Abstract
UK Biobank (UKB) is widely employed to investigate mental health disorders and related exposures; however, its applicability and relevance in a clinical setting and the assumptions required have not been sufficiently and systematically investigated. Here, we present the first validation study using secondary care mental health data with linkage to UKB from Oxford - Clinical Record Interactive Search (CRIS) focusing on comparison of demographic information, diagnostic outcome, medication record and cognitive test results, with missing data and the implied bias from both resources depicted.We applied a natural language processing model to extract information embedded in unstructured text from clinical notes and attachments. Using a contingency table we compared the demographic information recorded in UKB and CRIS. We calculated the positive predictive value (PPV, proportion of true positives cases detected) for mental health diagnosis and relevant medication.Amongst the cohort of 854 subjects, PPVs for any mental health diagnosis for dementia, depression, bipolar disorder and schizophrenia were 41.6%, and were 59.5%, 12.5%, 50.0% and 52.6%, respectively. Self-reported medication records in UKB had general PPV of 47.0%, with the prevalence of frequently prescribed medicines to each typical mental health disorder considerably different from the information provided by CRIS.UKB is highly multimodal, but with limited follow-up records, whereas CRIS offers a longitudinal high-resolution clinical picture with more than ten years of observations. The linkage of both datasets will reduce the self-report bias and synergistically augment diverse modalities into a unified resource to facilitate more robust research in mental health.
Highlights
Almost 14% of the global burden of diseases is related to neuropsy chiatric disorders including common mental health disorders such as depression [1]
We explored the correlation amongst a range of cognitive tests between UK Biobank (UKB) and Clinical Record Interactive Search (CRIS)/OX (Appendix E)
With the reference standard; (2) the self-reported diagnostic data alone in the UKB identified less than half of the cases and individuals with the apparent diagnosis when other sources were included; (3) together with the Hospital Episode Statistics (HES) inpatient psychiatric diagnoses, death registry and algorithmicdefined outcomes, the UKB data can be used with limited reliability to identify patients with mental health disorders
Summary
Almost 14% of the global burden of diseases is related to neuropsy chiatric disorders including common mental health disorders such as depression [1]. These disorders are measured in different cohorts such as UK Biobank (UKB). UKB is a large population-based data resource (>500,000 participants) with a wide variety of exposures involving demographic, lifestyle, environmental and health information for the assessment of determinants of various life-threatening and disabling conditions, including mental health disorders. Whilst UKB could be a great resource for mental health research, the reliability and validity of the included measures in comparison to physician confirmed information remains largely unknown. Validation studies to date focused only on one aspect of the data accuracy, such as the precision of diagnosis for a certain disease [4,5]; many used adjudicated outcomes by clinicians as their
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