Morgan Ann, Sinnott Sarah-Jo, Smeeth Liam, Minassian Caroline, Quint Jennifer
Department of Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, UK.
BJGP Open. 2021 Apr 26;5(2). doi: 10.3399/BJGPO.2020.0117. Print 2021 Apr.
Previous work has demonstrated that the recording of acute health outcomes, such as myocardial infarction (MI), may be suboptimal in primary healthcare databases.
To assess the completeness and accuracy of the recording of stroke in UK primary care.
DESIGN & SETTING: A population-based longitudinal cohort study.
Cases of stroke were identified separately in Clinical Practice Research Datalink (CPRD) primary care records and linked Hospital Episode Statistics (HES). The recording of events in the same patient across the two datasets was compared. The reliability of strategies to identify fatal strokes in primary care and hospital records was also assessed.
Of the 75 674 stroke events that were identified in either CPRD or HES data during the period of the study, 54 929 (72.6%) were recorded in CPRD and 51 013 (67.4%) were recorded in HES. Two-fifths ( = 30 268) of all recorded strokes were found in both datasets (allowing for a time window of 120 days). Among these 'matched' strokes the subtype was recorded accurately in approximately 75% of CPRD records (compared with coding in HES); however, 43.5% of ischaemic strokes in HES were coded as 'non-specific' strokes in CPRD data. Furthermore, 48.2% had same-day recordings, and 56.2% were date-matched within ±1 day.
The completeness and accuracy of stroke recording is improved by the use of linked hospital and primary care records. For studies that have a time-sensitive research question, the use of linked, as opposed to stand-alone, CPRD data is strongly recommended.
先前的研究表明，在基层医疗数据库中，急性健康结局（如心肌梗死）的记录可能并不理想。
评估英国基层医疗中中风记录的完整性和准确性。
一项基于人群的纵向队列研究。
在临床实践研究数据链（CPRD）基层医疗记录和关联的医院事件统计数据（HES）中分别识别中风病例。比较两个数据集中同一患者事件的记录情况。还评估了在基层医疗和医院记录中识别致命中风策略的可靠性。
在研究期间，在CPRD或HES数据中识别出的75674例中风事件中，54929例（72.6%）记录在CPRD中，51013例（67.4%）记录在HES中。在两个数据集中均发现了五分之二（即30268例）的所有记录中风（允许120天的时间窗口）。在这些“匹配”的中风中，约75%的CPRD记录准确记录了亚型（与HES中的编码相比）；然而，HES中43.5%的缺血性中风在CPRD数据中被编码为“非特异性”中风。此外，48.2%的中风有同日记录，56.2%在±1天内日期匹配。
通过使用关联的医院和基层医疗记录，中风记录的完整性和准确性得到了提高。对于有时间敏感性研究问题的研究，强烈建议使用关联的CPRD数据，而不是单独的数据。
