tbuckley/cabot-search huggingface dataset:
Vorasidenib (VOR; AG-881), an inhibitor of mutant IDH1 and IDH2, in patients (pts) with recurrent/progressive glioma: Updated results from the phase I non-enhancing glioma population.
Authors: Ingo K. Mellinghoff, Katherine B. Peters, Timothy Francis Cloughesy, Howard A. Burris III, Elizabeth Anne Maher, Filip Janku, Gregory Michael Cote, Macarena Ines De La Fuente, Jennifer Leigh Clarke, Kha Le, Li Liu, Man Yuen, Marissa Arnofsky, Islam Hassan, Lori Steelman, Shuchi Sumant Pandya, Patrick Y. Wen
Journal: Journal of Clinical Oncology (2020)

2504 Background: Isocitrate dehydrogenase 1 and 2 mutations (m IDH1/2) occur in approximately 70% and 4% of low-grade gliomas (LGGs), respectively, promoting oncogenesis via increased production of D-2-hydroxyglutarate. In this ongoing phase 1 trial, VOR, a potent, oral, reversible, brain-penetrant, first-in-class dual inhibitor of mIDH1/2, is being evaluated in advanced m IDH1/2 solid tumors, including gliomas. Safety and preliminary results were presented previously (Mellinghoff et al., J Clin Oncol 2018). Here, we report updated data for the non-enhancing glioma pt population. Methods: Pts with recurrent/progressive m IDH1/2 glioma received VOR daily (continuous 28-day cycles). Key eligibility criteria included: ≥18 years; histologically or cytologically confirmed glioma with documented m IDH1/2; ECOG 0-2; and evaluable disease by RANO-LGG criteria. Dose escalation cohorts enrolled using a Bayesian logistic regression model (BLRM) escalation guided by the overdose control (EWOC). Tumor response was evaluated by MRI every 8 weeks using RANO-LGG criteria by local assessment. Results: As of 28 Nov 2019, 22 pts with non-enhancing glioma had received VOR and 8 (36%) remain on treatment. M/F, 8/14; grade 2/3, 17/5; median age, 47 years; m IDH1/2, 20/1; 1p19q intact, 9/22; median (range) number of prior systemic therapies, 2 (1–4). Common (≥5 pts) treatment-emergent adverse events (AEs) of any grade and regardless of causality included increased ALT/AST (63.6%/59.1%), headache (45.5%), nausea (40.9%), neutropenia (31.8%), fatigue and hyperglycemia (27.3% each), and seizures and decreased white blood cell count (22.7% each). Transaminase elevations were grade 1 in severity at dose levels &lt; 100mg and were less frequent (5 [38.5%] of 13 pts). Three subjects had related grade ≥3 AEs; 2 discontinued due to AEs. Objective response rate was 13.6% (1 partial response, 2 minor responses), and 17 (77.3%) pts achieved stable disease. 60.5% of pts were progression free and alive at 24 months. Conclusions: In this previously treated population with non-enhancing glioma, VOR was associated with a favorable safety profile. The study results also show encouraging preliminary activity within that population, with PFS duration extending to 24 months or longer in 60% of participants. A global randomized phase 3 study of VOR in grade 2 non-enhancing glioma pts who have had surgery only is currently enrolling (NCT04164901). Clinical trial information: NCT02481154 .
A study on depression in patients with chest pain
Authors: 杨利群, 李田昌, 胡大一, 边红
Journal: BMJ (2006)

