Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
JAMA Dermatol. 2013 Jul;149(7):789-94. doi: 10.1001/jamadermatol.2013.3049.
To evaluate the prevalence of comorbid conditions among patients with alopecia areata (AA) seen at tertiary care hospitals in Boston, Massachusetts, during an 11-year period.
Retrospective cross-sectional study.
Tertiary care hospitals in Boston, including Brigham and Women's Hospital and Massachusetts General Hospital.
We identified 3568 individuals with AA seen in the Partners health care system in Boston between January 1, 2000, and January 1, 2011. We performed comprehensive searches of the Research Patient Data Repository using International Classification of Diseases, Ninth Revision code 704.01. We randomly selected 350 patients and manually reviewed their medical records to train and validate a novel artificial intelligence program. This program then used natural language processing to review free-text medical records and confirm a diagnosis of AA. To confirm the algorithm, we manually reviewed a subset of records and found 93.9% validity.
The prevalence of comorbid conditions was assessed.
Common comorbid conditions included autoimmune diagnoses (thyroid disease in 14.6%, diabetes mellitus in 11.1%, inflammatory bowel disease in (2.0%) [corrected], systemic lupus erythematosus in 4.3%, rheumatoid arthritis in 3.9%, and psoriasis and psoriatic arthritis in (6.3%) [corrected], atopy (allergic rhinitis, asthma, and/or eczema in 38.2% and contact dermatitis and other eczema in 35.9%), and mental health problems (depression or anxiety in 25.5%). We also found high prevalences of hyperlipidemia (24.5%), hypertension (21.9%), and gastroesophageal reflux disease (17.3%). This profile was different from that seen in a comparison psoriasis and psoriatic arthritis group.
We found a high prevalence of comorbid conditions among individuals with AA presenting to academic medical centers in Boston. Physicians caring for patients with AA should consider screening for comorbid conditions.
评估在马萨诸塞州波士顿的三级保健医院就诊的斑秃（AA）患者的合并症患病率，时间跨度为 11 年。
回顾性横断面研究。
波士顿的三级保健医院，包括布莱根妇女医院和马萨诸塞州综合医院。
我们在 2000 年 1 月 1 日至 2011 年 1 月 1 日期间，从波士顿的合作伙伴医疗保健系统中确定了 3568 名 AA 患者。我们使用国际疾病分类第 9 版代码 704.01 对研究患者数据存储库进行了全面检索。我们随机选择了 350 名患者，并对其病历进行了人工审查，以培训和验证一个新的人工智能程序。该程序使用自然语言处理来审查自由文本病历，并确认 AA 的诊断。为了验证算法，我们对部分病历进行了人工审查，发现准确率为 93.9%。
评估了合并症的患病率。
常见的合并症包括自身免疫性疾病诊断（甲状腺疾病 14.6%、糖尿病 11.1%、炎症性肠病 2.0%[纠正]、系统性红斑狼疮 4.3%、类风湿关节炎 3.9%、银屑病和银屑病关节炎 6.3%[纠正]、特应症（过敏性鼻炎、哮喘和/或湿疹 38.2%、接触性皮炎和其他湿疹 35.9%）和心理健康问题（抑郁或焦虑 25.5%）。我们还发现高脂血症（24.5%）、高血压（21.9%）和胃食管反流病（17.3%）的患病率也很高。与银屑病和银屑病关节炎组相比，这一特征有所不同。
我们发现，在波士顿的学术医疗中心就诊的 AA 患者中，合并症的患病率较高。治疗 AA 患者的医生应考虑筛查合并症。
