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Article ; Online: Using electronic health records to streamline provider recruitment for implementation science studies

Chiamaka L. Okorie / Elise Gatsby / Florian R. Schroeck / A. Aziz Ould Ismail / Kristine E. Lynch

PLoS ONE, Vol 17, Iss

2022 Volume 5

Abstract: Background Healthcare providers are often targeted as research participants, especially for implementation science studies evaluating provider- or system-level issues. Frequently, provider eligibility is based on both provider and patient factors. Manual ...

Abstract	Background Healthcare providers are often targeted as research participants, especially for implementation science studies evaluating provider- or system-level issues. Frequently, provider eligibility is based on both provider and patient factors. Manual chart review and self-report are common provider screening strategies but require substantial time, effort, and resources. The automated use of electronic health record (EHR) data may streamline provider identification for implementation science research. Here, we describe an approach to provider screening for a Veterans Health Administration (VHA)-funded study focused on implementing risk-aligned surveillance for bladder cancer patients. Methods Our goal was to identify providers at 6 pre-specified facilities who performed ≥10 surveillance cystoscopy procedures among bladder cancer patients in the 12 months prior to recruitment start on January 16, 2020, and who were currently practicing at 1 of 6 pre-specified facilities. Using VHA EHR data (using CPT, ICD10 procedure, and ICD10 diagnosis codes), we identified cystoscopy procedures performed after an initial bladder cancer diagnosis (i.e., surveillance procedures). Procedures were linked to VHA staff data to determine the provider of record, the number of cystoscopies they performed, and their current location of practice. To validate this approach, we performed a chart review of 105 procedures performed by a random sample of identified providers. The proportion of correctly identified procedures was calculated (Positive Predictive Value (PPV)), along with binomial 95% confidence intervals (CI). Findings We identified 1,917,856 cystoscopies performed on 703,324 patients from October 1, 1999—January 16, 2020, across the nationwide VHA. Of those procedures, 40% were done on patients who had a prior record of bladder cancer and were completed by 15,065 distinct providers. Of those, 61 performed ≥ 10 procedures and were currently practicing at 1 of the 6 facilities of interest in the 1 year prior to study ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Overall and sex-specific risk factors for subjective cognitive decline

Karen C. Schliep / William A. Barbeau / Kristine E. Lynch / Michelle K. Sorweid / Michael W. Varner / Norman L. Foster / Fares Qeadan

Biology of Sex Differences, Vol 13, Iss 1, Pp 1-

findings from the 2015–2018 Behavioral Risk Factor Surveillance System Survey

2022 Volume 14

Abstract: Highlights Subjective Cognitive Decline (SCD) is one of the earliest noticeable symptoms of Alzheimer’s disease and related dementias. While there is no current cure for dementia, research indicates that at least 35% of dementia risk may be modifiable by ...

Abstract	Highlights Subjective Cognitive Decline (SCD) is one of the earliest noticeable symptoms of Alzheimer’s disease and related dementias. While there is no current cure for dementia, research indicates that at least 35% of dementia risk may be modifiable by decreasing exposures years or even decades before cognitive decline becomes clinically evident. Prior research has shown that the risk of dementia in individuals with cognitive impairment is higher in women than in men, as is the overall risk of dementia. Among a nationally representative population of over 200,000 adults, ages 45 years and older, SCD prevalence was 11% for both women and men. Women and men also had nearly equivalent overall population-attributable fractions to explain subjective cognitive decline (39.7% for women versus 41.3% for men). The top three contributing risk factors for both women and men were social isolation, depression, and hypertension, which explained three-quarters of the overall population-attributable fraction.
Keywords	Subjective cognitive decline ; Dementia ; Cognitive dysfunction ; Behavioral Risk Factor Surveillance System ; Risk factors ; Sex factors ; Medicine ; R ; Physiology ; QP1-981
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Using electronic health records to streamline provider recruitment for implementation science studies.

