Abstract
BackgroundElectronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES) in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK), general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources.MethodsMillion Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82]) between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record.ResultsOver 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22), stroke, both overall (I60-64) and by subtype, and pulmonary embolism (I26), HES records appeared to be both reliable and complete.ConclusionHospital admission data in England provide diagnostic information for vascular disease of sufficient reliability for epidemiological analyses.
Highlights
Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES) in England, is increasingly used in medical research
General practitioners’ return rates and analysable data Over 90% of study forms sent to general practitioners were returned
Reasons for unavailable data in returned forms included general practice records being incomplete or no longer available, because the study participant was no longer registered with the practice, or most commonly, she had died. (After a woman’s death, her records are sent to the relevant health authority in the practice region for archiving.) We examined the number of deaths which had occurred before data collection in 2010 in women in each HES diagnostic group, using linked Office for National Statistics mortality data
Summary
Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES) in England, is increasingly used in medical research. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. In England, one example is the Hospital Episode Statistics (HES) [1], which contains records of hospital admissions including diagnosis data. The use of such datasets is promoted by the National Institute of Health Research. General practice records are the most comprehensive source of an individual’s medical history in the United Kingdom (UK), as they include information on investigations and diagnoses in primary, secondary and tertiary care. The aim is to assess whether HES diagnoses of vascular disease are of sufficient reliability for epidemiological research
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