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A method for reporting and classifying acute infectious diseases in a prospective study of young children: TEDDY

Lönnrot, Maria; Lynch, Kristian LU ; Larsson, Helena LU ; Lernmark, Åke LU ; Rewers, Marian; Hagopian, William; She, Jin-Xiong; Simell, Olli; Ziegler, Anette-G and Akolkar, Beena, et al. (2015) In BMC Pediatrics 15.
Abstract
Background: Early childhood environmental exposures, possibly infections, may be responsible for triggering islet autoimmunity and progression to type 1 diabetes (T1D). The Environmental Determinants of Diabetes in the Young (TEDDY) follows children with increased HLA-related genetic risk for future T1D. TEDDY asks parents to prospectively record the child's infections using a diary book. The present paper shows how these large amounts of partially structured data were reduced into quantitative data-sets and further categorized into system-specific infectious disease episodes. The numbers and frequencies of acute infections and infectious episodes are shown. Methods: Study subjects (n = 3463) included children who had attended study visits... (More)
Background: Early childhood environmental exposures, possibly infections, may be responsible for triggering islet autoimmunity and progression to type 1 diabetes (T1D). The Environmental Determinants of Diabetes in the Young (TEDDY) follows children with increased HLA-related genetic risk for future T1D. TEDDY asks parents to prospectively record the child's infections using a diary book. The present paper shows how these large amounts of partially structured data were reduced into quantitative data-sets and further categorized into system-specific infectious disease episodes. The numbers and frequencies of acute infections and infectious episodes are shown. Methods: Study subjects (n = 3463) included children who had attended study visits every three months from age 3 months to 4 years, without missing two or more consecutive visits during the follow-up. Parents recorded illnesses prospectively in a TEDDY Book at home. The data were entered into the study database during study visits using ICD-10 codes by a research nurse. TEDDY investigators grouped ICD-10 codes and fever reports into infectious disease entities and further arranged them into four main categories of infectious episodes: respiratory, gastrointestinal, other, and unknown febrile episodes. Incidence rate of infections was modeled as function of gender, HLA-DQ genetic risk group and study center using the Poisson regression. Results: A total of 113,884 ICD-10 code reports for infectious diseases recorded in the database were reduced to 71,578 infectious episodes, including 74.0% respiratory, 13.1% gastrointestinal, 5.7% other infectious episodes and 7.2% febrile episodes. Respiratory and gastrointestinal infectious episodes were more frequent during winter. Infectious episode rates peaked at 6 months and began declining after 18 months of age. The overall infectious episode rate was 5.2 episodes per person-year and varied significantly by country of residence, sex and HLA genotype. Conclusions: The data reduction and categorization process developed by TEDDY enables analysis of single infectious agents as well as larger arrays of infectious agents or clinical disease entities. The preliminary descriptive analyses of the incidence of infections among TEDDY participants younger than 4 years fits well with general knowledge of infectious disease epidemiology. This protocol can be used as a template in forthcoming time-dependent TEDDY analyses and in other epidemiological studies. (Less)
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publication status
published
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keywords
Childhood infections, Prospective study, Type 1 diabetes
in
BMC Pediatrics
volume
15
publisher
BioMed Central
external identifiers
  • wos:000351724500001
  • scopus:84925682598
  • pmid:25884839
ISSN
1471-2431
DOI
10.1186/s12887-015-0333-8
language
English
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yes
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763eafe0-d0b2-4c92-9b6b-f944e6ed66d0 (old id 5282017)
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http://www.ncbi.nlm.nih.gov/pubmed/25884839?dopt=Abstract
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2015-05-05 15:02:46
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2017-10-22 04:19:15
@article{763eafe0-d0b2-4c92-9b6b-f944e6ed66d0,
  abstract     = {Background: Early childhood environmental exposures, possibly infections, may be responsible for triggering islet autoimmunity and progression to type 1 diabetes (T1D). The Environmental Determinants of Diabetes in the Young (TEDDY) follows children with increased HLA-related genetic risk for future T1D. TEDDY asks parents to prospectively record the child's infections using a diary book. The present paper shows how these large amounts of partially structured data were reduced into quantitative data-sets and further categorized into system-specific infectious disease episodes. The numbers and frequencies of acute infections and infectious episodes are shown. Methods: Study subjects (n = 3463) included children who had attended study visits every three months from age 3 months to 4 years, without missing two or more consecutive visits during the follow-up. Parents recorded illnesses prospectively in a TEDDY Book at home. The data were entered into the study database during study visits using ICD-10 codes by a research nurse. TEDDY investigators grouped ICD-10 codes and fever reports into infectious disease entities and further arranged them into four main categories of infectious episodes: respiratory, gastrointestinal, other, and unknown febrile episodes. Incidence rate of infections was modeled as function of gender, HLA-DQ genetic risk group and study center using the Poisson regression. Results: A total of 113,884 ICD-10 code reports for infectious diseases recorded in the database were reduced to 71,578 infectious episodes, including 74.0% respiratory, 13.1% gastrointestinal, 5.7% other infectious episodes and 7.2% febrile episodes. Respiratory and gastrointestinal infectious episodes were more frequent during winter. Infectious episode rates peaked at 6 months and began declining after 18 months of age. The overall infectious episode rate was 5.2 episodes per person-year and varied significantly by country of residence, sex and HLA genotype. Conclusions: The data reduction and categorization process developed by TEDDY enables analysis of single infectious agents as well as larger arrays of infectious agents or clinical disease entities. The preliminary descriptive analyses of the incidence of infections among TEDDY participants younger than 4 years fits well with general knowledge of infectious disease epidemiology. This protocol can be used as a template in forthcoming time-dependent TEDDY analyses and in other epidemiological studies.},
  articleno    = {24},
  author       = {Lönnrot, Maria and Lynch, Kristian and Larsson, Helena and Lernmark, Åke and Rewers, Marian and Hagopian, William and She, Jin-Xiong and Simell, Olli and Ziegler, Anette-G and Akolkar, Beena and Krischer, Jeffrey and Hyöty, Heikki},
  issn         = {1471-2431},
  keyword      = {Childhood infections,Prospective study,Type 1 diabetes},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Pediatrics},
  title        = {A method for reporting and classifying acute infectious diseases in a prospective study of young children: TEDDY},
  url          = {http://dx.doi.org/10.1186/s12887-015-0333-8},
  volume       = {15},
  year         = {2015},
}