Chiamaka L Okorie / Elise Gatsby / Florian R Schroeck / A Aziz Ould Ismail / Kristine E Lynch

PLoS ONE, Vol 17, Iss 5, p e

2022 Volume 0267915

Abstract	Background Healthcare providers are often targeted as research participants, especially for implementation science studies evaluating provider- or system-level issues. Frequently, provider eligibility is based on both provider and patient factors. Manual chart review and self-report are common provider screening strategies but require substantial time, effort, and resources. The automated use of electronic health record (EHR) data may streamline provider identification for implementation science research. Here, we describe an approach to provider screening for a Veterans Health Administration (VHA)-funded study focused on implementing risk-aligned surveillance for bladder cancer patients. Methods Our goal was to identify providers at 6 pre-specified facilities who performed ≥10 surveillance cystoscopy procedures among bladder cancer patients in the 12 months prior to recruitment start on January 16, 2020, and who were currently practicing at 1 of 6 pre-specified facilities. Using VHA EHR data (using CPT, ICD10 procedure, and ICD10 diagnosis codes), we identified cystoscopy procedures performed after an initial bladder cancer diagnosis (i.e., surveillance procedures). Procedures were linked to VHA staff data to determine the provider of record, the number of cystoscopies they performed, and their current location of practice. To validate this approach, we performed a chart review of 105 procedures performed by a random sample of identified providers. The proportion of correctly identified procedures was calculated (Positive Predictive Value (PPV)), along with binomial 95% confidence intervals (CI). Findings We identified 1,917,856 cystoscopies performed on 703,324 patients from October 1, 1999-January 16, 2020, across the nationwide VHA. Of those procedures, 40% were done on patients who had a prior record of bladder cancer and were completed by 15,065 distinct providers. Of those, 61 performed ≥ 10 procedures and were currently practicing at 1 of the 6 facilities of interest in the 1 year prior to study ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Elevated Risk of Chronic Respiratory Conditions within 60 Days of COVID-19 Hospitalization in Veterans

Catherine Park / Javad Razjouyan / Nicola A. Hanania / Drew A. Helmer / Aanand D. Naik / Kristine E. Lynch / Christopher I. Amos / Amir Sharafkhaneh

Healthcare, Vol 10, Iss 300, p

2022 Volume 300

Abstract: SARS-CoV-2 infection prominently affects the respiratory system, and patients hospitalized with COVID-19 are at an increased risk of developing respiratory conditions. We examined the risk of new respiratory conditions of COVID-19 among hospitalized ... ...

Abstract	SARS-CoV-2 infection prominently affects the respiratory system, and patients hospitalized with COVID-19 are at an increased risk of developing respiratory conditions. We examined the risk of new respiratory conditions of COVID-19 among hospitalized patients in the national Veterans Health Administration between 15 February 2020 and 16 June 2021. The study cohort included all COVID-19-tested, hospitalized individuals who survived the index admission and did not have any previously diagnosed chronic respiratory conditions (asthma, bronchitis, chronic lung disease, chronic obstructive pulmonary disease (COPD), emphysema, or venous thromboembolism) before SARS-CoV-2 testing. Of 373,048 patients hospitalized after SARS-CoV-2 testing, 18,686 positive and 37,372 negative patients met the inclusion/exclusion criteria and were matched by age, sex, and race using propensity score matching. The results showed that the SARS-CoV-2 positive group had a greater risk of developing asthma (adjusted odds ratio (aOR) = 1.37), bronchitis (aOR = 2.81), chronic lung disease (aOR = 2.14), COPD (aOR = 1.56), emphysema (aOR = 1.52), and venous thromboembolism (aOR = 1.92) within 60 days after the index COVID date of testing. These findings could inform that the clinical care team considers a risk of new respiratory conditions and address these conditions in the post-hospitalization management of the patient, which could potentially lead to reduce the risk of complications and optimize recovery.
Keywords	COVID-19 ; hospitalization ; respiratory condition ; propensity score matching ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing Smoking Status and Risk of SARS-CoV-2 Infection

Alice B. S. Nono Djotsa / Drew A. Helmer / Catherine Park / Kristine E. Lynch / Amir Sharafkhaneh / Aanand D. Naik / Javad Razjouyan / Christopher I. Amos

Healthcare, Vol 10, Iss 7, p

A Machine Learning Approach among Veterans

2022 Volume 1244

Abstract: The role of smoking in the risk of SARS-CoV-2 infection is unclear. We used a retrospective cohort design to study data from veterans’ Electronic Medical Record to assess the impact of smoking on the risk of SARS-CoV-2 infection. Veterans tested for the ... ...

