CPRD Aurum database: Assessment of data quality and completeness of three important comorbidities

Abstract

Purpose: The Clinical Practice Research Datalink (CPRD) now provides a new medical record database, CPRD Aurum. This is the second of several studies being undertaken to assess the quality of CPRD Aurum data for research. Methods: We included patients aged 20+, with at least one lab test result of any type from a random sample of 50 000 patients in CPRD Aurum. We assessed whether diagnosis codes for type 2 diabetes, hyperlipidemia, and iron deficiency or unspecified anemia were accompanied by supporting codes including lab results and treatments (correctness) and whether lab results, treatments, or other codes indicate a missing diagnosis record (completeness). Results: Among 37 502 patients in CPRD Aurum, correctness of type 2 diabetes, hyperlipidemia, and anemia diagnoses was high (99%, 93%, and 97%, respectively). Completeness was only high for type 2 diabetes (94%-98%); completeness for hypercholesterolemia and anemia diagnoses was modest even when the presence of treatments and lab results indicated the conditions were likely present (51%-59% and 58%-70%, respectively). Conclusions: Our findings indicate that for studies of type 2 diabetes, hyperlipidemia, and iron deficiency or unspecified anemia, the diagnosis code is likely to be correct where present. However, a significant proportion of cases of hyperlipidemia or anemia will be missed if only diagnosis codes are used to select patients with these conditions. Researchers should consider using treatments, supporting codes, and, when available, lab data to supplement diagnosis codes and enhance case capture when including these conditions in studies using CPRD Aurum.

Quality and Completeness of Myocardial Infarction Recording in Clinical Practice Research Datalink Aurum

“…The findings of this study are consistent with two prior assessments conducted in this same data sample: 10 , 11 diagnoses recorded in CPRD Aurum are of relatively high correctness for use in medical research; however, completeness may not be sufficient for all research questions. When using CPRD Aurum data, researchers should consider study design choices or the addition of linked data.…”

“…This 50,000-patient sample was also used for additional validation studies on CPRD Aurum data that describe other data elements and outcomes. 10 , 11 …”

“…This 50,000-patient sample was also used for additional validation studies on CPRD Aurum data that describe other data elements and outcomes. 10,11 The start and end of each patient's active CPRD Aurum electronic record were estimated using the available registration, prescription, and clinical data. Cohort entry was the latest of the patient's estimated CPRD Aurum start date and April 1, 1997.…”

“… 9 Prior publications have described the quality and completeness of coding for pulmonary embolism, diabetes, hypercholesterolemia and anemia. 10 , 11 In this paper, we describe the use of data source agreement to evaluate acute myocardial infarction (MI) diagnoses in CPRD Aurum primary care compared with Hospital Episode Statistics (HES), which captures MIs in secondary care. This comparison provides information on “correctness” (ie, accuracy, validity) and “completeness” (ie, presence, missingness) of MI diagnoses recorded in CPRD Aurum.…”

Initiation of four basal insulins and subsequent treatment modification in people treated for type 2 diabetes in the United Kingdom: Changes over the period 2003–2018

“…The CPRD is well suited for the study of diabetes, as long‐term management of people with type 2 diabetes is primarily handled by general practitioners in the UK 18 . In addition, a recent study revealed 99% correctness and 94%–98% completeness for diagnoses related to type 2 diabetes in CPRD Aurum, 19 and other laboratory measures have also been validated in the CPRD 20 …”