目的 了解因胸痛住院、行冠状动脉介入诊疗的患者伴随抑郁的情况及冠心病患者伴随抑郁的相关危险因素.方法154名准备行冠状动脉介入手术且符合条件的患者入选.应用抑郁自评量表对所有患者于术前2 d内进行评分.结果118例冠心病(冠状动脉造影阳性)患者中51例(43.2%)伴随抑郁;36例非冠心病(冠状动脉造影阴性)患者中8例(22.2%)伴随抑郁,两组间差异有统计学意义.伴随抑郁者出现冠心病的比值比(OR)为2.44(95%CI 1.01～5.90,P=0.047).对于冠心病患者来说,合并糖尿病、心绞痛症状重、心功能分级差、有生活事件、高收入者伴随抑郁的OR值分别为2.85(95%CI 1.21～6.73,P=0.017)、2.84(95%CI 1.09～7.39,P=0.033)、3.97(95%CI 1.23～12.79,P=0.021)、3.57(95%CI 1.32～9.66,P=0.012)、0.29(95%CI 0.09～0.88,P=0.029).冠心病伴或不伴随抑郁其冠状动脉病变严重程度差异无统计学意义.结论冠心病患者中抑郁患病率高,抑郁是冠心病的独立危险因素;糖尿病、心绞痛症状重、心功能差、有生活事件是冠心病患者出现抑郁的危险因素,而高收入是抑郁的保护因素;抑郁与冠状动脉病变严重程度无关。
Retrospective review of chronic pain causes and management in multiple myeloma patients.
Authors: Ami Atulkumar Dave, Jaime K Lewis, Agne Paner
Journal: Journal of Clinical Oncology (2020)

e20552 Background: The survival of patients with multiple myeloma has improved dramatically since the introduction of proteasome inhibitors such as bortezomib, which can have the adverse effect of peripheral neuropathy. This study retrospectively examines causes of chronic pain in myeloma patients and the modalities and duration of treatments used for pain control. Methods: Rush University Medical Center multiple myeloma patients who were diagnosed and treated between 2000-2019 were included. Outcome measures were abstracted from the medical record and included: classes of pain medication used, duration of treatment, prevalence of peripheral neuropathy symptoms, and use of adjunct treatment modalities. Descriptive statistical models including Chi-square and Fisher’s exact test were used for categorical variable analysis. Results: In all, 134 patients were included, of which 75.4% (N = 101) patients received at least one cycle of bortezomib. 42.5% (N = 57) patients were seen in palliative clinic. 72.9% (N = 97) reported bone pain symptoms. A total of 73.7% (N = 98) patients experienced peripheral neuropathy symptoms. 86.1% (N = 87) of patients who received bortezomib reported neuropathy, as compared to 34.4% (N = 11) of patients who did not have bortezomib therapy (OR 11.8, p &lt; 0.0001). 66.4% (N = 67) patients who received bortezomib took anticonvulsants as compared to 31.3% (N = 10) of those who did not receive bortezomib (OR 4.3, p &lt; 0.0005). Patients were on anticonvulsant therapy for a mean of 32.6 months (SD = 26.7) with no significant difference in the bortezomib group. 79.7% (N = 106) patients took opioid medications. Norco was the most commonly used opioid (N = 55) and average duration of use was 36.6 months (SD = 34). 18.8% (N = 25) took antidepressant medications such as TCAs or SNRIs for pain, and all of these patients received bortezomib therapy (p = 0.0003). 36.6% (N = 45) of patients received radiation and 16.5% (N = 22) underwent kyphoplasty. 70.7% (N = 94) patients attended at least one physical therapy session. There was no statistically significant difference in radiation or kyphoplasty utilization between patients who had received bortezomib and those who had not, but there was a significant difference in physical therapy (OR 4.9, p &lt; 0.0001). Conclusions: Patients who received bortezomib as part of their myeloma treatment were more likely to experience peripheral neuropathy and required anticonvulsant therapy more frequently. It is important to better understand and define the health burden of chronic pain and use of pain medications in patients with multiple myeloma.
由病例认识慢性阻塞性肺疾病与哮喘的鉴别诊断
Authors: 陈欣, 林江涛
Journal: BMJ (2008)