Abstract	The role of smoking in the risk of SARS-CoV-2 infection is unclear. We used a retrospective cohort design to study data from veterans’ Electronic Medical Record to assess the impact of smoking on the risk of SARS-CoV-2 infection. Veterans tested for the SARS-CoV-2 virus from 02/01/2020 to 02/28/2021 were classified as: Never Smokers (NS), Former Smokers (FS), and Current Smokers (CS). We report the adjusted odds ratios (aOR) for potential confounders obtained from a cascade machine learning algorithm. We found a 19.6% positivity rate among 1,176,306 veterans tested for SARS-CoV-2 infection. The positivity proportion among NS (22.0%) was higher compared with FS (19.2%) and CS (11.5%). The adjusted odds of testing positive for CS (aOR:0.51; 95%CI: 0.50, 0.52) and FS (aOR:0.89; 95%CI:0.88, 0.90) were significantly lower compared with NS. Four pre-existing conditions, including dementia, lower respiratory infections, pneumonia, and septic shock, were associated with a higher risk of testing positive, whereas the use of the decongestant drug phenylephrine or having a history of cancer were associated with a lower risk. CS and FS compared with NS had lower risks of testing positive for SARS-CoV-2. These findings highlight our evolving understanding of the role of smoking status on the risk of SARS-CoV-2 infection.
Keywords	SARS Coronavirus 2 ; smoking ; machine learning ; veteran ; Medicine ; R
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The impact of low- versus high-intensity surveillance cystoscopy on surgical care and cancer outcomes in patients with high-risk non-muscle-invasive bladder cancer (NMIBC).

Michael E Rezaee / Kristine E Lynch / Zhongze Li / Todd A MacKenzie / John D Seigne / Douglas J Robertson / Brenda Sirovich / Philip P Goodney / Florian R Schroeck

PLoS ONE, Vol 15, Iss 3, p e

2020 Volume 0230417

Abstract: Purpose To assess the association of low- vs. guideline-recommended high-intensity cystoscopic surveillance with outcomes among patients with high-risk non-muscle invasive bladder cancer (NMIBC). Materials & methods A retrospective cohort study of ... ...

Abstract	Purpose To assess the association of low- vs. guideline-recommended high-intensity cystoscopic surveillance with outcomes among patients with high-risk non-muscle invasive bladder cancer (NMIBC). Materials & methods A retrospective cohort study of Veterans Affairs patients diagnosed with high-risk NMIBC between 2005 and 2011 with follow-up through 2014. Patients were categorized by number of surveillance cystoscopies over two years following diagnosis: low- (1-5) vs. high-intensity (6 or more) surveillance. Propensity score adjusted regression models were used to assess the association of low-intensity cystoscopic surveillance with frequency of transurethral resections, and risk of progression to invasive disease and bladder cancer death. Results Among 1,542 patients, 520 (33.7%) underwent low-intensity cystoscopic surveillance. Patients undergoing low-intensity surveillance had fewer transurethral resections (37 vs. 99 per 100 person-years; p<0.001). Risk of death from bladder cancer did not differ significantly by low (cumulative incidence [CIn] 8.4% [95% CI 6.5-10.9) at 5 years) vs. high-intensity surveillance (CIn 9.1% [95% CI 7.4-11.2) at 5 years, p = 0.61). Low vs. high-intensity surveillance was not associated with increased risk of bladder cancer death among patients with Ta (CIn 5.7% vs. 8.2% at 5 years p = 0.24) or T1 disease at diagnosis (CIn 10.2% vs. 9.1% at 5 years, p = 0.58). Among patients with Ta disease, low-intensity surveillance was associated with decreased risk of progression to invasive disease (T1 or T2) or bladder cancer death (CIn 19.3% vs. 31.3% at 5 years, p = 0.002). Conclusions Patients with high-risk NMIBC undergoing low- vs. high-intensity cystoscopic surveillance underwent fewer transurethral resections, but did not experience an increased risk of progression or bladder cancer death. These findings provide a strong rationale for a clinical trial to determine whether low-intensity surveillance is comparable to high-intensity surveillance for cancer control in high-risk ...
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Using Real World Data to Understand HIV and COVID-19 in the U.S.A. and Spain

