Ludvigsson Jonas F, Lashkariani Mariam
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden,
Clin Epidemiol. 2019 Jan 14;11:101-114. doi: 10.2147/CLEP.S191914. eCollection 2019.
The ESPRESSO study constitutes a novel approach to examine the etiology and prognosis of gastrointestinal disease in which histopathology plays a prominent role. Between 2015 and 2017, all pathology departments (n=28) in Sweden were contacted and asked to procure histopathology record data from the gastrointestinal tract (pharynx to anus), liver, gallbladder, and pancreas. For each individual, local histopathology IT personnel retrieved data on personal identity number, date of histopathology, topography (where the biopsy is taken), morphology (biopsy appearance), and where available free text. In total, between 1965 and 2017, histopathology record data were available in 2.1 million unique individuals, but the number of data entries was 6.1 million because more than one biopsy was performed in many of the study participants. Index individuals with histopathology data were matched with up to five controls from the general population. We also identified all first-degree relatives (parents, children, full siblings), and the index individual's first spouse. The total study population consisted of 13.0 million individuals. Data from all the study participants have been linked to Swedish National Healthcare Registers allowing research not only on such aspects as fetal and perinatal conditions and the risk of future gastrointestinal disease but also on the risk of comorbidity and complications (including cancer and death). Furthermore, the ESPRESSO database allows researchers and practitioners to identify diagnoses and disease phenotypes not currently indexed in national registers (including disease precursors). The ESPRESSO database increases the sensitivity and specificity of already-recorded diseases in the national health registers. This paper is an overview of the ESPRESSO database.
ESPRESSO研究采用了一种全新的方法来研究胃肠道疾病的病因和预后，其中组织病理学发挥着重要作用。2015年至2017年期间，研究人员联系了瑞典所有的病理科（共28个），要求其提供胃肠道（从咽到肛门）、肝脏、胆囊和胰腺的组织病理学记录数据。对于每一个体，当地的组织病理学信息技术人员检索了个人身份号码、组织病理学日期、部位（活检取材部位）、形态学（活检外观）以及可用的自由文本等数据。总体而言，在1965年至2017年期间，210万独特个体拥有组织病理学记录数据，但数据条目数量为610万，因为许多研究参与者接受了不止一次活检。有组织病理学数据的索引个体与来自普通人群的多达五名对照进行匹配。我们还识别了所有一级亲属（父母、子女、同胞兄弟姐妹）以及索引个体的首任配偶。研究总人群包括1300万个体。所有研究参与者的数据已与瑞典国家医疗保健登记册相链接，这使得研究不仅可以涉及胎儿和围产期状况以及未来患胃肠道疾病的风险等方面，还可以研究合并症和并发症（包括癌症和死亡）的风险。此外，ESPRESSO数据库使研究人员和从业者能够识别国家登记册中目前未编入索引的诊断和疾病表型（包括疾病前驱病变）。ESPRESSO数据库提高了国家健康登记册中已记录疾病的敏感性和特异性。本文是对ESPRESSO数据库的概述。
