Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)
Objectives The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database.Setting 951...
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BMJ Publishing Group
2014-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/4/7/e005540.full |
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| author | John R Hurst Jennifer K Quint Hana Müllerova Liam Smeeth Harriet Forbes Susan Eaton Rachael L DiSantostefano Kourtney Davis |
| author_facet | John R Hurst Jennifer K Quint Hana Müllerova Liam Smeeth Harriet Forbes Susan Eaton Rachael L DiSantostefano Kourtney Davis |
| author_sort | John R Hurst |
| collection | DOAJ |
| description | Objectives The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database.Setting 951 participants registered with a CPRD practice in the UK between 1 January 2004 and 31 December 2012. Individuals were selected for ≥1 of 8 algorithms to identify people with COPD. General practitioners were sent a brief questionnaire and additional evidence to support a COPD diagnosis was requested. All information received was reviewed independently by two respiratory physicians whose opinion was taken as the gold standard.Primary outcome measure The primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed.Results 951 questionnaires were sent and 738 (78%) returned. After quality control, 696 (73.2%) patients were included in the final analysis. All four algorithms including a specific COPD diagnostic code performed well. Using a diagnostic code alone, the PPV was 86.5% (77.5–92.3%) while requiring a diagnosis plus spirometry plus specific medication; the PPV was slightly higher at 89.4% (80.7–94.5%) but reduced case numbers by 10%. Algorithms without specific diagnostic codes had low PPVs (range 12.2–44.4%).Conclusions Patients with COPD can be accurately identified from UK primary care records using specific diagnostic codes. Requiring spirometry or COPD medications only marginally improved accuracy. The high accuracy applies since the introduction of an incentivised disease register for COPD as part of Quality and Outcomes Framework in 2004. |
| format | Article |
| id | doaj-art-dab462d57f1648a29f331123bd2ac28b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2014-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dab462d57f1648a29f331123bd2ac28b2025-02-06T16:25:19ZengBMJ Publishing GroupBMJ Open2044-60552014-07-014710.1136/bmjopen-2014-005540Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)John R Hurst0Jennifer K Quint1Hana Müllerova2Liam Smeeth3Harriet Forbes4Susan Eaton5Rachael L DiSantostefano6Kourtney Davis7UCL Respiratory, University College London, London, UK3 School of Public Health, Imperial College London, London, UK2Department of Respiratory Epidemiology, GlaxoSmithKline R&D, Uxbridge, UKprofessor2 Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK4Clinical Practice Research Datalink Group, Medicines and Healthcare Products Regulatory Agency, London, UKJanssen Pharmaceuticals, Titusville, New Jersey, USA2Department of Respiratory Epidemiology, GlaxoSmithKline R&D, Uxbridge, UKObjectives The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database.Setting 951 participants registered with a CPRD practice in the UK between 1 January 2004 and 31 December 2012. Individuals were selected for ≥1 of 8 algorithms to identify people with COPD. General practitioners were sent a brief questionnaire and additional evidence to support a COPD diagnosis was requested. All information received was reviewed independently by two respiratory physicians whose opinion was taken as the gold standard.Primary outcome measure The primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed.Results 951 questionnaires were sent and 738 (78%) returned. After quality control, 696 (73.2%) patients were included in the final analysis. All four algorithms including a specific COPD diagnostic code performed well. Using a diagnostic code alone, the PPV was 86.5% (77.5–92.3%) while requiring a diagnosis plus spirometry plus specific medication; the PPV was slightly higher at 89.4% (80.7–94.5%) but reduced case numbers by 10%. Algorithms without specific diagnostic codes had low PPVs (range 12.2–44.4%).Conclusions Patients with COPD can be accurately identified from UK primary care records using specific diagnostic codes. Requiring spirometry or COPD medications only marginally improved accuracy. The high accuracy applies since the introduction of an incentivised disease register for COPD as part of Quality and Outcomes Framework in 2004.https://bmjopen.bmj.com/content/4/7/e005540.full |
| spellingShingle | John R Hurst Jennifer K Quint Hana Müllerova Liam Smeeth Harriet Forbes Susan Eaton Rachael L DiSantostefano Kourtney Davis Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) BMJ Open |
| title | Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) |
| title_full | Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) |
| title_fullStr | Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) |
| title_full_unstemmed | Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) |
| title_short | Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD) |
| title_sort | validation of chronic obstructive pulmonary disease recording in the clinical practice research datalink cprd gold |
| url | https://bmjopen.bmj.com/content/4/7/e005540.full |
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