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Leveraging Laboratory Results from Multiple Data Sources to Re-Assess a Possible Association between Serum Uric Acid and Schizophrenia in Real World Practice Settings

Speaker(s)

Aguilar D1, Chick J1, James MP2, Wade RL3, Winniewicz PW2, Lu J1, Waheed R4
1IQVIA, Plymouth Meeting, PA, USA, 2Quest Diagnostics, Secaucus, NJ, USA, 3IQVIA, Falls Church, VA, USA, 4Quest Diagnostics, Cleveland, OH, USA

OBJECTIVES: : The relationship between serum uric acid (UA) and schizophrenia has been extensively investigated but remains unclear. Analysis of this relationship in RWD requires sufficient sample size and integrating multiple data sources. We leveraged laboratory results from a national supplier (Quest Diagnostics) to enhance clinical records in IQVIA’s Ambulatory Electronic Medical Records (AEMR).

METHODS: Adult patients with schizophrenia (ICD9/10CM/SNOMED-CT) and medication order(s) for antipsychotics (GPI) and UA results between 11/1/2018-10/31/2021 were identified. A gender/age-matched control group was selected from non-schizophrenia patients with UA results during the same timeframe. Gender-specific categorization of high/medium/low UA range levels (in mg/dL) were constructed for schizophrenia and control groups (mean UA used for patients with multiple results). Demographic variables and clinical profiles from available EMR history were summarized for schizophrenia UA subgroups with control comparisons.

RESULTS: Of 57,413 schizophrenia patients, 2,124 had UA results in our Quest-enhanced data source: mean observation period 6.0±4.4 years, 51.3% women, mean age 57.7±13.9 years, and 49.3% Caucasian. UA levels were nearly identical between schizophrenia patients (6.0±1.8mg/dL) and controls (5.9±1.7mg/dL). As expected, diagnoses of gout and hyperuricemia were more common in patients with high UA versus normal/low UA. However, high UA schizophrenia patients were also more likely to have co-morbidities like chronic kidney disease and hypertension, whereas patients in the low UA group were more likely to have gastrointestinal-related diagnoses and hyponatremia; such findings also contributing to a co-morbid profile that was generally more pronounced in schizophrenia patients versus controls.

CONCLUSIONS: We found nearly identical UA levels between schizophrenia and control groups. However, we observed differences in clinical profiles between high-versus-low UA (and versus controls) that require further investigation to adjust for drug therapy, disease duration and comorbidities. It is possible to construct large real-world databases linking EMR and clinical labs to investigate elusive associations between biometric measurements and diagnoses/outcomes.

Code

RWD66

Topic

Epidemiology & Public Health, Real World Data & Information Systems, Study Approaches

Topic Subcategory

Disease Classification & Coding, Distributed Data & Research Networks, Electronic Medical & Health Records

Disease

No Additional Disease & Conditions/Specialized Treatment Areas