患者女,55岁.主述慢性咳喘30余年,加重5d入院.30年前出现慢性咳嗽、咳痰、喘息症状,每年9月份至11月份发作.10年前症状开始加重,发作时间延长至每年的8月底至12月份.曾被就诊医院诊断慢性支气管炎,哮喘,经消炎、平喘治疗后症状可以较快缓解。
Low dose spironolactone alleviates cardiac remolding in patients with NYHA daass I - II heart failure
Authors: Hong-yan Duan, Yong-qiang Li, Ping Luo, Hai-tao Yang, Shi-chao Zhao, Jian-min Lu, Yan-sheng Huang, Li-xia Wang
Journal: BMJ (2011)

Objective To evaluate the efficacy and safety of spironolactone in treatment NYHA (New York Heart Association) class Ⅰ - Ⅱ heart failure patients. Methods Eighty eight patients with NYHA class Ⅰ - Ⅱ heart failure were randomized to sprionolactone or placebo groups. Patients were assessed by echocardiography and 6-minute walking test (6MWT) ,plasma aldosterone and NT-proBNP were measured before and 6 months after treatment; serum potassium and creatinine were monitored through the study. Results The E/A and E/E' in spironolactone group were significantly lower than those of control group (1.2±0.7 vs. 1.7±0.6, P=0.007;15.2±2.3vs. 17.7±3.0, P=0.000). No differences were observed in left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)between two groups after treatment. Left ventricular mass index (LVMI) in spironolactone group decreased after theatment [(117 ±27) g/m2 vs. (112 ± 19) g/m2,P = 0.044]. Plasma aldosterone level in spironolactone group after treatment was significantly lower than that of control group [ ( 157 ± 16) ng/L vs.( 165 ± 16) ng/L, P =0. 021 ]. Although there were no differences in plasma NT-proBNP level between two groups after treatment, it decreased significantly comparing with that of before treatment ( P = 0. 000). No differences were observed in serum potassium and creatinine between two groups after treatment. However serum potassium and creatinine in spironolactone group increased significantly after treatment [ ( 83 ± 18 )pmol/Lvs. (87 ± 22) μmol/L, P =0.047; (4.4 ±0.4) mmoL/L vs. (4.5 ±0.6) mmol/L, P =0. 012]. Conclusion Spironolactone can alleviate cardiac remolding and diastolic function in NYHA class Ⅰ - Ⅱ heart failure patients.

Key words: 
Heart failure, congestive;  Spironolactone;  Therapy
Community healthcare service improvement and public hospital reform
Authors: 李长明
Journal: BMJ (2009)

社区卫生服务的发展受到了很多大医院关注,有些大医院伸腿办社区卫生服务中心或让专家到周边社区参加一些诊疗工作,帮助发展社区卫生服务,这很好.但在发展社区卫生服务中大医院究竟应该如何发挥作用?还应从改革深层面上思考和讨论.大医院与社区卫生服务中心相比,从历史渊源、资源占有、诊治功能、社会认知度和影响力等方面都占有绝对的优势。
Oncology volume assessment program: Novel approach to determine patient volumes at Vanderbilt-Ingram Cancer Center (VICC) and Vanderbilt University Medical Center (VUMC).
Authors: Leeland Ekstrom, Michael K. Gibson, Jordan Berlin, Judsen Schneider, James Stover
Journal: Journal of Clinical Oncology (2020)

