Thiruvengadam Muniraj1, Dhiraj Yadav2, Judah N Abberbock3, Samer Alkaade4, Stephen T Amann5, Michelle A Anderson6, Peter A Banks7, Randall E Brand8, Darwin Conwell9, Gregory A Cote10, Christopher E Forsmark11, Timothy B Gardner12, Andres Gelrud13, Nalini Guda14, Michele D Lewis15, Joseph Romagnuolo16, Bimaljit S Sandhu17, Stuart Sherman18, Vikesh K Singh19, Adam Slivka8, Gong Tang3, David C Whitcomb20, C Mel Wilcox21. 1. Department of Medicine, Yale University, New Haven, CT, USA. 2. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: yadavd@upmc.edu. 3. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Medicine, Saint Louis University, St. Louis, MO, USA. 5. Digestive Health Specialists, Tupelo, MS, USA. 6. Department of Medicine, University of Michigan, Ann Arbor, MI, USA. 7. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 8. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 9. Department of Medicine, Ohio State University, Columbus, OH, USA. 10. Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. 11. Department of Medicine, University of Florida, Gainesville, FL, USA. 12. Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. 13. Gastro Health and Miami Cancer Institute, Miami, FL, USA. 14. Associates LLC, Aurora Health Care, St. Luke's Medical Center, Milwaukee, WI, USA. 15. Department of Medicine, Mayo Clinic, Jacksonville, FL, USA. 16. Palmetto Health, Columbia, SC, USA. 17. Richmond Gastroenterology Associates, St. Mary's Hospital, Richmond, VA, USA. 18. Department of Medicine, Indiana University, Indianapolis, IN, USA. 19. Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 20. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Cell Biology & Physiology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA. 21. Department of Medicine, University of Alabama Birmingham, Birmingham, AL, USA.
Abstract
BACKGROUND: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. METHODS: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008-2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000-2006). RESULTS: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32-8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. CONCLUSIONS: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.
BACKGROUND: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. METHODS: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008-2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000-2006). RESULTS: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32-8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. CONCLUSIONS: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.
Authors: Dhiraj Yadav; Robert H Hawes; Randall E Brand; Michelle A Anderson; Mary E Money; Peter A Banks; Michele D Bishop; John Baillie; Stuart Sherman; James DiSario; Frank R Burton; Timothy B Gardner; Stephen T Amann; Andres Gelrud; Christopher Lawrence; Beth Elinoff; Julia B Greer; Michael O'Connell; M Michael Barmada; Adam Slivka; David C Whitcomb Journal: Arch Intern Med Date: 2009-06-08
Authors: C Mel Wilcox; Dhiraj Yadav; Tian Ye; Timothy B Gardner; Andres Gelrud; Bimaljit S Sandhu; Michele D Lewis; Samer Al-Kaade; Gregory A Cote; Christopher E Forsmark; Nalini M Guda; Darwin L Conwell; Peter A Banks; Thiruvengadam Muniraj; Joseph Romagnuolo; Randall E Brand; Adam Slivka; Stuart Sherman; Stephen R Wisniewski; David C Whitcomb; Michelle A Anderson Journal: Clin Gastroenterol Hepatol Date: 2014-10-24 Impact factor: 11.382
Authors: Dhiraj Yadav; Adam Slivka; Stuart Sherman; Robert H Hawes; Michelle A Anderson; Frank R Burton; Randall E Brand; Michele D Lewis; Timothy B Gardner; Andres Gelrud; James Disario; Stephen T Amann; John Baillie; Christopher Lawrence; Michael O'Connell; Albert B Lowenfels; Peter A Banks; David C Whitcomb Journal: Pancreatology Date: 2011-01-18 Impact factor: 3.996
Authors: David C Whitcomb; Dhiraj Yadav; Slivka Adam; Robert H Hawes; Randall E Brand; Michelle A Anderson; Mary E Money; Peter A Banks; Michele D Bishop; John Baillie; Stuart Sherman; James DiSario; Frank R Burton; Timothy B Gardner; Stephen T Amann; Andres Gelrud; Simon K Lo; Mark T DeMeo; William M Steinberg; Michael L Kochman; Babak Etemad; Christopher E Forsmark; Beth Elinoff; Julia B Greer; Michael O'Connell; Janette Lamb; M Michael Barmada Journal: Pancreatology Date: 2008-09-03 Impact factor: 3.996
Authors: Merve Gurakar; Niloofar Y Jalaly; Mahya Faghih; Tina Boortalary; Javad R Azadi; Mouen A Khashab; Christopher Fan; Anthony N Kalloo; Atif Zaheer; Vikesh K Singh; Elham Afghani Journal: Scand J Gastroenterol Date: 2021-10-18 Impact factor: 3.027