Validation of the recording of acute exacerbations of COPD in the clinical practice research datalink: Phase 1 results

Abstract

Background: The Clinical Practice Research Datalink (CPRD) is a UK database of primary care health records covering 11 million residents of England and Wales, including at least 200000 COPD patients. We aimed to validate the recording of acute exacerbations of COPD (AECOPD). Methods: We randomly selected a sample of 1600 patients with a validated diagnosis 1 of COPD from CPRD-GOLD. Combinations of prescription of oral steroids and antibiotics, symptoms, and diagnostic codes for lower respiratory tract infections (LRTI) and AECOPD were used to create 16 possible definitions of AECOPD in CPRD. Questionnaires were sent to general practitioners (GPs) asking for confirmation of their patients9 AECOPD on the dates queried and for additional information to support the AECOPD occurrence. Responses were reviewed independently by two respiratory physicians. The positive predictive value (PPV) was calculated for each of the definitions. Results: 998 (72.2%) questionnaires were returned. 459 questionnaires containing data for 3316 possible AECOPD have been processed and analysed to date. The PPV for 5 of the top definitions are reported in Table 1. Conclusions: AECOPD across a range of severities can be reliably identified within CPRD, the highest PPV being LRTI code together with prescription of antibiotics and oral steroids. 1. Quint JK et al. BMJ Open. 2014:4 Sponsored by MRC and GSK.