e14047 Background: There is currently a lack of easily-accessible data regarding the volume and type of cancer patients seen at VUMC, despite extensive use of an electronic medical record (EMR) with a dedicated tumor registry. This leads to errors in estimating metrics that depend on subject accrual to clinical trials. We aimed to develop a tool to determine the number of head and neck squamous cell carcinoma (HNSCC) patients, stratified by desired subsets, seen yearly at the VUMC in order to achieve a more accurate and efficacious approach to estimating future patient accrual to clinical trials. Methods: Working with Nashville Biosciences, we identified patients with HNSCC using ICD codes in combination with VUMC’s Tumor Registry data (collected for patients diagnosed and treated at VUMC). We estimated the rate of accrual of HNSCC patient blood samples (a proxy for ICD code) based on the number of specimens acquired over the past 3 years. Each patient was counted only once based on their first blood sample acquired during this period, based on a comprehensive list of laboratories and clinical procedures that require a specimen to be drawn. We then evaluated the distribution of patients by primary site, standardized to SEER registry terminology. We also investigated what fraction of patients received treatment with surgery, radiation, and/or chemotherapy (we expect that this includes treatment with biologics) using a combination of ICD9/10 and CPT coding. Results: We identified a total of 1,131 HNSCC patients. SEER summary staging information was available for 603 patients - 432 (72%) had Stage 1-3 disease and 171 (28%) had Stage 4 disease. Primary site data was available for 717 patients - 648 (90%) HNSCC of the oral cavity, 20 (3%) had HNSCC of the oropharynx, 29 (4%) HNSCC of the larynx, 20 (3%) HNSCC of the hypopharynx. Of all patients, we found that 598 had at least 1 code for chemotherapy, 540 for radiotherapy, and 825 for surgery such that the majority (96%) received cancer treatment. We have not evaluated the timing of the treatment relative to diagnosis. Conclusions: By using ICD codes and tumor registry data extracted from VUMC’s EMR, we determined the site distribution and type of treatment for HNSCC over a 3-year period. The disease site distribution did not match prior experience Refinements are ongoing. However, once improved, these methods may be used to estimate future clinical trial accrual, thus reducing start-up time, cost and poor trial site performance, while increasing accrual.
Preliminary evaluate the safety and efficacy of anlotinib in advanced sarcoma patients in multi-line therapy.
Authors: Yao Weitao, Jiaqiang Wang, Peng Zhang, Xin Wang, Xinhui Du, Zhichao Tian, Xiaoying Niu
Journal: Journal of Clinical Oncology (2020)

11526 Background: Patients with advanced bone and soft tissue sarcoma are mostly treated with chemotherapy, but the effect is poor. Anlotinib hydrochloride is a multi-targeted receptor of tyrosine kinase inhibitors (TKI), which has demonstrated therapeutic effects on a variety of sarcoma subtypes, and is approved for the treatment of advanced soft tissue sarcomas in China. Methods: This is a single-arm, prospective, single-center clinical study. The included criteria were patients with pathological diagnose of bone and soft tissue sarcoma, at least one measurable lesion (according to RECIST 1.1), failed of more than first-line therapy (except for alveolar soft tissue sarcoma) in the last 6 months, with the normal function of main organs. All patients received anlotinib for more than 1 month. The primary study endpoint was objective response rate (ORR). Disease control rate (DCR) and side effects was also calculated. Results: At the latest follow up in Jan. 20th, 2020, a total of 31 patients were enrolled. The median age of the patients was 38 (8-79) years. The main subtypes included osteosarcoma (25.8%), undifferentiated pleomorphic sarcoma (19.4%), synovial sarcoma (16.1%), fibrosarcoma (12.9%). 83.9% of patients received for at least third-line therapy of anlotinib. The oral administration time was 1.5-15 months, with the average of 4.34 months. The ORR was 29%. The DCR was 77.4%. Patients who had received other TKI drugs had an ORR of 20% and a DCR of 70% in 10 cases (32.2%) in this group. mPFS and mOS have not been reached. Adverse events were mainly in grades I and II, including 6 (19.4%) of anorexia or diarrhea, 5 (16.1%) of pain, 4 (12.9%) of hand-foot syndrome, 3 (9.7%)of hypertension, fatigue and mucosa ulcer each. One case had hypertension in grades III. Conclusions: Anlotinib has shown a definite effect in the treatment of advanced sarcomas. Effectiveness can also be observed in patients who have failed in other targeted therapy. The adverse events are minor and can be tolerated. Clinical trial information: NCT04223583 .
无痛胃镜检查的临床观察
Authors: 徐宝宏, 陈雪华, 李静, 马敬梅, 张凤英
Journal: BMJ (2007)

