Lawrenson R, Todd J C, Leydon G M, Williams T J, Farmer R D
European Institute of Health and Medical Sciences, University of Surrey, Guildford, London.
Br J Clin Pharmacol. 2000 Jun;49(6):591-6. doi: 10.1046/j.1365-2125.2000.00199.x.
The study was conducted to determine whether the method for selecting cases of venous thromboembolism (VTE) from general practice databases significantly affected the findings of an epidemiological study.
Cases of VTE were identified from the UK General Practice Research Database (GPRD) by searching for codes for deep vein thrombosis (DVT) and pulmonary embolism (PE). These had to be supported by evidence of anticoagulation and be exposed to a combined oral contraceptive (COC) at the time of the event. Additional information about the event was sought from general practitioners who were requested to complete a questionnaire and to supply anonymised copies of hospital letters and discharge summaries.
Of the 285 cases identified from the GPRD, additional information was available for 177 VTE events. This information showed that 84% of those events were supported by hospital investigations or a death certificate. Using only verified cases, rather than all GPRD identified events, did not alter the results of the epidemiological study.
The GPRD provides information of sufficiently high quality to allow valid epidemiological research of VTE events. Excluding cases without a database record of hospital admission would lead to valid events being overlooked, and an under-estimate of the disease incidence.
本研究旨在确定从全科医疗数据库中选择静脉血栓栓塞症（VTE）病例的方法是否会显著影响一项流行病学研究的结果。
通过搜索深静脉血栓形成（DVT）和肺栓塞（PE）的编码，从英国全科医疗研究数据库（GPRD）中识别VTE病例。这些病例必须有抗凝治疗的证据，并且在事件发生时正在服用复方口服避孕药（COC）。从全科医生那里获取有关该事件的更多信息，要求他们填写一份问卷，并提供医院信件和出院小结的匿名副本。
在从GPRD中识别出的285例病例中，有177例VTE事件获得了更多信息。这些信息显示，其中84%的事件得到了医院检查或死亡证明的支持。仅使用经过核实的病例，而不是所有GPRD识别出的事件，并未改变流行病学研究的结果。
GPRD提供了足够高质量的信息，以允许对VTE事件进行有效的流行病学研究。排除没有医院入院数据库记录的病例会导致一些有效的事件被忽视，并低估疾病的发病率。
