Boston Collaborative Drug Surveillance Program, Lexington, Massachusetts, USA.
Clinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK.
Pharmacoepidemiol Drug Saf. 2020 Nov;29(11):1456-1464. doi: 10.1002/pds.5135. Epub 2020 Sep 28.
The Clinical Practice Research Datalink (CPRD) now provides a new medical record database, CPRD Aurum. This is the second of several studies being undertaken to assess the quality of CPRD Aurum data for research.
We included patients aged 20+, with at least one lab test result of any type from a random sample of 50 000 patients in CPRD Aurum. We assessed whether diagnosis codes for type 2 diabetes, hyperlipidemia, and iron deficiency or unspecified anemia were accompanied by supporting codes including lab results and treatments (correctness) and whether lab results, treatments, or other codes indicate a missing diagnosis record (completeness).
Among 37 502 patients in CPRD Aurum, correctness of type 2 diabetes, hyperlipidemia, and anemia diagnoses was high (99%, 93%, and 97%, respectively). Completeness was only high for type 2 diabetes (94%-98%); completeness for hypercholesterolemia and anemia diagnoses was modest even when the presence of treatments and lab results indicated the conditions were likely present (51%-59% and 58%-70%, respectively).
Our findings indicate that for studies of type 2 diabetes, hyperlipidemia, and iron deficiency or unspecified anemia, the diagnosis code is likely to be correct where present. However, a significant proportion of cases of hyperlipidemia or anemia will be missed if only diagnosis codes are used to select patients with these conditions. Researchers should consider using treatments, supporting codes, and, when available, lab data to supplement diagnosis codes and enhance case capture when including these conditions in studies using CPRD Aurum.
临床实践研究数据链（CPRD）现在提供了一个新的病历数据库，即 CPRD Aurum。这是正在进行的几项研究中的第二项，旨在评估 CPRD Aurum 数据用于研究的质量。
我们纳入了年龄在 20 岁及以上的患者，这些患者来自 CPRD Aurum 随机样本中的 50000 名患者，他们至少有一项任何类型的实验室检测结果。我们评估了 2 型糖尿病、高脂血症和缺铁或非特指性贫血的诊断代码是否伴有包括实验室结果和治疗在内的支持性代码（准确性），以及实验室结果、治疗或其他代码是否表明存在缺失的诊断记录（完整性）。
在 CPRD Aurum 中的 37502 名患者中，2 型糖尿病、高脂血症和贫血的诊断准确性很高（分别为 99%、93%和 97%）。完整性仅在 2 型糖尿病中很高（94%-98%）；即使治疗和实验室结果表明存在这些情况的可能性很大，高胆固醇血症和贫血诊断的完整性也只是适度的（分别为 51%-59%和 58%-70%）。
我们的研究结果表明，对于 2 型糖尿病、高脂血症和铁缺乏或非特指性贫血的研究，在存在诊断代码的情况下，诊断代码很可能是正确的。然而，如果仅使用诊断代码来选择患有这些疾病的患者，那么很大一部分高脂血症或贫血病例将会被遗漏。在使用 CPRD Aurum 进行这些疾病的研究时，研究人员应考虑使用治疗方法、支持性代码，并且在可用时，使用实验室数据来补充诊断代码，并增强病例捕获。
