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Automated mass screening for comorbidities of vitiligo using the National Health Insurance database.

Although the study design for identifying specific disease associations using health insurance database has been well established, few studies explore unknown comorbidities. We conducted a series of automated case-control studies for all International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10) diagnostic codes (A01 to Z99) using the Korean National Health Insurance database from 2007 to 2017 to reveal undiscovered disease associations of vitiligo. A total of 90,297 vitiligo patients and 90,297 age- and sex-matched controls without vitiligo were included, and disease associations for 1,265 relevant diagnostic codes were screened. A meta-analysis of the individual odds ratios for each ICD-10 code was performed to identify the possibility of selection bias. Finally, the association with vitiligo was significantly increased in 45 diseases and decreased in 6 diseases. We not only reaffirmed the positive correlation between vitiligo and other autoimmune diseases, but also observed associations with obsessive-compulsive disorder and melanoma. On the other hand, femur fracture showed a negative correlation. In this study, we attempted an automated mass screening and suggested a possible selection bias. In the era of large-scale databases, a systematic and comprehensive approach might be needed.

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