Department of Health Sciences, University of Leicester, Leicester, UK.
Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield General Hospital, Leicester, UK.
Prim Health Care Res Dev. 2022 Nov 28;23:e77. doi: 10.1017/S1463423622000718.
Major lower extremity amputations (MLEAs) are understood to be well recorded in secondary care in England in the Hospital Episode Statistics (HES) database. It is unclear how well MLEAs are recorded in primary care databases.
This study compared MLEA event case ascertainment in Clinical Practice Research Datalink (CPRD) to that in HES.
MLEA events were ascertained in CPRD and in HES linkage between 1 January 2010 and 31 December 2019. The number of MLEA events and the number of patients with at least one MLEA in each database were recorded and compared. Individual events were matched between the databases using varying date-matching windows. Reasons for differences in case ascertainment were explored.
In total 23 262 patients had at least one MLEA record, 8716 (37.5%) had an MLEA record in HES only, 5393 (23.2%) in CPRD only and 9153 (39.4%) in both. Out of a total of 75 221 events, 13 071 (62.4%) were recorded in HES only and 44 151 (81.3%) in CPRD only. 7874 (37.6%) of HES events were recorded in CPRD and 10 125 (18.6%) of CPRD events were recorded in HES when using the maximum date matching window of 28 days plus the time between admission and procedure. The main reasons for differences in case ascertainment included, re-recordings and miscoding in CPRD.Compared to HES, MLEAs are poorly recorded in CPRD predominantly due to re-recordings of events and miscoding procedures. CPRD data cannot solely be relied upon to ascertain cases of MLEA; however, HES linkage to CPRD may be useful to obtain medical history of diagnoses, medication and diagnostic tests.
在英格兰的医院入院统计（HES）数据库中，主要下肢截肢（MLEA）被认为在二级护理中得到了很好的记录。但在初级保健数据库中 MLEA 的记录情况尚不清楚。
本研究比较了临床实践研究数据链（CPRD）和 HES 中 MLEA 事件的确定情况。
在 CPRD 和 HES 之间，于 2010 年 1 月 1 日至 2019 年 12 月 31 日进行了 MLEA 事件的确定。记录并比较了每个数据库中的 MLEA 事件数量和至少有一个 MLEA 的患者数量。使用不同的日期匹配窗口，在数据库之间匹配个体事件。探讨了病例确定差异的原因。
共有 23262 名患者至少有一个 MLEA 记录，8716 名（37.5%）仅在 HES 中有 MLEA 记录，5393 名（23.2%）仅在 CPRD 中有 MLEA 记录，9153 名（39.4%）同时在两个数据库中有记录。在总共 75221 个事件中，13071 个（62.4%）仅在 HES 中记录，44151 个（81.3%）仅在 CPRD 中记录。在使用 28 天加入院和手术之间的时间的最大日期匹配窗口时，7874 个（37.6%）HES 事件记录在 CPRD 中，10125 个（18.6%）CPRD 事件记录在 HES 中。病例确定差异的主要原因包括 CPRD 中的重复记录和错误编码。与 HES 相比，CPRD 中 MLEA 的记录情况较差，主要原因是事件的重复记录和程序的错误编码。CPRD 数据不能单独用于确定 MLEA 病例；但是，HES 与 CPRD 的链接可能有助于获取诊断、药物和诊断测试的病史。
