{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:50:52Z","timestamp":1791445852715,"version":"4.3.3"},"reference-count":32,"publisher":"BMJ","issue":"5","funder":[{"name":"New Zealand Lottery Health Research"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,20]]},"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the incidence of primary care presentations for herpes zoster (zoster) in a representative New Zealand population and to evaluate the utilisation of primary healthcare services following zoster diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional retrospective cohort study used a natural language processing software inference algorithm to identify general practice consultations for zoster by interrogating 22\u2009million electronic medical record (EMR) transactions routinely recorded from January 2005 to December 2015. Data linking enabled analysis of the demographics of each case. The frequency of doctor visits was assessed prior to and after the first consultation diagnosing zoster to determine health service utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>General practice, using EMRs from two primary health organisations located in the lower North Island, New Zealand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Thirty-nine general practices consented interrogation of their EMRs to access deidentified records for all enrolled patients. Out-of-hours and practice nurse consultations were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The incidence of first and repeated zoster-related visits to the doctor across all age groups and associated patient demographics. To determine whether zoster affects workload in general practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, for 6 189 019 doctor consultations, the incidence of zoster was 48.6 per 10\u2009000 patient-years (95%\u2009CI 47.6 to 49.6). Incidence increased from the age of 50 years to a peak rate of 128 per 10\u2009000 in the age group of 80\u201390 years and was significantly higher in females than males (p&lt;0.001). Over this 11-year period, incidence increased gradually, notably in those aged 80\u201385 years. Only 19% of patients had one or more follow-up zoster consultations within 12 months of a zoster index consultation. The frequency of consultations, for any reason, did not change between periods before and after the diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Zoster consultations in general practice are rare, and the burden of these cases on overall general practice caseload is low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-021241","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:01:31Z","timestamp":1527811291000},"page":"e021241","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Quantifying the incidence and burden of herpes zoster in New Zealand general practice: a retrospective cohort study using a natural language processing software inference algorithm"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8760-5245","authenticated-orcid":false,"given":"Nikki M","family":"Turner","sequence":"first","affiliation":[{"name":"Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayden","family":"MacRae","sequence":"additional","affiliation":[{"name":"DataCraft Analytics Limited, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L","family":"Nowlan","sequence":"additional","affiliation":[{"name":"Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"McBain","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria H","family":"Stubbe","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Dowell","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,5,31]]},"reference":[{"key":"2025121512201012000_8.5.e021241.1","doi-asserted-by":"publisher","DOI":"10.2217\/fvl.10.90"},{"key":"2025121512201012000_8.5.e021241.2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268801005921"},{"key":"2025121512201012000_8.5.e021241.3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.18773\/austprescr.2012.067","article-title":"Herpes zoster: epidemiology, clinical features, treatment and prevention","volume":"35","author":"Wehrhahn","year":"2012","journal-title":"Aust Prescr"},{"key":"2025121512201012000_8.5.e021241.4","doi-asserted-by":"crossref","first-page":"S207","DOI":"10.1086\/522152","article-title":"The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine","volume":"197 Suppl 2","author":"Schmader","year":"2008","journal-title":"J Infect Dis"},{"key":"2025121512201012000_8.5.e021241.5","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268808000678"},{"key":"2025121512201012000_8.5.e021241.6","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a3516e"},{"key":"2025121512201012000_8.5.e021241.