Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
BMC Med Res Methodol. 2012 Oct 23;12:161. doi: 10.1186/1471-2288-12-161.
Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES) in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK), general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources.
Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82]) between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman's general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record.
Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22), stroke, both overall (I60-64) and by subtype, and pulmonary embolism (I26), HES records appeared to be both reliable and complete.
Hospital admission data in England provide diagnostic information for vascular disease of sufficient reliability for epidemiological analyses.
电子链接到常规行政数据集，如英国的医院入院统计数据（HES），在医学研究中越来越多地被使用。相对而言，人们对 HES 诊断信息在流行病学研究中的可靠性知之甚少。在英国（UK），全科医生为个人保存有关初级、二级和三级保健的综合记录。我们对大型英国队列研究的一个随机样本参与者进行了比较，以评估 HES 和全科医生记录中血管疾病诊断的一致性。
在 1997 年 4 月 1 日至 2005 年 3 月 31 日期间，我们确定了 HES 记录中有血管疾病（缺血性心脏病[ICD-10 编码 I20-I25]、脑血管疾病[G45、I60-I69]或静脉血栓栓塞[I26、I80-I82]）住院的百万妇女研究参与者。在每个广泛的诊断组中，以及没有这种 HES 诊断的女性中，大约有一千名女性被随机选择进行研究。我们要求每位女性的全科医生提供她的血管疾病史信息，然后将这些信息与 HES 诊断记录进行比较。
超过 90%发送给全科医生的研究表格被退回，其中 88%的表格包含可分析的数据。对于绝大多数有信息可用的研究参与者，全科医生和 HES 记录中的诊断信息是一致的。总体而言，对于 93%有 HES 血管疾病诊断的女性，全科医生的记录与 HES 诊断相符；对于 97%没有 HES 血管疾病诊断的女性，全科医生没有血管疾病的诊断记录。对于严重的血管疾病，包括心肌梗死（I21-22）、中风，包括总体（I60-64）和亚型，以及肺栓塞（I26），HES 记录似乎既可靠又完整。
英格兰的住院数据为血管疾病的流行病学分析提供了足够可靠的诊断信息。
