Correctness and Completeness of Breast Cancer Diagnoses Recorded in UK CPRD Aurum and CPRD GOLD Databases: Comparison to Hospital Episode Statistics and Cancer Registry (Companion Paper 2)

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Clinical Epidemiology Pub Date : 2023-12-16 DOI:10.2147/clep.s434829

Katrina Wilcox Hagberg, Catherine Vasilakis-Scaramozza, Rebecca Persson, David Neasham, George Kafatos, Susan Jick

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Abstract

Purpose: To evaluate the new Clinical Practice Research Datalink (CPRD) Aurum database, we estimated ‘correctness’ (ie accuracy, validity) and ‘completeness’ (ie presence, missingness) of malignant breast cancer diagnoses recorded in CPRD Aurum compared to external linked data sources: Hospital Episode Statistics (HES) Admitted Patient Care (APC), HES Outpatient (OP), and Cancer Registry (CR), and to the previously validated CPRD GOLD.
Methods: Linkage-eligible, female patients with incident malignant breast cancer diagnosis recorded in at least one study data source were selected. Correctness was the proportion of malignant breast cancer cases recorded in CPRD Aurum or GOLD who also had a diagnosis recorded in HES APC/OP (2004– 2019) or CR (2004– 2016). Completeness was estimated by identifying all malignant breast cancer diagnoses in HES APC/OP or CR and calculating the proportion with a concordant diagnosis in CPRD Aurum or GOLD.
Results: Compared to HES APC/OP, there were 85,659 and 31,452 eligible patients in CPRD Aurum and GOLD, respectively. Correctness estimates were high (CPRD Aurum 83.5%, GOLD 81.7%). Compared to CR, there were 70,190 and 29,597 eligible patients in CPRD Aurum and GOLD, respectively: correctness was 89.1% for CPRD Aurum and 88.2% for GOLD. Completeness estimates for CPRD Aurum and GOLD were high (> 90%). Diagnoses were recorded in CPRD Aurum within − 7 to 74 days of those in the linked sources. Reasons for discordant diagnostic coding included presence of treatment or other clinical codes only, diagnosis coded after end of follow-up, non-malignant breast cancer in linked data, and administrative codes in lieu of diagnostic codes.
Conclusion: These results indicate that correctness and completeness of malignant breast cancer diagnoses in CPRD Aurum were high and similar to CPRD GOLD. This provides confidence in use of CPRD Aurum for research purposes. Where complete case capture is important, researchers should consider linkage to HES APC or CR.

Keywords: CPRD Aurum, CPRD GOLD, breast cancer, validation

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英国 CPRD Aurum 和 CPRD GOLD 数据库中记录的乳腺癌诊断的正确性和完整性：与医院病例统计和癌症登记的比较（配套文件 2）

目的：为了评估新的临床实践研究数据链（CPRD）Aurum 数据库，我们评估了 CPRD Aurum 与外部链接数据源相比所记录的恶性乳腺癌诊断的 "正确性"（即准确性、有效性）和 "完整性"（即存在、遗漏）：方法：将符合链接条件的女性乳腺癌患者与医院病历统计（Hospital Episode Statistics，HES）住院病人护理（Admitted Patient Care，APC）、HES 门诊病人护理（Outpatient Care，OP）、癌症登记（Cancer Registry，CR）以及之前经过验证的 CPRD GOLD 进行对比：方法：选取符合链接条件、至少在一个研究数据源中记录有恶性乳腺癌诊断的女性患者。正确性是指在 CPRD Aurum 或 GOLD 中记录的恶性乳腺癌病例中，同时在 HES APC/OP （2004-2019 年）或 CR（2004-2016 年）中也有诊断记录的病例所占比例。通过识别 HES APC/OP 或 CR 中的所有恶性乳腺癌诊断，并计算 CPRD Aurum 或 GOLD 中具有一致诊断的比例，来估计完整性：与 HES APC/OP 相比，CPRD Aurum 和 GOLD 中分别有 85,659 和 31,452 名符合条件的患者。正确率较高（CPRD Aurum 为 83.5%，GOLD 为 81.7%）。与 CR 相比，CPRD Aurum 和 GOLD 符合条件的患者人数分别为 70190 人和 29597 人：CPRD Aurum 的正确率为 89.1%，GOLD 为 88.2%。CPRD Aurum 和 GOLD 的完整性估计值较高（90%）。CPRD Aurum 中的诊断记录与链接来源中的诊断记录相差 7 至 74 天。诊断编码不一致的原因包括：仅存在治疗或其他临床编码、随访结束后才进行诊断编码、链接数据中存在非恶性乳腺癌，以及以行政编码代替诊断编码：这些结果表明，CPRD Aurum 中恶性乳腺癌诊断的正确性和完整性很高，与 CPRD GOLD 相似。这为将 CPRD Aurum 用于研究目的提供了信心。如果完整的病例采集非常重要，研究人员应考虑与HES APC或CR建立联系：CPRD Aurum、CPRD GOLD、乳腺癌、验证

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.