Comparison of cancer diagnosis recording between the Clinical Practice Research Datalink, Cancer Registry and Hospital Episodes Statistics

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Title: Comparison of cancer diagnosis recording between the Clinical Practice Research Datalink, Cancer Registry and Hospital Episodes Statistics
Authors: Arhi, CS
Bottle, A
Burns, EM
Clarke, JM
Aylin, P
Ziprin, P
Darzi, A
Item Type: Journal Article
Abstract: Introduction The Clinical Practice Research Datalink (CPRD) is a large electronic dataset of primary care medical records. For the purpose of epidemiological studies, it is necessary to ensure accuracy and completeness of cancer diagnoses in CPRD. Method Cases included had a colorectal, oesophagogastric (OG), breast, prostate or lung cancer diagnosis recorded in a least one of CPRD, Cancer Registry (CR) or Hospital Episodes Statistics(HES) between 2000 and 2013. Agreement in diagnosis between the datasets, difference in dates, survival at one and five-years, and whether patient characteristics differed according to the dataset or the timing of diagnosis were investigated. Results 116,769 patients were included. For each cancer, approximately 10% of cases identified from CPRD or HES were not confirmed in the CR. 25.5% colorectal, 26.0% OG, 8.9% breast, 32.0% lung and 18.6% prostate cases identified from the CR were missing in CPRD. The diagnosis date was recorded later in CPRD compared with CR for each cancer, ranging from 81.1% for prostate to 59.6% for colorectal, especially if the diagnosis was an emergency. Compared with the CR and HES, the adjusted risk of a missing diagnosis in CPRD was significantly higher if the patient was older, had more co-morbidities or was diagnosed as an emergency. Survival at one and five-years was highest for CPRD. Conclusion Patient demographics and the route of diagnosis impact the accuracy of cancer diagnosis in CPRD. Although CPRD provides invaluable primary care data, patients should ideally be identified from the CR to reduce bias.
Issue Date: 1-Dec-2018
Date of Acceptance: 26-Aug-2018
ISSN: 0361-090X
Publisher: Elsevier
Start Page: 148
End Page: 157
Journal / Book Title: Cancer Epidemiology
Volume: 57
Copyright Statement: © 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence
Sponsor/Funder: Imperial College Healthcare NHS Trust
The Peter Sowerby Charitable Foundation
National Institute for Health Research
Dr Foster Intelligence
Funder's Grant Number: NRLS2
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Clinical practice research datalink
Cancer registry
Hospital episodes statistics
Accuracy of diagnosis
1112 Oncology And Carcinogenesis
1117 Public Health And Health Services
Oncology & Carcinogenesis
Publication Status: Published
Online Publication Date: 2018-10-02
Appears in Collections:Division of Surgery
Faculty of Medicine
Epidemiology, Public Health and Primary Care

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