Quality and Completeness of Myocardial Infarction Recording in Clinical Practice Research Datalink Aurum

Persson, Rebecca; Sponholtz, Todd R.; Vasilakis‐Scaramozza, Catherine; Hagberg, Katrina Wilcox; Williams, Tim; Kotecha, Dipak; Myles, Puja; Jick, Susan S.

doi:10.2147/clep.s319245

Cited by 16 publications

(20 citation statements)

References 15 publications

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“…For example, in a random sample of 50,000 patients in CPRD Aurum, 94% of the 1,260 patients with a code for myocardial infarction had corroborating evidence in the secondary care HES records. [3] Similar to our transparent approach to coding, the process of integrating primary and secondary healthcare sources in DaRe2THINK will be documented in an open-access, prospectively-published Statical Analysis Plan. The DaRe2 approach was only possible with the support and guidance of our Patient and Public Involvement (PPI) team.…”

Section: Discussionmentioning

confidence: 99%

“…[46] Linkage is critical to understanding the full healthcare utilisation of each participant. [3] In this case allowing for the combination of historical and future primary care data, with that pertaining to hospitalisation and procedures across the NHS nationally, as well as information on cause of death from the national register. EHR-based trials may have an advantage in this regard compared to traditional trials, where investigators are relied on to document safety and outcome events.…”

Section: Discussionmentioning

confidence: 99%

“…[2] This is an attractive (and cost-efficient) prospect for clinical research, particular as the quality of EHR data is typically high due to the need for accurate billing and reimbursement purposes. [3][4][5] Observational clinical research has benefited for many decades from EHR data. Evolving technology and coding systems, coupled with more complete EHR coverage, has provided the opportunity for randomised controlled trials (RCT) to be embedded alongside EHR systems, taking advantage of existing clinical data and follow-up.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic approach to outcome assessment from coded electronic healthcare records in the DaRe2THINK NHS-embedded randomised trial

Wang

Mobley

Țica

et al. 2022

Preprint

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Background: Improving the efficiency of clinical trials is key to their continued importance in directing evidence-based patient care. Digital innovations, in particular the use of electronic healthcare records (EHR), allow for large-scale screening and follow-up of participants. However, it is critical these developments are accompanied by robust and transparent methods that can support high quality and high clinical value research. Methods: The DaRe2THINK trial includes a series of novel processes, including nationwide pseudonymised pre-screening of the primary care EHR across England, digital enrolment, remote e-consent, and no-visit follow-up by linking all primary and secondary care health data with patient-reported outcomes. Findings: DaRe2THINK is a pragmatic, healthcare-embedded randomised trial testing whether earlier use of direct oral anticoagulants in patients with prior or current atrial fibrillation can prevent thromboembolic events and cognitive decline (www.birmingham.ac.uk/dare2think). This paper outlines the systematic approach and methodology employed to define patient information and outcome events. This includes transparency on all medical code lists and phenotypes used in the trial across a variety of national data sources, including Clinical Practice Research Datalink Aurum (primary care), Hospital Episode Statistics (secondary care) and the Office for National Statistics (mortality). Interpretation: Co-designed by a patient and public involvement team, DaRe2THINK presents an opportunity to transform the approach to randomised trials in the setting of routine healthcare, providing high-quality evidence generation in populations representative of the community at-risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic approach to outcome assessment from coded electronic healthcare records in the DaRe2THINK NHS-embedded randomised trial

Wang

Mobley

Țica

et al. 2022

Preprint

Self Cite

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“…CPRD Aurum has been described in previously published studies. [7][8][9] These studies suggest that the quality of recording is high, particularly for acute medical events, but further studies are needed to assess the recording of chronic conditions. In this study, we assessed quality of RA recording in CPRD Aurum by evaluating the presence of diagnoses, prescriptions, and labs codes expected with a RA diagnosis based on UK National Institute for Health and Care Excellence (NICE) clinical guidelines.…”