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-004833","article-title":"Systematic review of incidence and complications of herpes zoster: towards a global perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"2025121512201012000_8.5.e021241.8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-170"},{"key":"2025121512201012000_8.5.e021241.9","first-page":"1341","volume-title":"Mayo Clinic Proceeding","volume":"82","author":"Yawn","year":"2007"},{"key":"2025121512201012000_8.5.e021241.10","first-page":"56","article-title":"Herpes zoster (shingles) at a large New Zealand general practice: incidence over 5 years","volume":"127","author":"Reid","year":"2014","journal-title":"N Z Med J"},{"key":"2025121512201012000_8.5.e021241.11","doi-asserted-by":"publisher","DOI":"10.1586\/erv.10.30"},{"key":"2025121512201012000_8.5.e021241.12","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-11-201312030-00006"},{"key":"2025121512201012000_8.5.e021241.13","doi-asserted-by":"publisher","DOI":"10.1086\/430325"},{"key":"2025121512201012000_8.5.e021241.14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq077"},{"key":"2025121512201012000_8.5.e021241.15","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21599"},{"key":"2025121512201012000_8.5.e021241.16","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268807007893"},{"key":"2025121512201012000_8.5.e021241.17","first-page":"265","article-title":"Varicella and herpes zoster vaccines: WHO position paper, June 2014","volume":"89","author":"Anon","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"key":"2025121512201012000_8.5.e021241.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-008160","article-title":"Accessing primary care Big Data: the development of a software algorithm to explore the rich content of consultation records","volume":"5","author":"MacRae","year":"2015","journal-title":"BMJ Open"},{"key":"2025121512201012000_8.5.e021241.19","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12911-015-0201-3","article-title":"Identifying influenza-like illness presentation from unstructured general practice clinical narrative using a text classifier rule-based expert system versus a clinical expert","volume":"15","author":"MacRae","year":"2015","journal-title":"BMC Med Inform Decis Mak"},{"key":"2025121512201012000_8.5.e021241.20","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017146","article-title":"Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software","volume":"7","author":"Dowell","year":"2017","journal-title":"BMJ Open"},{"key":"2025121512201012000_8.5.e021241.21","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19970415)16:7<791::AID-SIM500>3.0.CO;2-#"},{"key":"2025121512201012000_8.5.e021241.22","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1745-7939.2001.tb01602.x","article-title":"Degrees of Deprivation in New Zealand \u2014 An Atlas of Socioeconomic Difference: By P. Crampton, C. Salmond, R. Kirkpatrick, R. Scarborough and C. Skelly","volume":"57","author":"Houghton","year":"2001","journal-title":"N Z Geog"},{"key":"2025121512201012000_8.5.e021241.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.1998.tb01505.x"},{"key":"2025121512201012000_8.5.e021241.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0160446","article-title":"Healthcare Resource Utilisation Associated with Herpes Zoster in a Prospective Cohort of Older Australian Adults","volume":"11","author":"Karki","year":"2016","journal-title":"PLoS One"},{"key":"2025121512201012000_8.5.e021241.25","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/171.3.701"},{"key":"2025121512201012000_8.5.e021241.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68773-4"},{"key":"2025121512201012000_8.5.e021241.27","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1477-7525-12-92","article-title":"Burden of post-herpetic neuralgia in a sample of UK residents aged 50 years or older: findings from the Zoster Quality of Life (ZQOL) study","volume":"12","author":"Serpell","year":"2014","journal-title":"Health Qual Life Outcomes"},{"key":"2025121512201012000_8.5.e021241.28","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-402"},{"key":"2025121512201012000_8.5.e021241.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.11.012"},{"key":"2025121512201012000_8.5.e021241.30","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jinf.2016.05.008","article-title":"The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013","volume":"73","author":"Hobbelen","year":"2016","journal-title":"J Infect"},{"key":"2025121512201012000_8.5.e021241.31","unstructured":"Enrolment in a primary health organisation. Ministry of health NZ. http:\/\/www.health.govt.nz\/our-work\/primary-health-care\/about-primary-health-organisations\/enrolment-primary-health-organisation (accessed 27 Oct 2017)."},{"key":"2025121512201012000_8.5.e021241.32","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jhin.2011.11.011","article-title":"Varicella zoster virus infection among healthcare workers in Taiwan: seroprevalence and predictive value of history of varicella infection","volume":"80","author":"Wu","year":"2012","journal-title":"J Hosp Infect"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-021241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:20:21Z","timestamp":1765830021000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-021241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,5,31]]},"published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1136\/bmjopen-2017-021241"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-021241","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5]]}}}