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Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study

Overview of attention for article published in British Medical Journal, April 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (98th percentile)

Readers on

mendeley
126 Mendeley
citeulike
1 CiteULike
Title
Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study
Published in
British Medical Journal, April 2017
DOI 10.1136/bmj.j1415
Pubmed ID
Authors

Akbar K Waljee, Mary A M Rogers, Paul Lin, Amit G Singal, Joshua D Stein, Rory M Marks, John Z Ayanian, Brahmajee K Nallamothu, Waljee, Akbar K, Rogers, Mary A M, Lin, Paul, Singal, Amit G, Stein, Joshua D, Marks, Rory M, Ayanian, John Z, Nallamothu, Brahmajee K, Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, Ayanian JZ, Nallamothu BK

Abstract

Objective To determine the frequency of prescriptions for short term use of oral corticosteroids, and adverse events (sepsis, venous thromboembolism, fractures) associated with their use.Design Retrospective cohort study and self controlled case series.Setting Nationwide dataset of private insurance claims.Participants Adults aged 18 to 64 years who were continuously enrolled from 2012 to 2014.Main outcome measures Rates of short term use of oral corticosteroids defined as less than 30 days duration. Incidence rates of adverse events in corticosteroid users and non-users. Incidence rate ratios for adverse events within 30 day and 31-90 day risk periods after drug initiation.Results Of 1 548 945 adults, 327 452 (21.1%) received at least one outpatient prescription for short term use of oral corticosteroids over the three year period. Use was more frequent among older patients, women, and white adults, with significant regional variation (all P<0.001). The most common indications for use were upper respiratory tract infections, spinal conditions, and allergies. Prescriptions were provided by a diverse range of specialties. Within 30 days of drug initiation, there was an increase in rates of sepsis (incidence rate ratio 5.30, 95% confidence interval 3.80 to 7.41), venous thromboembolism (3.33, 2.78 to 3.99), and fracture (1.87, 1.69 to 2.07), which diminished over the subsequent 31-90 days. The increased risk persisted at prednisone equivalent doses of less than 20 mg/day (incidence rate ratio 4.02 for sepsis, 3.61 for venous thromboembolism, and 1.83 for fracture; all P<0.001).Conclusion One in five American adults in a commercially insured plan were given prescriptions for short term use of oral corticosteroids during a three year period, with an associated increased risk of adverse events.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 126 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 2%
Tunisia 1 <1%
Japan 1 <1%
Norway 1 <1%
Unknown 121 96%

Demographic breakdown

Readers by professional status Count As %
Other 34 27%
Student > Ph. D. Student 15 12%
Researcher 13 10%
Professor > Associate Professor 13 10%
Student > Postgraduate 12 10%
Other 39 31%
Readers by discipline Count As %
Medicine and Dentistry 95 75%
Unspecified 9 7%
Nursing and Health Professions 4 3%
Agricultural and Biological Sciences 4 3%
Neuroscience 3 2%
Other 11 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 530. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 June 2018.
All research outputs
#10,222
of 11,403,309 outputs
Outputs from British Medical Journal
#235
of 38,552 outputs
Outputs of similar age
#708
of 267,252 outputs
Outputs of similar age from British Medical Journal
#17
of 912 outputs
Altmetric has tracked 11,403,309 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 38,552 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 25.9. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,252 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 912 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 98% of its contemporaries.