M Elle Saine1,2,3, Dena M Carbonari1, Craig W Newcomb1, Arlene M Gallagher4, Betina T Blak5, Jason A Roy1,6, Jennifer Wood7, Serena Cardillo2, Sean Hennessy1, Brian L Strom1,6, Vincent Lo Re1,2. 1. Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 2. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. 4. Clinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK. 5. AstraZeneca UK Limited, Luton, UK. 6. Rutgers Biomedical & Health Sciences, The State University of New Jersey, Newark, NJ, USA. 7. Department of Global Pharmacovigilance and Epidemiology, Bristol-Myers Squibb, Hopewell, NJ, USA.
Abstract
PURPOSE: The ability of the Clinical Practice Research Datalink (CPRD) to ascertain all-cause hospitalizations remains unknown. We determined the proportion of hospitalizations in CPRD that were also recorded in Hospital Episode Statistics (HES), and vice versa, among patients initiating oral antidiabetic (OAD) therapy. METHODS: We conducted a retrospective cohort study from October 2009 to September 2012 among OAD-treated patients registered with general practitioners who contribute to CPRD and consent to HES linkage. In CPRD, we identified initial hospitalizations for each calendar year by an Inpatient Referral, Consultation Type code, or Read code indicating an inpatient episode and determined if an admission date was recorded in HES within ±30 days. We then identified initial HES admission dates and determined if a hospitalization was documented in CPRD within ±30 days. Sensitivity analyses were conducted utilizing HES discharge, rather than admission, dates. RESULTS: Among 8574 OAD-treated HES-linked patients in CPRD, 6574 initial hospitalizations across the study period were identified in CPRD, and 5188 (78.9% [95% CI, 77.9%-79.9%]) were confirmed by a HES admission date within ±30 days (median difference, ±3 days [IQR, 1-7 days]). Among 8609 initial hospital admissions in HES, 4803 (55.7% [95% CI, 54.7%-56.8%]) hospitalizations were recorded in CPRD within ±30 days (median difference, ±4 days [IQR, 1-9 days]). Similar results were observed using HES discharge dates. CONCLUSION: A substantial minority of patient-level hospitalization data are nonconcordant between HES and CPRD. Pharmacoepidemiologic studies within CPRD that seek to identify hospitalizations should consider linkage with HES to ensure adequate ascertainment of inpatient events.
PURPOSE: The ability of the Clinical Practice Research Datalink (CPRD) to ascertain all-cause hospitalizations remains unknown. We determined the proportion of hospitalizations in CPRD that were also recorded in Hospital Episode Statistics (HES), and vice versa, among patients initiating oral antidiabetic (OAD) therapy. METHODS: We conducted a retrospective cohort study from October 2009 to September 2012 among OAD-treated patients registered with general practitioners who contribute to CPRD and consent to HES linkage. In CPRD, we identified initial hospitalizations for each calendar year by an Inpatient Referral, Consultation Type code, or Read code indicating an inpatient episode and determined if an admission date was recorded in HES within ±30 days. We then identified initial HES admission dates and determined if a hospitalization was documented in CPRD within ±30 days. Sensitivity analyses were conducted utilizing HES discharge, rather than admission, dates. RESULTS: Among 8574 OAD-treated HES-linked patients in CPRD, 6574 initial hospitalizations across the study period were identified in CPRD, and 5188 (78.9% [95% CI, 77.9%-79.9%]) were confirmed by a HES admission date within ±30 days (median difference, ±3 days [IQR, 1-7 days]). Among 8609 initial hospital admissions in HES, 4803 (55.7% [95% CI, 54.7%-56.8%]) hospitalizations were recorded in CPRD within ±30 days (median difference, ±4 days [IQR, 1-9 days]). Similar results were observed using HES discharge dates. CONCLUSION: A substantial minority of patient-level hospitalization data are nonconcordant between HES and CPRD. Pharmacoepidemiologic studies within CPRD that seek to identify hospitalizations should consider linkage with HES to ensure adequate ascertainment of inpatient events.
Authors: Alyaa M Ajabnoor; Salwa S Zghebi; Rosa Parisi; Darren M Ashcroft; Martin K Rutter; Tim Doran; Matthew J Carr; Mamas A Mamas; Evangelos Kontopantelis Journal: PLoS Med Date: 2022-06-07 Impact factor: 11.613
Authors: Simone Wolf; Abhishek S Chitnis; Anandan Manoranjith; Mollie Vanderkarr; Javier Quintana Plaza; Laura V Gador; Chantal E Holy; Charisse Sparks; Simon M Lambert Journal: BMC Musculoskelet Disord Date: 2022-02-09 Impact factor: 2.362