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首页> 外文期刊>BMJ Open >Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)
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Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)

机译：在临床实践研究数据链接（CPRD-GOLD）中验证慢性阻塞性肺疾病的记录

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Objectives The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database. Setting 951 participants registered with a CPRD practice in the UK between 1 January 2004 and 31 December 2012. Individuals were selected for ≥1 of 8 algorithms to identify people with COPD. General practitioners were sent a brief questionnaire and additional evidence to support a COPD diagnosis was requested. All information received was reviewed independently by two respiratory physicians whose opinion was taken as the gold standard. Primary outcome measure The primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed. Results 951 questionnaires were sent and 738 (78%) returned. After quality control, 696 (73.2%) patients were included in the final analysis. All four algorithms including a specific COPD diagnostic code performed well. Using a diagnostic code alone, the PPV was 86.5% (77.5–92.3%) while requiring a diagnosis plus spirometry plus specific medication; the PPV was slightly higher at 89.4% (80.7–94.5%) but reduced case numbers by 10%. Algorithms without specific diagnostic codes had low PPVs (range 12.2–44.4%). Conclusions Patients with COPD can be accurately identified from UK primary care records using specific diagnostic codes. Requiring spirometry or COPD medications only marginally improved accuracy. The high accuracy applies since the introduction of an incentivised disease register for COPD as part of Quality and Outcomes Framework in 2004.
机译：目的目前尚不清楚从电子基层医疗记录中识别患有慢性阻塞性肺疾病（COPD）的人的最佳方法。我们使用英国电子健康记录数据库Clinical Practice Research Datalink评估了不同方法的准确性。在2004年1月1日至2012年12月31日期间，共有951名参与者在英国进行了CPRD执业注册。从8种算法中选择1项以上的个体来识别COPD。向全科医生发送了简短的调查表，并要求其他证据支持COPD诊断。两位呼吸内科医师独立审查了收到的所有信息，他们的意见被视为黄金标准。主要结局指标准确性的主要指标是阳性预测值（PPV），即每种算法所确认的COPD确认人群所占的比例。结果发送了951份问卷，返回738份（78％）。经过质量控制后，最终分析中包括696名患者（73.2％）。包括特定的COPD诊断代码的所有四种算法均运行良好。仅使用诊断代码，PPV为86.5％（77.5–92.3％），同时需要诊断，肺活量测定和特定药物治疗; PPV略高，为89.4％（80.7–94.5％），但案件数量减少了10％。没有特定诊断代码的算法的PPV较低（范围为12.2-44.4％）。结论可以使用特定的诊断代码从英国的初级保健记录中准确识别出COPD患者。要求肺活量测定法或COPD药物只能稍微提高准确性。自从2004年引入COPD激励性疾病登记册作为“质量和成果框架”的一部分以来，就具有很高的准确性。

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