对2005年7月至12月门诊和住院的120例患者施行无痛胃镜检查、治疗,结果除1例食管癌合并食管气管瘘的患者因插镜过程中出现刺激性呛咳而终止检查外,其余119患者均顺利完成检查及治疗,成功率99.2%.患者术后一般2～8 min清醒,无严重并发症及副反应.提示无痛胃镜检查是一种安全、有效、舒适的方法。
Palbociclib in hormone positive metastatic breast cancer: A real world multicenter Indian experience.
Authors: Amit Rauthan, Poonam Patil, S.P. Somashekhar, Linu Abraham Jacob, Lokanatha D, Kishore Kumar, Pavithran Keechilat, DK Vijayakumar, Shekar Patil, Shashidhara H P, Shabber Zaveri, Nitin Yashas
Journal: Journal of Clinical Oncology (2020)

e13057 Background: Palbociclib, a selective CDK4/6 inhibitor, in combination with hormonal therapy has become the standard of care in the treatment of hormonal positive (HR+) metastatic breast cancer (MBC). There is limited efficacy and safety data in Indian patients. Methods: This is a multicenter retrospective study of real world experience of patients with HR+, Her 2 neu negative MBC who received Palbociclib in 5 centers of south India between Oct 2016 and Aug 2019. Endpoints were overall response rate (ORR), progression free survival (PFS) and toxicity. Results: 133 patients received Palbociclib; 83 (62.4%) in the first line setting (hormone naïve MBC) and 50 (37.6%) in the second line (MBC progressed on at least one line of hormonal therapy). Median age was 56 years (range 48-76). All patients started with 125mg/day. In the 83 first line patients, 46 (55.4%) had denovo MBC, 37 (44.6%) had post-adjuvant relapse. 38 (45.8%) had bone only and 45 (54.2%) had visceral metastases. Letrozole was the companion drug in 76%, Fulvestrant in 18%, Exemestane in 6%. 5 (6%) patients achieved complete response (CR), 54 (65%) partial response (PR), 12 (14.5%) stable disease (SD) and 12 (14.5%) had progressive disease (PD). ORR was 71%. At a median followup of 18 months, the median PFS was not reached (maximum ongoing followup 38 months). The median PFS in the denovo metastatic disease versus relapsed disease was not reached versus 18 months (p = 0.021). The median PFS was significantly better in bone only versus visceral metastases (not reached versus 28 months, p = 0.007). In the 50 second line patients, 15 (30%) had bone only and 35 (70%) had visceral metastases. Companion drug was Fulvestrant in 64%, Letrozole in 20%, Exemestane in 16%. 60% received prior chemotherapy. Best response was CR 3 (6%), PR 23 (46%), SD 4 (8%), PD 17 (34%), not assessed 3 (6%). ORR was 52%. The median PFS was 14 months. PFS in bone only versus visceral disease was 14 months versus 13 months (p = 0.382). Neutropenia was present in 75.2%, thrombocytopenia in 19.5%, anaemia in 18%. Neutropenia was grade 1 in 26%, grade 2 in 51%, grade 3 in 23%; with no febrile neutropenia. 30% had dose delays and 8.2% had dose reduction. Conclusions: Palbociclib has resulted in similar efficacy and safety in Indian patients as the PALOMA trials. Neutropenia was the commonest side effect, which was uncomplicated and easily managed with dose delays. Using CDK4/6 inhibitors with hormonal therapy has become the standard of care in HR+ MBC Indian patients.
Strategy and practice of maternal health care
Authors: 王临虹, 狄江丽
Journal: BMJ (2007)

