Korean J Gastroenterol.  2016 Aug;68(2):77-86. 10.4166/kjg.2016.68.2.77.

Optimal Operational Definition of Patient with Peptic Ulcer Bleeding for Big Data Analysis Using Combination of Clinical Characteristics in a Secondary General Hospital

• Lee JW
• Kim HK
• Woo YS
• Jahng J
• Jin YR
• Park JH
• Kim YS
• Jung HY

• KMID: 2350084
• DOI: http://doi.org/10.4166/kjg.2016.68.2.77

Abstract

BACKGROUND/AIMS
Peptic ulcer bleeding (PUB) is the most common cause of upper gastrointestinal bleeding in Korea but there has been no research done using big data. This study evaluates the optimal operational definition (OD) for big data research by analyzing clinical characteristics of PUB.
METHODS
We reviewed the clinical characteristics of 92 patients with PUB confirmed on endoscopy in Wonkwang University Sanbon Hospital (January 2013 to December 2014). We calculated sensitivity and positive predictive value (PPV) to detect confirmed PUB patients using ODs developed by combining clinical features of patients with PUB.
RESULTS
The mean patient age was 63 years. Men had higher prevalence of PUB than women. Bleeding gastric ulcer was proportionately common in the age range of 40s to 60s in men, while a significantly higher rate of bleeding occurred in women older than 70s. The rate of drug-induced ulcer was 28.2%, whereas the prevalence of Helicobacter pylori was 47.8%. Among the hospitalized patients with diagnostic code of PUB, we ruled out patients with endoscopic removal of gastric adenoma or peritonitis, and selected patients who had been administered intravenous proton pump inhibitor. The sensitivity in this setting was 82.6%, and PPV was 88.4%.
CONCLUSIONS
PUB was more common in older patients, and there was a clear gender difference in gastric ulcer bleeding by age. With a proper OD using PUB diagnostic codes, we can identify true patients with sufficiently high sensitivity and PPV.

Keyword

Peptic ulcer hemorrhage; Big data; Operational definition; Sensitivity and specificity; Predictive value of tests

MeSH Terms

Adenoma
Endoscopy
Female
Helicobacter pylori
Hemorrhage*
Hospitals, General*
Humans
Korea
Male
Outpatients
Peptic Ulcer Hemorrhage
Peptic Ulcer*
Peritonitis
Predictive Value of Tests
Prevalence
Proton Pumps
Sensitivity and Specificity
Statistics as Topic*
Stomach Ulcer
Ulcer
Proton Pumps

Figure

• 

  Fig. 1. Distribution by age and sex. (A) Patients with peptic ulcer bleeding were evenly distributed over the forties age decade. (B) In gender analysis of gastric ulcer (GU) bleeding, the proportions of patients with bleeding gastric ulcer was high in the age range of 40s to 60s in men, while higher rate of bleeding occurred at age older than 70s in female (p<0.001, Fisher's exact test). (C) There was no significant gender difference in duodenal ulcer (DU) bleeding.

Reference

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