Supplemental tables: Clinical manifestations and healthcare utilization before diagnosis of transthyretin amyloidosis

<b>These are peer-reviewed supplementary materials for the article '</b><b>Clinical manifestations and healthcare </b><b>utilization before diagnosis of </b><b>transthyretin amyloidosis' published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Supplemental Table I:</b> Diagnostic testing and therapeutic procedures during three years prior to diagnosis<b>Supplemental Table II: </b>Healthcare utilization during three years prior to diagnosis<b>Introduction:</b> Initial clinical manifestations of transthyretin amyloidosis (ATTR) are not well understood, making timely diagnosis challenging. <b>Methods:</b> Patients aged ≥68 years newly diagnosed with ATTR were identified using Medicare Research Identifiable Files. Symptom manifestation and healthcare utilization were measured during 3 years pre-diagnosis; demographics and comorbidity index during 1-year prediagnosis. Controls (ATTR-free) werematched 1:1 to patientswith ATTR based on age, sex and region; same index date and enrollment as match. <b>Results:</b> We identified 552 matched ATTR-control pairs: mean age 78.3 (standard deviation 6.3) and 64.5% male. Among patients with ATTR (vs controls), cardiovascular conditions (92.9 vs 75.9%) and hospitalization (54.0 vs 35.5%) were frequent during 3 years pre-diagnosis. <b>Conclusion:</b> Patients with ATTR have multiple symptoms and hospitalizations pre-diagnosis, recognition of which may facilitate earlier diagnosis and treatment.

本材料为发表于《比较疗效研究杂志（Journal of Comparative Effectiveness Research）》的论文《转甲状腺素蛋白淀粉样变性确诊前的临床表现与医疗资源利用》的同行评议补充材料。
补充表I：确诊前三年的诊断检测与治疗操作
补充表II：确诊前三年的医疗资源利用情况
引言：转甲状腺素蛋白淀粉样变性（transthyretin amyloidosis，ATTR）的初始临床表现尚未被充分阐明，导致及时诊断颇具挑战。
方法：本研究利用医疗保险研究可识别档案（Medicare Research Identifiable Files）筛选出年龄≥68岁的新发ATTR确诊患者。在确诊前3年内统计患者的症状表现与医疗资源利用情况，确诊前1年内统计其人口统计学特征与共病指数。以1:1的比例，按照年龄、性别、地域匹配无ATTR的对照人群，且对照人群的索引日期与入组情况与病例组保持一致。
结果：本研究共纳入552对匹配的ATTR-对照人群，研究对象平均年龄为78.3岁（标准差6.3），男性占比64.5%。与对照组相比，ATTR患者在确诊前3年内的心血管疾病发生率（92.9% vs 75.9%）与住院率（54.0% vs 35.5%）均显著更高。
结论：ATTR患者在确诊前已出现多种症状与住院经历，识别此类特征有助于推动更早的诊断与治疗。