建国以来,我国孕产期保健工作取得了长足的发展,母婴健康水平显著提高.为进一步提高管理水平,把各级医疗保健机构组织起来,明确职责分工,密切配合,做到临床和保健相结合,提高防治质量,降低孕产妇死亡率、围产儿死亡率、残疾儿出生率和提高新生儿的健康素质,我国卫生部分别于1987年和1989年制定了《全国城市围产保健管理办法(试行)》和《农村孕产妇系统保健管理办法(试行)》。
一次性胸腔穿刺装置的研制及临床应用
Authors: 蒋毅, 王君
Journal: BMJ (2006)

传统的胸腔穿刺针针尾连接一橡皮胶管,以便和注射器相连,但在临床使用中有如下不足之处.[1]:①橡皮胶管口径大,和注射器连接不严密,需用手用力捏紧,否则有可能并发气胸.[2] ;②在穿刺过程中排空注射器时,常先用止血钳夹闭橡皮胶管,不方便;③穿刺针尖进入胸膜腔多凭针尖的抵抗感突然消失为判断标志,而当抵抗感的变化不明显时则易致穿刺过深,有可能伤及肺脏;④传统的穿刺针为反复消毒重复使用的器材,存在造成交叉感染的危险;⑤如无消毒穿刺包,则无法进行穿刺,延误治疗.因此,本研究将穿刺针装置进行改进,设计为一次性胸腔穿刺装置(国家实用新型专利,专利号:ZL 200520082146.1),经临床应用,效果满意.现将结果报道如下。
A combined genomic and immune profile in patients with head and neck squamous cell carcinoma treated with immunotherapy: A pilot study.
Authors: Andrea Botticelli, Silvia Mezi, Giulia Pomati, Ilaria Zizzari, Bruna Cerbelli, Giulia Mammone, Alessandro Corsi, Cira di Gioia, Giulia D'Amati, Carlo della Rocca, Carlo Catalano, Marco De Vincentiis, Antonella Polimeni, Valentino Valentini, Vincenzo Tombolini, Marianna Nuti, Paolo Marchetti
Journal: Journal of Clinical Oncology (2020)

e18506 Background: In head and neck squamous cell carcinoma (HNSCC) only a small subset of patients (pts) really benefits from immunotherapy, suggesting the need of validated molecular and immunological predictive biomarkers. The aim of the study was to evaluate both the genomic and immune profile of HNSCC correlating it to early progression to immunotherapy. Methods: This is a pilot study evaluating immune and molecular profile in platinum-refractory HNSCC pts treated with Nivolumab. Blood samples were collected at baseline (T0) and at second cycle of therapy (T1). The immune profile was studied by multiplex assay, evaluating circulating: CD137, CTLA4, PD1, PDL1, PDL2, CD27, TIM3, LAG3, GITR, HVEM, BTLA, CD80, CD28 and IDO. The comprehensive genomic profile was evaluated at baseline on formalin-fixed paraffin-embedded samples of the tumor through Foundation One Cdx test. The results obtained were correlated with early progression (within 3 months from the start of therapy). Results: Ten pts were enrolled in the study. Early progression occurred in 6 pts (60%). Median progression free survival and overall survival were 3 months (1-11) and 6.5 months (1-12), respectively. In all patients ≥ 5 genetic mutations were detected; median number of mutation was 6 (5-14); 8/10 pts had a tumor mutational burden less than 10 Muts/mb. The more frequent genetic alterations involved the cycline-dependent-kynase pathway (9/10), the transcription factor associated gene TP53 (8/10) and the PI3K-Akt-PTEN signaling pathways (5/10). Less frequent alterations involved FGFR family (4/10), NOTCH signaling pathway (3/10) and TERT (4/10). Early progression was slightly associated with the number of mutations detected (p = 0.06). The rising or falling trend of circulating levels of biomarkers were detected in 9/10 pts and included modification in IDO (1/10), LAG3 (3/10), GITR (3/10), BTLA (3/10), CD137 (4/10), CTLA4 (4/10), PD1 (2/10), Tim3 (3/10), CD28 (3/10), HVEM (3/10), CD80 (2/10). No modifications were recorded in PDL1, PDL2 and CD27. Conclusions: Our results, although in a small cohort, highlighted the complexity and heterogeneity of landscape in HNSCC pts. A novel evaluation that combines molecular and immune profile is needed. In the context of a poor prognosis disease the combination of personalized molecular and immune approaches could represent a promising strategy to improve survival.
脑外伤致异地口音综合征一例
Authors: 王文涛, 张雨秀
Journal: BMJ (2004)

