title: [Optimal Operational Definition of Patient with Peptic Ulcer Bleeding for Big Data Analysis Using Combination of Clinical Characteristics in a Secondary General Hospital].
abstract: OBJECTIVE
  Peptic ulcer bleeding (PUB) is the most common cause of upper gastrointestinal bleeding in Korea but there has been no research done using big data. This study evaluates the optimal operational definition (OD) for big data research by analyzing clinical characteristics of PUB.
  
  
  METHODS
  We reviewed the clinical characteristics of 92 patients with PUB confirmed on endoscopy in Wonkwang University Sanbon Hospital (January 2013 to December 2014). We calculated sensitivity and positive predictive value (PPV) to detect confirmed PUB patients using ODs developed by combining clinical features of patients with PUB.
  
  
  RESULTS
  The mean patient age was 63 years. Men had higher prevalence of PUB than women. Bleeding gastric ulcer was proportionately common in the age range of 40s to 60s in men, while a significantly higher rate of bleeding occurred in women older than 70s. The rate of drug-induced ulcer was 28.2%, whereas the prevalence of Helicobacter pylori was 47.8%. Among the hospitalized patients with diagnostic code of PUB, we ruled out patients with endoscopic removal of gastric adenoma or peritonitis, and selected patients who had been administered intravenous proton pump inhibitor. The sensitivity in this setting was 82.6%, and PPV was 88.4%.
  
  
  CONCLUSIONS
  PUB was more common in older patients, and there was a clear gender difference in gastric ulcer bleeding by age. With a proper OD using PUB diagnostic codes, we can identify true patients with sufficiently high sensitivity and PPV.
authors.affiliation: Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors.forename: Hyun Ki
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Woo
authors.affiliation: Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors.forename: Jaehoon
authors.initials: J
authors.lastname: Jahng
authors.affiliation: Department of Medical Record, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors.forename: Young Ran
authors.initials: YR
authors.lastname: Jin
authors.affiliation: Big Data Steering Department, National Health Insurance Service, Wonju, Korea.
authors.forename: Jong Heon
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.|Scientific Committee of the Korean College of Helicobacter and Upper Gastrointestinal Research, Seoul, Korea.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.|Scientific Committee of the Korean College of Helicobacter and Upper Gastrointestinal Research, Seoul, Korea.
authors.forename: Hwoon Yong
authors.initials: HY
authors.lastname: Jung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D063728:Secondary Care Centers; D012737:Sex Factors
chemical_list: D054328:Proton Pump Inhibitors
keywords: Big data; Operational definition; Peptic ulcer hemorrhage; Predictive value of tests; Sensitivity and specificity