Geographical information system (GIS) as a new tool to evaluate epidemiology based on spatial analysis and clinical outcomes in acromegaly

Abstract

Geographical information systems (GIS) have emerged as a group of innovative software components useful for projects in epidemiology and planning in Health Care System. This is an original study to investigate environmental and geographical influences on epidemiology of acromegaly in Brazil. We aimed to validate a method to link an acromegaly registry with a GIS mapping program, to describe the spatial distribution of patients, to identify disease clusters and to evaluate if the access to Health Care could influence the outcome of the disease. Clinical data from 112 consecutive patients were collected and home addresses were plotted in the GIS software for spatial analysis. The buffer spatial distribution of patients living in Brasilia showed that 38.1 % lived from 0.33 to 8.66 km, 17.7 % from 8.67 to 18.06 km, 22.2 % from 18.07 to 25.67 km and 22 % from 25.68 to 36.70 km distant to the Reference Medical Center (RMC), and no unexpected clusters were identified. Migration of 26 patients from 11 others cities in different regions of the country was observed. Most of patients (64 %) with adenomas bigger than 25 mm lived more than 20 km away from RMC, but no significant correlation between the distance from patient’s home to the RMC and tumor diameter (r = 0.45 p = 0.20) nor for delay in diagnosis (r = 0.43 p = 0.30) was found. The geographical distribution of diagnosed cases did not impact in the latency of diagnosis or tumor size but the recognition of significant migration denotes that improvements in the medical assistance network are needed.

Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer

“…The Southeast and South regions of Brazil are the most developed and sites of referral centers for high complexity, including cancer diagnosis and treatment. There may be a migration of cases to such regions, a phenomenon already documented in the country by Naves et al [ 66 ]. Therefore, although many studies indicate increased risk of development and death from oral cancer in people in areas of greater socioeconomic vulnerability [ 31 , 55 , 56 , 60 , 67 ], there is still uncertainty and limited knowledge about the relationship between socioeconomic factors and oral cancer.…”

“…Three hypotheses have been raised to explain these findings. First, more developed urban centers with better organization of the work process may have more services available, resulting in immigration of cases and increasing mortality rates recorded in these locations [ 66 ]. Secondly, it is possible that the oral health care model in Brazil is still not effectively identifying early stage cases.…”

Geographic information system analysis on the distribution of patients visiting the periodontology department at a dental college hospital

“…Geographic information systems (GISs) are computer-based tools that facilitate the mapping and analysis of geographical data [ 1 ]. The recent development of GIS has enhanced accessibility to spatial data, and the development of spatial analysis has enabled the study of epidemiology in a spatiotemporal dimension of the environment, which was otherwise impossible [ 2 3 ]. In particular, GIS connects individuals with the environment and provides more insight for the understanding of the spatial distribution of patients affected by a certain disease [ 4 5 6 ].…”

A GIS-based spatial correlation analysis for ambient air pollution and AECOPD hospitalizations in Jinan, China

“…Better interpretation of the patterns, trends and relationships between disease and demography, environment, space and time could be obtained through GIS. Thus GIS has important application in medical and health area, especially in the application of etiological research [11,12].…”