Validation of the Recording of Acute Exacerbations of COPD in UK Primary Care Electronic Healthcare Records
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{"title"=>"Validation of the recording of acute exacerbations of COPD in UK primary care electronic healthcare records", "type"=>"journal", "authors"=>[{"first_name"=>"Kieran J.", "last_name"=>"Rothnie", "scopus_author_id"=>"56541625200"}, {"first_name"=>"Hana", "last_name"=>"Müllerová", "scopus_author_id"=>"6602455464"}, {"first_name"=>"John R.", "last_name"=>"Hurst", "scopus_author_id"=>"7202860805"}, {"first_name"=>"Liam", "last_name"=>"Smeeth", "scopus_author_id"=>"7003651182"}, {"first_name"=>"Kourtney", "last_name"=>"Davis", "scopus_author_id"=>"7403213774"}, {"first_name"=>"Sara L.", "last_name"=>"Thomas", "scopus_author_id"=>"56030316300"}, {"first_name"=>"Jennifer K.", "last_name"=>"Quint", "scopus_author_id"=>"16507541000"}], "year"=>2016, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"609034705", "sgr"=>"84962312918", "pmid"=>"26959820", "scopus"=>"2-s2.0-84962312918", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "doi"=>"10.1371/journal.pone.0151357", "issn"=>"19326203"}, "id"=>"a1f5abc7-1b39-366f-85a9-31f8ebe7ed52", "abstract"=>"Background Acute Exacerbations of COPD (AECOPD) identified from electronic healthcare records (EHR) are important for research, public health and to inform healthcare utilisation and ser- vice provision. However, there is no standardised method of identifying AECOPD in UK EHR. We aimed to validate the recording of AECOPD in UK EHR. Methods We randomly selected 1385 patients with COPD from the Clinical Practice Research Data- link.Weselected dates of possible AECOPDbased on 15 different algorithms between Jan- uary 2004 and August 2013. Questionnaires were sent to GPs asking for confirmation of their patients’ AECOPD on the dates identified and for any additional relevant information. Responses were reviewed independently by two respiratory physicians. Positive predictive value (PPV) and sensitivity were calculated. Results The response rate was 71.3%. AECOPD diagnostic codes, lower respiratory tract infection (LRTI) codes, and prescriptions of antibiotics and oral corticosteroids (OCS) together for 5–14 days had a high PPV (>75%) for identifying AECOPD. Symptom-based algorithms and prescription of antibiotics or OCS alone had lower PPVs (60–75%). A combined strat- egy of antibiotic and OCS prescriptions for 5–14 days, or LRTI or AECOPD code resulted in a PPV of 85.5% (95% CI, 82.7–88.3%) and a sensitivity of 62.9%(55.4–70.4%). Conclusion", "link"=>"http://www.mendeley.com/research/validation-recording-acute-exacerbations-copd-uk-primary-care-electronic-healthcare-records-8", "reader_count"=>34, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Researcher"=>17, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Other"=>2, "Student > Master"=>3, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Researcher"=>17, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Other"=>2, "Student > Master"=>3, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Biochemistry, Genetics and Molecular Biology"=>2, "Mathematics"=>2, "Medicine and Dentistry"=>21, "Pharmacology, Toxicology and Pharmaceutical Science"=>3, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>21}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>4}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>3}}, "reader_count_by_country"=>{"Canada"=>1, "Brazil"=>1}, "group_count"=>6}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/4828951"], "description"=>"<p>Patient flow through the study.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106816, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.g001", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Patient_flow_through_the_study_/3106816", "title"=>"Patient flow through the study.", "pos_in_sequence"=>2, "defined_type"=>1, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828984"], "description"=>"<p>PPV and sensitivity of composite strategies to identify AECOPD including only patients for whom additional information was available from their GP questionnaire.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106849, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t006", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/PPV_and_sensitivity_of_composite_strategies_to_identify_AECOPD_including_only_patients_for_whom_additional_information_was_available_from_their_GP_questionnaire_/3106849", "title"=>"PPV and sensitivity of composite strategies to identify AECOPD including only patients for whom additional information was available from their GP questionnaire.", "pos_in_sequence"=>8, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828957"], "description"=>"<p>Description of the algorithms tested.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106819, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t001", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Description_of_the_algorithms_tested_/3106819", "title"=>"Description of the algorithms tested.", "pos_in_sequence"=>3, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828960"], "description"=>"<p>Characteristics of the 988 patients included in the analysis.