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Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records

Lookup NU author(s): Dr Claire WelshORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2016 Elsevier BV. Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not initial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully.

Publication metadata

Author(s): Welsh CE, Duz M, Parkin TDH, Marshall JF

Publication type: Article

Publication status: Published

Journal: Preventive Veterinary Medicine

Year: 2017

Volume: 136

Pages: 11-18

Print publication date: 01/01/2017

Online publication date: 22/11/2016

Acceptance date: 21/11/2016

Date deposited: 17/10/2019

ISSN (print): 0167-5877

ISSN (electronic): 1873-1716

Publisher: Elsevier BV


DOI: 10.1016/j.prevetmed.2016.11.012

PubMed id: 28010903


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