ObjectivesThe 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.Setting951 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 measureThe primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed.Results951 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%).ConclusionsPatients 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.

Background: Formative qualitative research is foundational to the methodological development process of quantitative health preference research (HPR). Despite its ability to improve the validity of the quantitative evidence, formative qualitative research is underreported.Objective: To improve the frequency and quality of reporting, we developed guidelines for reporting this type of research. The guidelines focus on formative qualitative research used to develop robust and acceptable quantitative study protocols and corresponding survey instruments in HPR.Methods: In December 2018, a steering committee was formed as a means to accumulate the expertise of the HPR community on the reporting guidelines (21 members, seven countries, multiple settings, and disciplines). Using existing guidelines and examples, the committee constructed, revised, and refined the guidelines. The guidelines underwent beta-testing by three researchers and further revision to the guidelines were made based on their feedback as well as from comments from members of the International Academy of Health Preference Research (IAHPR) and the editorial board of The Patient.Results: The guidelines have five components: introductory material (4 domains); methods (12); results/findings (2); discussion (2); and other (2). They are concordant with existing guidelines, published examples, beta testing results, and expert comments.Conclusions: Publishing formative qualitative research is a necessary step towards strengthening the foundation of any quantitative study, enhancing the relevance of its preference evidence. The guidelines should aid researchers, reviewers and regulatory agencies as well as promote transparency within HPR more broadly. Key Points for Decision Makers• These are the first guidelines on reporting formative qualitative research on patient experience that support the development of quantitative preference study protocols and corresponding instruments. • These guidelines focus on reporting techniques that enhance transparency and trustworthiness, thereby improving the likelihood that the scientific contributions of quantitative preference studies are well-founded, improving the validity of the quantitative evidence.

No abstract

In this large US-based cohort, Eos > 2% was prevalent in participants with COPD and normal lung function. Among participants with COPD, Eos > 2% was associated with specific characteristics including lower rates of some co-morbidities; however, the clinical implications and relationships between Eos levels, COPD mechanisms, and risk of outcomes require further evaluation.