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106825, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t002", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Characteristics_of_the_988_patients_included_in_the_analysis_/3106825", "title"=>"Characteristics of the 988 patients included in the analysis.", "pos_in_sequence"=>4, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828933", "https://ndownloader.figshare.com/files/4828939"], "description"=>"<div><p>Background</p><p>Acute Exacerbations of COPD (AECOPD) identified from electronic healthcare records (EHR) are important for research, public health and to inform healthcare utilisation and service provision. However, there is no standardised method of identifying AECOPD in UK EHR. We aimed to validate the recording of AECOPD in UK EHR.</p><p>Methods</p><p>We randomly selected 1385 patients with COPD from the Clinical Practice Research Datalink. We selected dates of possible AECOPD based on 15 different algorithms between January 2004 and August 2013. Questionnaires were sent to GPs asking for confirmation of their patients’ AECOPD on the dates identified and for any additional relevant information. Responses were reviewed independently by two respiratory physicians. Positive predictive value (PPV) and sensitivity were calculated.</p><p>Results</p><p>The response rate was 71.3%. AECOPD diagnostic codes, lower respiratory tract infection (LRTI) codes, and prescriptions of antibiotics and oral corticosteroids (OCS) together for 5–14 days had a high PPV (>75%) for identifying AECOPD. Symptom-based algorithms and prescription of antibiotics or OCS alone had lower PPVs (60–75%). A combined strategy of antibiotic and OCS prescriptions for 5–14 days, or LRTI or AECOPD code resulted in a PPV of 85.5% (95% CI, 82.7–88.3%) and a sensitivity of 62.9% (55.4–70.4%).</p><p>Conclusion</p><p>Using a combination of diagnostic and therapy codes, the validity of AECOPD identified from EHR can be high. These strategies are useful for understanding health-care utilisation for AECOPD, informing service provision and for researchers. These results highlight the need for common coding strategies to be adopted in primary care to allow easy and accurate identification of events.</p></div>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106801, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0151357.s001", "https://dx.doi.org/10.1371/journal.pone.0151357.s002"], "stats"=>{"downloads"=>10, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Validation_of_the_Recording_of_Acute_Exacerbations_of_COPD_in_UK_Primary_Care_Electronic_Healthcare_Records/3106801", "title"=>"Validation of the Recording of Acute Exacerbations of COPD in UK Primary Care Electronic Healthcare Records", "pos_in_sequence"=>1, "defined_type"=>4, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828969"], "description"=>"<p>Flow of events through the study.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106834, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t003", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Flow_of_events_through_the_study_/3106834", "title"=>"Flow of events through the study.", "pos_in_sequence"=>5, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828975"], "description"=>"<p>PPV and sensitivity for the algorithms.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106840, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t004", "stats"=>{"downloads"=>2, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/PPV_and_sensitivity_for_the_algorithms_/3106840", "title"=>"PPV and sensitivity for the algorithms.", "pos_in_sequence"=>6, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/4828981"], "description"=>"<p>PPV and sensitivity of the algorithms to identify AECOPD including only patients for whom additional information was available from their GP questionnaire.</p>", "links"=>[], "tags"=>["code", "LRTI", "EHR", "GP", "service provision", "AECOPD", "calculated.ResultsThe response rate", "OCS", "Care Electronic Healthcare Records BackgroundAcute Exacerbations", "UK", "CI", "August 2013. Questionnaires", "PPV", "Clinical Practice Research Datalink", "COPD"], "article_id"=>3106846, "categories"=>["Biotechnology", "Biological Sciences not elsewhere classified", "Marine Biology", "Science Policy", "Infectious Diseases", "Virology"], "users"=>["Kieran J. Rothnie", "Hana Müllerová", "John R. Hurst", "Liam Smeeth", "Kourtney Davis", "Sara L. Thomas", "Jennifer K. Quint"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0151357.t005", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/PPV_and_sensitivity_of_the_algorithms_to_identify_AECOPD_including_only_patients_for_whom_additional_information_was_available_from_their_GP_questionnaire_/3106846", "title"=>"PPV and sensitivity of the algorithms to identify AECOPD including only patients for whom additional information was available from their GP questionnaire.", "pos_in_sequence"=>7, "defined_type"=>3, "published_date"=>"2016-03-09 08:51:48"}

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Relative Metric

{"start_date"=>"2016-01-01T00:00:00Z", "end_date"=>"2016-12-31T00:00:00Z", "subject_areas"=>[]}
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