The Stockholm CREAtinine Measurements (SCREAM) project: protocol overview and regional representativeness.
Björn Runesson, Alessandro Gasparini, Abdul Rashid Qureshi, Olof Norin, Marie Evans, Peter Barany, Björn Wettermark, Carl Gustaf Elinder, Juan Jesús Carrero
Author Information
Björn Runesson: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
Alessandro Gasparini: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
Abdul Rashid Qureshi: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
Olof Norin: Public Healthcare Services Committee, Stockholm County Council , Stockholm , Sweden.
Marie Evans: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
Peter Barany: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
Björn Wettermark: Public Healthcare Services Committee, Stockholm County Council, Stockholm, Sweden; Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.
Carl Gustaf Elinder: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Public Healthcare Services Committee, Stockholm County Council, Stockholm, Sweden.
Juan Jesús Carrero: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
BACKGROUND: We here describe the construction of the Stockholm CREAtinine Measurement (SCREAM) cohort and assess its coverage/representativeness of the Stockholm county in Sweden. SCREAM has the principal aims to estimate the burden and consequences of chronic kidney disease (CKD) and to identify inappropriate drug use (prescription of nephrotoxic, contraindicated or ill-dosed drugs). METHODS: SCREAM is a repository of laboratory data of individuals, residing or accessing healthcare in the region of Stockholm, who underwent creatinine assessments between 2006-11. Laboratory tests were linked to administrative databases with complete information on socioeconomic status, demographic data, healthcare utilization, diagnoses, vital status and dispensed prescription medicines. RESULTS: SCREAM identified 1 118 507 adult Stockholm citizens with available creatinine tests between 2006-11. This corresponded to 66% of the complete population in the region. Geographical coverage was uniform, ranging between 62 and 72% throughout its 26 municipalities. Population coverage was higher across older age strata (50% coverage for age range 18-44 years, >75% for 45-64 years and >90% coverage for ≥65 years). Of note, 97 and 98% of all individuals with a diagnosis of diabetes mellitus or cardiovascular disease, respectively, were captured by SCREAM. Further, 89% of all deaths registered in the period occurred in individuals with a creatinine test undertaken. CONCLUSION: SCREAM represents the largest cohort to estimate the burden and healthcare implications of CKD in Sweden. The coverage and representativeness of the region of Stockholm was high and in accordance to both the commonness of creatinine assessment, and the medical indications for creatinine testing. The inclusion of individuals who sought medical care and had a creatinine test undertaken resulted in a slight over-representation of elderly and comorbid patients.
