Developing a large electronic primary care database (Doctors’ Independent Network) for research

Carey, Iain M.; Cook, Derek G; Wilde, Stephen De; Bremner, Stephen; Richards, Nicky; Caine, Steve; Strachan, David P.; Hilton, Sean

doi:10.1016/j.ijmedinf.2004.02.002

Cited by 41 publications

(42 citation statements)

References 12 publications

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“…We have outlined earlier methods for identifying good-quality data in DIN-LINK 8 and this approach was repeated with further updates of the database. Validations of the DIN-LINK database have shown that its age-gender population structure is highly comparable with another large primary care database (the General Practice Research Database), 8 and we have shown that prevalence rates for a wide range of conditions including ischaemic heart disease (IHD), 8 diabetes, 9 atrial fibrillation 10 and common childhood diagnoses 11 are similar to other published data. This report is based on 152 practices that contributed continuous high-quality data 8 between 2000 and 2005 (pre-and post-dating the introduction of QOF).…”

Section: Methodsmentioning

confidence: 99%

Blood pressure recording bias during a period when the Quality and Outcomes Framework was introduced

et al. 2009

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Section: Methodsmentioning

confidence: 99%

Blood pressure recording bias during a period when the Quality and Outcomes Framework was introduced

et al. 2009

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“…Methods have been outlined for identifying good-quality data in DIN-LINK and this approach was repeated. 19 Prevalence rates for a wide range of conditions including coronary heart disease (CHD) and atrial fibrillation (AF) compare well with other national data sources. 20,21 Morbidity and prescription data are coded by Read codes.…”

Section: Din-link (Formerly Din [Doctors' Independentmentioning

confidence: 99%

Trends and inequities in beta-blocker prescribing for heart failure

Shah

Carey²,

DeWilde³

et al. 2008

Br J Gen Pract

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Treatment with specific beta-blockers reduces mortality and hospitalisation in heart failure. AimTo describe trends and inequities in beta-blocker prescribing for heart failure. Design of studyRepeated cross-sectional analysis of a nationally representative primary care database (DIN-LINK). SettingA total of 152 UK general practices. MethodPrescribing of beta-blockers between 2000 and 2005 was examined among a yearly average of 7294 patients aged ≥50 years who had actively managed heart failure -defined as a recorded diagnosis of heart failure and two prescriptions of an angiotensinconverting enzyme inhibitor or angiotensin receptor blocker during the calendar year. The main outcome was the prescription of a guideline-recommended beta-blocker (bisoprolol, carvedilol, metoprolol, or nebivolol) in the year. Determinants of beta-blocker prescribing were analysed using logistic regression. ResultsBetween 2000 and 2005, age-adjusted use of recommended beta-blockers rose from 6.1% to 27.0% in men, and from 4.2% to 21.5% in women. In 2005, younger patients were more likely to be treated; the fully adjusted odds ratio was 4.83 (95% confidence interval = 3.78 to 6.17) for patients aged 60-64 years compared with those aged 85 years. Women and patients living in areas of socioeconomic deprivation were less likely to be treated. In 2005, in addition to treatment with guideline-recommended beta-blockers, a further 11.7% of men and 12.5% of women were prescribed other beta-blockers. ConclusionRecommended beta-blocker use has risen in the UK but remains low and inequitable, with many patients still treated with beta-blockers that are not recommended in guidelines. This suggests further improvements in prescribing are still possible.

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“…49,50 Three studies compared the GPRD with the Doctors' Independent Network (DIN), a UK-based primary care database that has been collecting routine data from over 300 practices distinct from the GPRD since 1989. [51][52][53] Generally, there was good agreement between the two databases for common childhood conditions, hay fever, ischaemic heart disease, and prescribing for skin emollients.…”

Section: The Gprd Compared With Other Databases or Statisticsmentioning

confidence: 99%

“…Other databases may use different coding systems; for instance DIN practices have always used Read Codes for recording diagnoses and prescriptions under a problemorientated medical record, which presents each medical record as a set of intertwined but separate problems. 51,52 Investigators attributed many of the differences between DIN and the GPRD to the Read and OXMIS coding systems used in the respective databases.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

Validity of diagnostic coding within the General Practice Research Database: a systematic review

2010

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The UK-based General Practice Research Database (GPRD) is a valuable source of longitudinal primary care records and is increasingly used for epidemiological research. AimTo conduct a systematic review of the literature on accuracy and completeness of diagnostic coding in the GPRD. Design of studySystematic review. MethodSix electronic databases were searched using search terms relating to the GPRD, in association with terms synonymous with validity, accuracy, concordance, and recording. A positive predictive value was calculated for each diagnosis that considered a comparison with a gold standard. Studies were also considered that compared the GPRD with other databases and national statistics. ResultsA total of 49 papers are included in this review. Forty papers conducted validation of a clinical diagnosis in the GPRD. When assessed against a gold standard (validation using GP questionnaire, primary care medical records, or hospital correspondence), most of the diagnoses were accurately recorded in the patient electronic record. Acute conditions were not as well recorded, with positive predictive values lower than 50%. Twelve papers compared prevalence or consultation rates in the GPRD against other primary care databases or national statistics. Generally, there was good agreement between disease prevalence and consultation rates between the GPRD and other datasets; however, rates of diabetes and musculoskeletal conditions were underestimated in the GPRD. ConclusionMost of the diagnoses coded in the GPRD are well recorded. Researchers using the GPRD may want to consider how well the disease of interest is recorded before planning research, and consider how to optimise the identification of clinical events. Keywordsdatabase management systems; meta-analysis; sensitivity and specificity; and systematic review.

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Developing a large electronic primary care database (Doctors’ Independent Network) for research

Cited by 41 publications

References 12 publications

Blood pressure recording bias during a period when the Quality and Outcomes Framework was introduced

Blood pressure recording bias during a period when the Quality and Outcomes Framework was introduced

Trends and inequities in beta-blocker prescribing for heart failure

Validity of diagnostic coding within the General Practice Research Database: a systematic review

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