Section: Purposementioning

confidence: 99%

Quality of rheumatoid arthritis recording in United Kingdom Clinical Practice Research Datalink Aurum

Vasilakis‐Scaramozza

Hagberg

Persson

et al. 2022

Pharmacoepidemiology and Drug

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Purpose While several studies have assessed quality and completeness of recording acute medical events in Clinical Practice Research Datalink (CPRD) Aurum, evaluation of additional chronic conditions is warranted. Methods We selected patients with a first diagnosis of rheumatoid arthritis (RA) coded in their CPRD Aurum record between 2005 and 2019. We assessed quality of RA diagnosis by evaluating additional information in the patient record that would corroborate the diagnosis. We report recording of diagnoses, prescriptions, labs, and referrals expected to be present based on NICE guidelines for RA management. Results There were 53 083 patients with a first recorded RA diagnosis during the study period: 43606 (82%) patients had RA drug treatments in their record, 7596 (14%) had supporting codes without drug treatment, and 1881 (4%) patients had only a RA diagnoses recorded in their medical record with no supporting codes or RA treatments. Patients with RA diagnosis only were more likely to be first diagnosed in the earliest time period of study. Labs for diagnosing and monitoring RA were most common among patients with RA treatment. Analgesic and glucocorticoid prescriptions were common in all study patients but were highest among patients with RA treatment. Among patients with RA diagnosis only, the overwhelming majority had only one RA diagnosis recorded (76%). Conclusions Our findings suggest that codes expected for monitoring and treatment of RA are routinely recorded in CPRD Aurum. These results support previous assessments, which found data recorded in CPRD Aurum to be of good quality for use in research.

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Musculoskeletal pain and its impact on prognosis following acute coronary syndrome or stroke: A linked electronic health record cohort study

Mason

Jordan

Heron

et al. 2023

Musculoskeletal Care

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ObjectiveMusculoskeletal painful conditions are a risk factor for cardiovascular disease (CVD), but less is known about whether musculoskeletal pain also worsens prognosis from CVD. The objective was to determine whether patients with musculoskeletal pain have poorer prognosis following acute coronary syndrome (ACS) or stroke.MethodsThe study utilised UK electronic primary care records (CPRD Aurum) with linkage to hospital and mortality records. Patients aged ≥45 years admitted to hospital with incident ACS/stroke were categorised by healthcare use for musculoskeletal pain (inflammatory conditions, osteoarthritis [OA], and regional pain) based on primary care consultations in the prior 24 months. Outcomes included mortality, length of stay, readmission and management of index condition (ACS/stroke).ResultsThere were 171,670 patients with incident ACS and 138,512 with stroke; 30% consulted for musculoskeletal pain prior to ACS/stroke and these patients had more comorbidity than those without musculoskeletal pain. Rates of mortality and readmission, and length of stay were higher in those with musculoskeletal pain, particularly OA and inflammatory conditions, in ACS. Readmission was also higher for patients with musculoskeletal pain in stroke. However, increased risks associated with musculoskeletal pain did not remain after adjustment for age and polypharmacy. Inflammatory conditions were associated with increased likelihood of prescriptions for dual anti‐platelets (ACS only) and anti‐coagulants.ConclusionsPatients with musculoskeletal pain have higher rates of poor outcome from ACS which relates to being older but also increased polypharmacy. The high rates of comorbidity including polypharmacy highlight the complexity of patients with musculoskeletal pain who have new onset ACS/stroke.

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Quality and Completeness of Myocardial Infarction Recording in Clinical Practice Research Datalink Aurum

Cited by 16 publications

References 15 publications

Systematic approach to outcome assessment from coded electronic healthcare records in the DaRe2THINK NHS-embedded randomised trial

Systematic approach to outcome assessment from coded electronic healthcare records in the DaRe2THINK NHS-embedded randomised trial

Quality of rheumatoid arthritis recording in United Kingdom Clinical Practice Research Datalink Aurum

Musculoskeletal pain and its impact on prognosis following acute coronary syndrome or stroke: A linked electronic health record cohort study

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