Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records.

This research article examines the relationship between various risk factors, including disease and medication, and the occurrence of first and subsequent episodes of a horse disease known as laminitis. The findings were obtained through analyzing electronic medical records from equine veterinary practice in the UK.

Research methods and findings

• The researchers applied text mining techniques to electronic medical records from seven UK veterinary practices. The aim was to identify episodes of laminitis, a painful and potentially crippling disease in horses, and any associated disease or pharmacologic risk factors. Specifically, they looked for indications of systemic or intra-synovial corticosteroid prescription (a type of medication that can potentially promote laminitis), and certain diseases or clinical signs that increase laminitis risk.
• To measure the associations between these risk factors and the occurrence of laminitis episodes, they employed statistical models called Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events.
• Through their analysis, the researchers found that over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. However, the risk factors contributing to the first laminitis episode and those leading to subsequent episodes showed variation. In particular, corticosteroid use (specifically the drug prednisolone) was found to be significantly associated only with subsequent laminitis episodes, not with the initial ones.

Implications and considerations

• The findings from this research shed light on the potential risk factors of laminitis and their varying impact on the recurrence of the disease. This could inform veterinary practices in the treatment and prevention of laminitis in horses.
• The use of electronic medical records in this study proved to be a useful resource for epidemiological research, offering advantages over more traditional data sources. However, it also posed certain challenges and limitations. For instance, these records may lack standardization and completeness, or may depend on the accuracy of data entry by veterinary staff.
• The research also underscores the need for a conceptual shift in disease diagnosis. That is, looking beyond the initial disease occurrence to consider the potential risk factors associated with subsequent disease episodes.