Julianna Kohler / Kristin M Kostka / Rupa Makadia / Roger Paredes / Talita Duarte-Salles / Scott L Duvall / Michael Matheny / Kristine E Lynch / Alison Cheng / Asieh Golozar / Jennifer C E Lane / Anthony G Sena / Peter J Rijnbeek / Daniel R Morales / Patrick B Ryan / Christian G Reich / George Siberry / Daniel Prieto-Alhambra

Characterizing Co-Infected Patients Across the Care Cascade

2020

Abstract: Objective: Most patients severely affected by COVID-19 have been elderly and patients with underlying chronic disease such as diabetes, cardiovascular disease, or respiratory disease. People living with HIV (PLHIV) may have greater risk of contracting or ...

Abstract	Objective: Most patients severely affected by COVID-19 have been elderly and patients with underlying chronic disease such as diabetes, cardiovascular disease, or respiratory disease. People living with HIV (PLHIV) may have greater risk of contracting or developing severe COVID-19 due to the underlying HIV infection or higher prevalence of comorbidities. Design: This is a cohort study, including PLHIV diagnosed, hospitalized, or requiring intensive services for COVID-19. Methods: Data sources include routine electronic medical record or claims data from the U.S. and Spain. Patient demographics, comorbidities, and medication history are described. Results: Four data sources had a population of HIV/COVID-19 coinfected patients ranging from 288 to 4606 lives. PLHIV diagnosed with COVID-19 were younger than HIV-negative patients diagnosed with COVID-19. PLHIV diagnosed with COVID-19 diagnosis had similar comorbidities as HIV-negative COVID-19 patients with higher prevalence of those comorbidities and history of severe disease. Treatment regimens were similar between PLHIV diagnosed with COVID-19 or PLHIV requiring intensive services. Conclusions: Our study uses routine practice data to explore HIV impact on COVID-19, providing insight into patient history prior to COVID-19. We found that HIV and COVID-19 coinfected patients have higher prevalence of underlying comorbidities such as cardiovascular and respiratory disease as compared to HIV-negative COVID-19 infected patients. We also found that, across the care cascade, co-infected patients who received intensive services were more likely to have more serious underlying disease or a history of more serious events as compared to PLHIV who were diagnosed with COVID-19.
Keywords	COVID-19 ; HIV ; Prevalence ; Comorbidities ; covid19
Subject code	610 ; 310
Publishing date	2020-11-13
Publishing country	eu
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Seek COVER

Ross D. Williams / Aniek F. Markus / Cynthia Yang / Talita Duarte-Salles / Scott L. DuVall / Thomas Falconer / Jitendra Jonnagaddala / Chungsoo Kim / Yeunsook Rho / Andrew E. Williams / Amanda Alberga Machado / Min Ho An / María Aragón / Carlos Areia / Edward Burn / Young Hwa Choi / Iannis Drakos / Maria Tereza Fernandes Abrahão / Sergio Fernández-Bertolín /

George Hripcsak / Benjamin Skov Kaas-Hansen / Prasanna L. Kandukuri / Jan A. Kors / Kristin Kostka / Siaw-Teng Liaw / Kristine E. Lynch / Gerardo Machnicki / Michael E. Matheny / Daniel Morales / Fredrik Nyberg / Rae Woong Park / Albert Prats-Uribe / Nicole Pratt / Gowtham Rao / Christian G. Reich / Marcela Rivera / Tom Seinen / Azza Shoaibi / Matthew E. Spotnitz / Ewout W. Steyerberg / Marc A. Suchard / Seng Chan You / Lin Zhang / Lili Zhou / Patrick B. Ryan / Daniel Prieto-Alhambra / Jenna M. Reps / Peter R. Rijnbeek