患者男性,50岁.因车祸致昏迷24 h入院.查体:浅昏迷,躁动不安,双侧上下眼睑可见皮下淤血,右侧脑脊液耳漏,左侧巴宾斯基征(+),格拉斯哥昏迷评分8分.头颅CT示左颞部硬膜外血肿,额骨骨折,右颞部脑挫伤.给予脱水降颅压、预防感染等治疗,7 d后神志转清,出现自发语言错乱.34 d出院,偶有烦躁,语言错乱好转,近记忆力、定向力丧失。
Development and Validation of the Chronic Disease Population Risk Tool (CDPoRT) to Predict Incidence of Adult Chronic Disease
Authors: Ryan Ng, Rinku Sutradhar, Kathy Kornas, Walter P. Wodchis, Joykrishna Sarkar, Randall Fransoo, Laura C. Rosella
Journal: JAMA Network Open (2020)

Predicting chronic disease incidence for the population provides a comprehensive picture to health policy makers of their jurisdictions' overall future chronic disease burden. However, no population-based risk algorithm exists for estimating the risk of first major chronic disease.To develop and validate the Chronic Disease Population Risk Tool (CDPoRT), a population risk algorithm that predicts the 10-year incidence of the first major chronic disease in the adult population.In this cohort study, CDPoRT was developed and validated with 6 cycles of the Canadian Community Health Survey, linked to administrative data from January 2000 to December 2014. Development and internal validation (bootstrap and split sample) of CDPoRT occurred in Ontario, Canada, from June 2018 to April 2019 followed by external validation in Manitoba from May 2019 to July 2019. The study cohorts included 133 991 adults (≥20 years) representative of the Ontario and Manitoba populations who did not have a history of major chronic disease.Predictors were routinely collected risk factors from the Canadian Community Health Survey, such as sociodemographic factors (eg, age), modifiable lifestyle risk factors (ie, alcohol consumption, cigarette smoking, unhealthy diet, and physical inactivity), and other health-related factors (eg, body mass index).Six major chronic diseases were considered, as follows: congestive heart failure, chronic obstructive pulmonary disease, diabetes, myocardial infarction, lung cancer, and stroke. Sex-specific CDPoRT algorithms were developed with a Weibull model. Model performance was evaluated with measures of overall predictive performance (eg, Brier score), discrimination (eg, Harrell C index), and calibration (eg, calibration curves).The Ontario cohort (n = 118 747) was younger (mean [SD] age, 45.6 [16.1] vs 46.3 [16.4] years), had more immigrants (23 808 [20.0%] vs 1417 [10.7%]), and had a lower mean (SD) body mass index (26.9 [5.1] vs 27.7 [5.4]) than the Manitoba cohort (n = 13 244). During development, the full and parsimonious CDPoRT models had similar Brier scores (women, 0.087; men, 0.091), Harrell C index values (women, 0.779; men, 0.783), and calibration curves. A simple version consisting of cigarette smoking, age, and body mass index performed slightly worse than the other versions (eg, Brier score for women, 0.088; for men, 0.092). Internal validation showed consistent performance across models, and CDPoRT performed well during external validation. For example, the female parsimonious version had C index values for bootstrap, split sample, and external validation of 0.778, 0.776, and 0.752, respectively.In this study, CDPoRT provided accurate, population-based risk estimates for the first major chronic disease.