est ...[more]

PMID: 32497106

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Project description:BackgroundFibrodysplasia ossificans progressiva (FOP), an ultra-rare, progressive, and permanently disabling disorder of extraskeletal ossification, is characterized by episodic and painful flare-ups and irreversible heterotopic ossification in muscles, tendons, and ligaments. Prevalence estimates have been hindered by the rarity of FOP and the heterogeneity of disease presentation. This study aimed to provide a baseline prevalence of FOP in the United States, based on contact with one of 3 leading treatment centers for FOP (University of Pennsylvania, Mayo Clinic, or University of California San Francisco), the International Fibrodysplasia Ossificans Progressiva Association (IFOPA) membership list, or the IFOPA FOP Registry through July 22, 2020.ResultsPatient records were reviewed, collected, and deduplicated using first and last name initials, sex, state, and year of birth. A Kaplan-Meier survival curve was applied to each individual patient to estimate the probability that he or she was still alive, and a probability-weighted net prevalence estimate was calculated. After deduplication, 373 unique patients were identified in the United States, 294 of whom who were not listed as deceased in any list. The average time since last contact for 284 patients was 1.5 years. Based on the application of the survival probability, it is estimated that 279 of these patients were alive on the prevalence date (22 July 2020). An adjusted prevalence of 0.88 per million US residents was calculated using either an average survival rate estimate of 98.4% or a conservative survival rate estimate of 92.3% (based on the Kaplan-Meier survival curve from a previous study) and the US Census 2020 estimate of 329,992,681 on prevalence day.ConclusionsThis study suggests that the prevalence of FOP is higher than the often-cited value of 0.5 per million. Even so, because inclusion in this study was contingent upon treatment by the authors, IFOPA membership with confirmed clinical diagnosis, and the FOP Registry, the prevalence of FOP in the US may be higher than that identified here. Thus, it is imperative that efforts be made to identify and provide expert care for patients with this ultra-rare, significantly debilitating disease.

Project description:Importance:Hearing loss is one of the most prevalent chronic conditions in the United States and has been associated with negative physical, social, cognitive, economic, and emotional consequences. Despite the high prevalence of hearing loss, substantial gaps in the utilization of amplification options, including hearing aids and cochlear implants (CI), have been identified. Objective:To investigate the contemporary prevalence, characteristics, and patterns of specialty referral, evaluation, and treatment of hearing difficulty among adults in the United States. Design, Setting, and Participants:A cross-sectional analysis of responses from a nationwide clustered representative sample of adults who participated in the 2014 National Health Interview Survey and responded to the hearing module questions was carried out. Main Outcomes and Measures:Data regarding demographics as well as self-reported hearing status, functional hearing, laterality, onset, and primary cause of the hearing loss were collected. In addition, specific data regarding hearing-related clinician visits, hearing tests, referrals to hearing specialist, and utilization of hearing aids and CIs were analyzed. Results:Among 239.6 million adults, 40.3 million (16.8%) indicated their hearing was less than "excellent/good," ranging from "a little trouble hearing" to "deaf." The mean (SD) age of participants was 47 (0.2) years with 48.2% being men and 51.8% women. Approximately 48.8 million (20.6%) had visited a physician for hearing problems in the preceding 5 years. Of these, 32.6% were referred to an otolaryngologist and 27.3% were referred to an audiologist. Functional hearing was reported as the ability to hear "whispering" or "normal voice" (225.4 million; 95.5%), to "only hear shouting" (8.0 million; 3.4%), and "not appreciating shouting" (2.8 million; 1.1%). Among the last group, 5.3% were recommended to have a CI, of which 22.1% had received one. Of the adults who indicated their hearing from "a little trouble hearing" to being "deaf," 12.9 million (32.2%) had never seen a clinician for hearing problems and 11.1 million (28.0%) had never had their hearing tested. Conclusions and Relevance:There are considerable gaps between self-reported hearing loss and patients receiving medical evaluation and recommended treatments for hearing loss. Improved awareness regarding referrals to otolaryngologists and audiologists as well as auditory rehabilitative options among clinicians may improve hearing loss care.

Dataset Information

A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States.

Publications

A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States.

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