Concordance in the recording of stroke across UK primary and secondary care datasets: a population-based cohort study
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Published version
Author(s)
Morgan, Ann
Sinnott, Sarah-Jo
Smeeth, Liam
Minassian, Caroline
Quint, Jennifer
Type
Journal Article
Abstract
Background: Previous work has demonstrated that the recording of acute health outcomes, such as myocardial infarction, may be suboptimal in primary healthcare databases. Aim: The aim of this analysis is to assess the completeness and accuracy of the recording of stroke in UK primary care. Design and setting: This is a population-based longitudinal cohort study. Methods: 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. Results: Of the 75,674 stroke events that were identified in either CPRD or HES data during the period of our study, 54,929 (72.6%) were recorded in CPRD and 51,013 (67.4%) were recorded in HES. Two fifths (n=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 to coding in HES): however, 43.5% of ischaemic strokes in HES were coded as “non-specific” strokes in CPRD data. Furthermore, 48% had same day-recordings, and 56% were date-matched within ±1 day. Conclusion: 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, we strongly recommend the use of linked, as opposed to stand-alone, CPRD data.
Date Issued
2021-04-26
Date Acceptance
2020-08-27
Citation
British Journal of General Practice Open, 2021, 5 (2), pp.1-11
ISSN
2398-3795
Publisher
Royal College of General Practitioners
Start Page
1
End Page
11
Journal / Book Title
British Journal of General Practice Open
Volume
5
Issue
2
Copyright Statement
© 2021, The Authors. This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)
License URL
Sponsor
British Lung Foundation
Identifier
https://bjgpopen.org/content/5/2/BJGPO.2020.0117
Grant Number
RG14-5
Subjects
Clinical Practice Research Datalink
electronic health records
primary health care
stroke
Publication Status
Published
Date Publish Online
2021-04-26