Epidemiology. 2018 Mar;29(2):308-313. doi: 10.1097/EDE.0000000000000786.
In the United Kingdom, hospital or cancer registry data can be linked to electronic medical records for a subset of general practices and years.
We used Clinical Practice Research Datalink data (2004-2012) from patients treated for overactive bladder. We electronically identified provisional cases of 10 common cancers in General Practitioner Online Database data and validated them by medical profile review. In practices with linkage to Hospital Episodes Statistics and National Cancer Data Repository (2004-2010), we validated provisional cancer cases against these data sources. This linkage also let us identify additional cancer diagnoses in individuals without cancer diagnosis records in the General Practitioner Online Database.
Among 50,840 patients, 1,486 provisional cancer cases were identified in the General Practitioner Online Database for 2004-2012. Medical profile review confirmed 93% of 661 cases in nonlinked practices (range, 100% of non-Hodgkin lymphomas and uterine cancer to 77% of skin melanomas) and 96% of 825 cases in linked practices (100% of kidney and uterine cancers to 92% of melanomas). In the subset of linked practices, for 2004-2010, 720 cases were confirmed, of which 68% were identifiable in the General Practitioner Online Database (range, 90% of breast to 36% of kidney cancers).
Most cases of cancer identified electronically in the General Practitioner Online Database were confirmed. A substantial proportion of cases, especially of cancer types not typically managed by general practitioners, would be missed without Hospital Episodes Statistics and National Cancer Data Repository data (and are likely missed in nonlinked practices). See video abstract at, http://links.lww.com/EDE/B315.
REGISTRATION (BEFORE STUDY CONDUCT): European Union electronic Register of Post-Authorisation Studies (EU PAS Registry) number EUPAS5529, http://www.encepp.eu/encepp/viewResource.htm?id=11107.
在英国,医院或癌症登记处的数据可以与部分普通诊所和年份的电子病历相关联。
我们使用了临床实践研究数据链接(2004-2012 年)中接受过膀胱过度活动症治疗的患者的数据。我们在全科医生在线数据库中电子识别出 10 种常见癌症的暂定病例,并通过医疗档案审查进行验证。在与医院事件统计和国家癌症数据仓库(2004-2010 年)有链接的实践中,我们根据这些数据源验证了暂定癌症病例。这种链接还使我们能够在没有全科医生在线数据库癌症诊断记录的个体中识别出其他癌症诊断。
在 50840 名患者中,2004-2012 年,全科医生在线数据库中确定了 1486 例暂定癌症病例。医疗档案审查证实了非链接实践中 661 例病例的 93%(范围为非霍奇金淋巴瘤和子宫癌的 100%至黑素瘤的 77%)和链接实践中 825 例病例的 96%(肾癌和子宫癌的 100%至黑素瘤的 92%)。在链接实践的子集中,2004-2010 年,有 720 例病例得到确认,其中 68%可在全科医生在线数据库中识别(范围为乳腺癌的 90%至肾癌的 36%)。
在全科医生在线数据库中电子识别的大多数癌症病例得到了证实。如果没有医院事件统计和国家癌症数据仓库的数据(并且很可能在非链接实践中遗漏),将会错过很大一部分病例,尤其是那些通常不由全科医生管理的癌症类型。请观看视频摘要,网址为,http://links.lww.com/EDE/B315。
登记(在研究进行之前):欧盟药品上市后监测研究电子登记册(EU PAS 注册表)编号 EUPAS5529,网址为 http://www.encepp.eu/encepp/viewResource.htm?id=11107。