Liver, Pancreas, and Biliary TractEpidemiology and natural history of primary biliary cirrhosis in a U.S. community☆,☆☆
Section snippets
Case ascertainment
Population-based epidemiologic research can be conducted in Olmsted County, Minnesota, because medical care is virtually self-contained within the community and there are relatively few providers. For example, most gastroenterology care is provided by the Mayo Clinic, which has maintained a common medical record system with its 2 large affiliated hospitals in the community (St. Mary's and Rochester Methodist) for more than 90 years. The diagnoses and surgical procedures recorded in these
Patient characteristics
Between 1975 and 1995, 46 Olmsted County residents had PBC diagnosed for the first time. All but one patient had PBC diagnosed clinically and thus was identified by the diagnostic index of the Rochester Epidemiology Project. The remaining patient who had a high AMA titer and met the study inclusion criteria was not given the diagnosis when he was evaluated in the late 1970s. Table 1 summarizes the demographic and clinical characteristics of these patients.The majority were women (41/46, 89%).
Discussion
We describe the incidence and prevalence of PBC in the United States. The epidemiology of PBC has been studied mainly in Europe, where the health care delivery system is such that tertiary care centers typically serve a relatively defined population. In North America, health care delivery tends to be more fragmented and such estimation has not been feasible because of the difficulty of collaboration among large number of providers in heterogeneous practice settings. In Olmsted County, however,
Acknowledgements
The authors thank Gwen Boe for her dedicated work in the preparation of the manuscript.
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Address requests for reprints to: W. Ray Kim, M.D., Division of Gastroenterology and Hepatology (Ch10), Mayo Clinic and Foundation, 200 First Street S.W., Rochester, Minnesota 55905. e-mail: [email protected]; fax: (507) 266-2810.
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Supported by grants DK34238 and AR30582 from the National Institutes of Health and the Mayo Foundation for Medical Research and Education.