BMC Medical Research Methodology, Vol 22, Iss 1, Pp 1-

using a disease proxy to rapidly develop and validate a personalized risk calculator for COVID-19 outcomes in an international network

2022 Volume 13

Abstract: Abstract Background We investigated whether we could use influenza data to develop prediction models for COVID-19 to increase the speed at which prediction models can reliably be developed and validated early in a pandemic. We developed COVID-19 ... ...

Abstract	Abstract Background We investigated whether we could use influenza data to develop prediction models for COVID-19 to increase the speed at which prediction models can reliably be developed and validated early in a pandemic. We developed COVID-19 Estimated Risk (COVER) scores that quantify a patient’s risk of hospital admission with pneumonia (COVER-H), hospitalization with pneumonia requiring intensive services or death (COVER-I), or fatality (COVER-F) in the 30-days following COVID-19 diagnosis using historical data from patients with influenza or flu-like symptoms and tested this in COVID-19 patients. Methods We analyzed a federated network of electronic medical records and administrative claims data from 14 data sources and 6 countries containing data collected on or before 4/27/2020. We used a 2-step process to develop 3 scores using historical data from patients with influenza or flu-like symptoms any time prior to 2020. The first step was to create a data-driven model using LASSO regularized logistic regression, the covariates of which were used to develop aggregate covariates for the second step where the COVER scores were developed using a smaller set of features. These 3 COVER scores were then externally validated on patients with 1) influenza or flu-like symptoms and 2) confirmed or suspected COVID-19 diagnosis across 5 databases from South Korea, Spain, and the United States. Outcomes included i) hospitalization with pneumonia, ii) hospitalization with pneumonia requiring intensive services or death, and iii) death in the 30 days after index date. Results Overall, 44,507 COVID-19 patients were included for model validation. We identified 7 predictors (history of cancer, chronic obstructive pulmonary disease, diabetes, heart disease, hypertension, hyperlipidemia, kidney disease) which combined with age and sex discriminated which patients would experience any of our three outcomes. The models achieved good performance in influenza and COVID-19 cohorts. For COVID-19 the AUC ranges were, COVER-H: ...
Keywords	Patient-level prediction modelling ; COVID-19 ; Risk score ; Medicine (General) ; R5-920
Subject code	310
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Seek COVER

Ross D. Williams / Aniek Markus / Cynthia Yang / Talita Duarte Salles / Scott L. DuVall / Thomas Falconer / Jitendra Jonnagaddala / Chungsoo Kim / Yeunsook Rho / Andrew Williams / Amanda Alberga / Min Ho An / María Aragón / Carlos Areia / Edward Burn / Young Hwa Choi / Iannis Drakos / Maria Tereza Fernandes Abrahão / Sergio Fernández-Bertolín /

George Hripcsak / Benjamin Skov Kaas-Hansen / Prasanna L Kandukuri / Jan A. Kors / Kristin Kostka / Siaw-Teng Liaw / Kristine E. Lynch, PhD / Michael E. Matheny / Gerardo Machnicki / Daniel Morales / Fredrik Nyberg / Rae Woong Park / Albert Prats-Uribe / Nicole Pratt / Gowtham Rao / Christian G. Reich / Marcela Rivera / Tom Seinen / Azza Shoaibi / Matthew E Spotnitz / Ewout W. Steyerberg / Marc A. Suchard / Seng Chan You / Lin Zhang / Lili Zhou / Patrick B. Ryan / Daniel Prieto-Alhambra / Jenna M. Reps / Peter R. Rijnbeek

Development and validation of a personalized risk calculator for COVID-19 outcomes in an international network

2020

Abstract: Seek Cover scores calculate the risk of patients if they are infected with COVID-19 for for 3 outcomes i) hospitalization with pneumonia, ii) hospitalization with pneumonia requiring intensive services or death iii) death in the 30 days after index date. ...

