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The Dexter software platform demonstrates the connection between early trauma and immune disorders
The University of Birmingham Venture Dexter has demonstrated the power of its Dexter software platform in a study that found people whose childhoods included abuse, neglect or domestic abuse have a significantly increased risk of developing rheumatoid arthritis or psoriasis later in life. The starting point for the recently published study was a database of over 16 million electronic health records, from which Dexter software defined a cohort, an arm that was exposed to childhood abuse and an arm that was not. The software then reviewed the records for medical codes of immune-mediated inflammatory disorders over a 26-year period...
The Dexter software platform demonstrates the connection between early trauma and immune disorders
The University of Birmingham Venture Dexter has demonstrated the power of its Dexter software platform in a study that found people whose childhoods included abuse, neglect or domestic abuse have a significantly increased risk of developing rheumatoid arthritis or psoriasis later in life.
The starting point for the recently published study was a database of over 16 million electronic health records, from which Dexter software defined a cohort, an arm that was exposed to childhood abuse and an arm that was not.
The software then reviewed the records for medical codes of immune-mediated inflammatory disorders (IMIDs) over a 26-year period and found that childhood maltreatment was associated with increased incidence rates of rheumatoid arthritis and psoriasis.
The increase in risk was significant for both diseases, and the association was stronger in women than in men.
The study was conducted by Dr. Liam Snook from the University of Birmingham led.
To our knowledge, this is the first matched longitudinal cohort study to examine the association between childhood maltreatment and immune-mediated inflammatory disorders (IMIDs) later in life.
Previous studies were meta-analyses that synthesized data from multiple independent studies, and these showed an increased risk of IMIDs in people whose childhood was abusive.
However, to determine incidence (the number of new cases over time) you need a cohort over time in a longitudinal study, rather than showing the onset of disease that is typically recorded in primary care. “
Professor Joht Singh Chandan, senior author, clinical professor of public health and health, leads at Birmingham Health Partners
Longitudinal studies that repeatedly collect information from the same group of people over time allow analysis of change over time and the influence of previous life circumstances on health later in life.
The uniqueness of the study lies in the Dexter software and can quickly inspect large databases of longitudinal data with billions of data points and provide reproducible, accurate and transparent results.
Professor Chandan, who is also head of customer success at Dexter Software, points to two implications from studies using this type of “big data.” He said: "For scientists, the study identifies an area that warrants further investigation into biological pathways that may link early life stressors to these two immune diseases. For public health professionals, it paints a better picture of the patient.“
“This approach can be used to identify health care disparities, alert health care providers, deliver patient groups that need special attention, and ultimately allocate health care resources to meet those with the greatest needs. In the future, we plan to use this approach to look at additional longitudinal data sets in crime, social care, and mental health care.“
About the study
Starting from 16 million records, the software identified 13.2 million records eligible for the study based on age and data quality requirements.
From this, 256,130 records were identified 18 years ago of abuse (physical, sexual or emotional), neglect, domestic abuse, either by the GP or coded in the codes relating to social services involvement. The control group consisted of 712,478 records matched on age, gender, deprivation and GP surgeries.
The records of these two cohorts were reviewed for diagnostic codes for immune-mediated inflammatory diseases (rheumatoid arthritis, psoriasis, celiac disease, multiple sclerosis, inflammatory bowel disease, and systemic lupus erythematosus) over a period of 26 years ending in 2021.
Results showed that the child maltreatment cohort had a significantly increased risk of:
• Rheumatoid arthritis: 11.19/100,000 patient-years versus 7.77/100,000 patient-years (p = 0.003)
• Psoriasis: 152.79/100,000 patient-years versus 128.74/100,000 patient-years (p < 0.001).
Sources:
Snook, L.,et al.(2024). The risk of immune-mediated inflammatory diseases following exposure to childhood maltreatment: a retrospective cohort study using UK primary care data. Heliyon. doi.org/10.1016/j.heliyon.2024.e40493.