Abstract
BackgroundValidation studies of the Clinical Practice Research Datalink (CPRD) Aurum database in the UK are critical for making decisions about its suitability and validity for research purposes.ObjectiveTo examine data source agreement of myocardial infarction (MI) diagnoses recorded in CPRD Aurum compared with linked Hospital Episode Statistics (HES) data. This comparison provides information on CPRD Aurum data correctness (accuracy, validity) and completeness (presence, missingness).MethodsPatients with MI diagnoses recorded in either data source were selected from a random sample of 50,000 patients in CPRD Aurum with HES linkage (1997–2017). Correctness was defined as the proportion of MI cases in CPRD Aurum with a concordant MI diagnosis recorded in HES or with strong supporting evidence in either data source. Completeness was defined as the proportion of patients with primary HES-coded MIs with strong supporting evidence that were also present in CPRD Aurum.ResultsThere were 1260 patients with MI recorded in the CPRD Aurum sample. The overall correctness of the recorded MI diagnoses was 94%: 986 patients (78%) had concordant diagnoses in HES within 90 days; 123 (10%) were concordant with HES, but with an inconclusive date and another 71 (6%) had strong supporting evidence for being a true MI case. There were 1125 patients with MI recorded in HES primary diagnosis fields with strong supporting evidence in either data source. Of these, 880 (78%) were present in CPRD Aurum, with completeness somewhat higher in more recent years.ConclusionMI diagnoses recorded in CPRD Aurum were highly likely to be correct, supporting its use in clinical research studies. Completeness was lower, indicating the need for data linkage for some studies.
Highlights
Clinical Practice Research Datalink (CPRD) Aurum is a database of United Kingdom (UK) general practice electronic health records sourced from Egton Medical Information Systems (EMIS®) patient management software that is newly available to researchers.[1]
The overall correctness of myocardial infarction (MI) diagnoses recorded in CPRD Aurum was high (94%) when assessed using either concordance with diagnoses recorded in Hospital Episode Statistics (HES) or strong supporting evidence in either database (Table 1)
This study demonstrates that MI diagnosis recording in CPRD Aurum is sufficient for most observational research
Summary
Clinical Practice Research Datalink (CPRD) Aurum is a database of United Kingdom (UK) general practice electronic health records sourced from Egton Medical Information Systems (EMIS®) patient management software that is newly available to researchers.[1]. We are conducting several validation assessments of CPRD Aurum using methodologies described by Weiskopf and Weng.[9] Prior publications have described the quality and completeness of coding for pulmonary embolism, diabetes, hypercholesterolemia and anemia.[10,11] In this paper, we describe the use of data source agreement to evaluate acute myocardial infarction (MI) diagnoses in CPRD Aurum primary care compared with Hospital Episode Statistics (HES), which captures MIs in secondary care. This comparison provides information on “correct ness” (ie, accuracy, validity) and “completeness” (ie, pre sence, missingness) of MI diagnoses recorded in CPRD Aurum.
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