Abstract	Seek Cover scores calculate the risk of patients if they are infected with COVID-19 for for 3 outcomes i) hospitalization with pneumonia, ii) hospitalization with pneumonia requiring intensive services or death iii) death in the 30 days after index date.
Keywords	covid19
Publishing date	2020-07-23
Publishing country	eu
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Risk of depression, suicidal ideation, suicide and psychosis with hydroxychloroquine treatment for rheumatoid arthritis

Jennifer C.E Lane / James Weaver / Kristin Kostka / Talita Duarte-Salles / Maria Tereza F Abrahao / Heba Alghoul / Osaid Alser / Thamir M Alshammari / Carlos Areia / Juan M. Banda / Patricia Biedermann / Edward Burn / Paula Casajust / Kristina Fišter / Jill Hardin / Laura Hester / George Hripcsak / Benjamin Skov Kaas-Hansen / Sajan Khosla /

Spyros Kolovos / Kristine E. Lynch / Rupa Makadia / Paras P. Mehta / Daniel R Morales / Henry Morgan-Stewart / Mees Mosseveld / Danielle Newby / Fredrik Nyberg / Anna Ostropolets / Rae Woong Park / Albert Prats-Uribe / Gowtham A. Rao / Christian Reich / Peter Rijnbeek / Anthony G. Sena / Azza Shoaibi / Matthew Spotnitz / Vignesh Subbian / Marc A Suchard / David Vizcaya / Haini Wen / Marcel de Wilde / Junqing Xie / Seng Chan You / Lin Zhang / Simon Lovestone / Patrick B Ryan / Daniel Prieto-Alhambra

a multi-national network cohort study

2020

Abstract: Objectives Concern has been raised in the rheumatological community regarding recent regulatory warnings that hydroxychloroquine used in the COVID-19 pandemic could cause acute psychiatric events. We aimed to study whether there is risk of incident ... ...

Abstract	Objectives Concern has been raised in the rheumatological community regarding recent regulatory warnings that hydroxychloroquine used in the COVID-19 pandemic could cause acute psychiatric events. We aimed to study whether there is risk of incident depression, suicidal ideation, or psychosis associated with hydroxychloroquine as used for rheumatoid arthritis (RA). Methods New user cohort study using claims and electronic medical records from 10 sources and 3 countries (Germany, UK and US). RA patients aged 18+ and initiating hydroxychloroquine were compared to those initiating sulfasalazine (active comparator) and followed up in the short (30-day) and long term (on treatment). Study outcomes included depression, suicide/suicidal ideation, and hospitalization for psychosis. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate database-specific calibrated hazard ratios (HR), with estimates pooled where I2<40%. Results 918,144 and 290,383 users of hydroxychloroquine and sulfasalazine, respectively, were included. No consistent risk of psychiatric events was observed with short-term hydroxychloroquine (compared to sulfasalazine) use, with meta-analytic HRs of 0.96 [0.79-1.16] for depression, 0.94 [0.49-1.77] for suicide/suicidal ideation, and 1.03 [0.66-1.60] for psychosis. No consistent long-term risk was seen, with meta-analytic HRs 0.94 [0.71-1.26] for depression, 0.77 [0.56-1.07] for suicide/suicidal ideation, and 0.99 [0.72-1.35] for psychosis. Conclusions Hydroxychloroquine as used to treat RA does not appear to increase the risk of depression, suicide/suicidal ideation, or psychosis compared to sulfasalazine. No effects were seen in the short or long term. Use at higher dose or for different indications needs further investigation.
Keywords	COVID-19 ; Hydroxychloroquine ; Safety ; Rheumatoid Arthritis ; Psychosis ; Depression ; Sulfasalazine ; Risk ; covid19
Subject code	310
Publishing date	2020-08-07
Publishing country	eu
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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