[ { "phenotype_id": "PH444", "phenotype_version_id": 888, "name": "Clinically Significant Alcohol Misuse", "definition": "In the UK, over 98 % of the population are registered with a general practice, with the clinical team providing primary care and access to most other services from the National Health Service (NHS). Even where the patient leaves a family practice and joins another, their GP record follows them, providing a continuous care record. Our data source was the UK Clinical Practice Research Datalink (CPRD), which is one of the largest population-based, longitudinal, primary care databases in the world (www.cprd.com). The CPRD has provided anonymised primary care records for public health and epidemiological research since 1987. It was initially established in London as the Value Added Medical Products (VAMP) ‘research bank’, which expanded across the UK to become the General Practice Research Database (GPRD) in 1993, and was developed further as the CPRD in 2012. It came into being because of a need to develop good quality IT computer systems for general practices in an era when most practices were still wholly reliant on paper records. All practices in the CPRD use Vision software rather than other general practice computing systems, and have consented to share anonymous data for academic research purposes. Around 7 % of the UK population is now represented in the CPRD. Although practices were not selected according to any scientific sampling strategy, a fortuitous by-product of the largely ad hoc processes via which practices have contributed data to the Datalink is that it is broadly representative of the UK primary care patient population by basic demographics such as age, gender and ethnicity. All consultations for registered patients in participating practices are recorded in the CPRD, with comprehensive and detailed clinical coding - the ‘Read’ codes - for symptoms, diagnoses, treatment (including prescribed medication), and referral to other forms of NHS care and to other health care providers. The September 2010 version of the CPRD we analysed contained approximately 10.6 million complete patient records. Before our study dataset was created, the Independent Scientific Advisory Committee of the CPRD granted approval. Consent from individual patients is not required to conduct CPRD-based studies.\n\n\nTo our knowledge there have been no published validation studies of personality disorder or alcohol misuse diagnoses in the CPRD. However, two systematic reviews have reported overall high levels of diagnostic validity in the CPRD and good levels of agreement with other routinely collected data sources. A generic limitation of the CPRD is that diagnostic behaviour varies considerably between GPs and between general practices. Different doctors may apply varying clinical Read codes for exactly the same condition, whilst some may enter free-text information instead of clinical coding. The Quality and Outcomes Framework was introduced in 2004, and recent evidence indicates that this national quality of care incentivisation initiative has produced a marked improvement in diagnostic accuracy and completeness for some chronic conditions during recent years in the CPRD.\n\n\nThe potential of this data source has been further enhanced by recent implementation of linkage to national mortality records. In 2008, complete prospective and historic linkage to national mortality registration data was implemented via the Office for National Statistics (ONS). Data linkage between CPRD and ONS is only available for English practices that have consented to participate in the linkage scheme. These linkages cover approximately 75 % of the contributing CPRD practices in England; the equivalent procedure has not yet been implemented for CPRD practices in the other UK nations: Scotland, Wales and Northern Ireland. Therefore, our case-control study was nested within a subset of the whole CPRD. We included adult suicides if the individual died between January 1st 2002 and December 31st 2011, and had at least a complete year of “up-to-standard” CPRD clinical data prior to the individual’s index-date (death). This quality criterion was also applied in selecting the matched living controls.\n\n\nSuicide case definition:\n\nIn the UK, most unnatural deaths of undetermined cause (or ‘open verdicts’) among adults are considered likely to be suicides. To reduce false-negative misclassification, and in line with standard practice for conducting epidemiological studies of suicide in the UK, our case definition included these open verdicts. The following ICD-10 codes were used: X60-84, Y10-Y34 (excluding Y33.9; ie deaths with adjourned inquests that are mostly deemed subsequently to be homicides), Y87.0 and Y87.2. Identifying PD, other mental disorders and comorbid alcohol misuse To delineate diagnoses of PD we searched the textual descriptions of the clinical Read codes for terms that included: ‘personality’, ‘psychopath’ or ‘sociopath’. We examined the relevant Read codes descriptors and reached a general consensus that we would define patients as having a PD if they had a diagnosis that included a substring of either ‘personality disorder’ or ‘psychopathic disorder’ to ensure that we had a clinically relevant sample with a PD diagnosis. We then identified an additional subgroup of ‘borderline PD: diagnosis of borderline or unstable personality disorder’. We also constructed two additional medical definitions to identify patients with: (1) Any diagnosed mental health disorder: all Read codes beginning with the letter ‘E’, ie a diagnosis of ‘Mental Disorders’ (please note that we excluded those patients coded for signs and symptoms of mental illness only but without an ‘E…’ diagnostic code); (2) Comorbid alcohol misuse: all code descriptions containing “alcohol” were extracted. Two senior clinicians (co-author and consultant psychiatrist: JS; first author and forensic mental health nurse consultant: MD) then independently identified and agreed a list of codes that indicated alcohol problems using a RAG (Red/Amber/Green) agreement system, where Red was defined as a definite clinically significant alcohol misuse problem; Amber, possible problem and Green no problem. Independent ratings were reviewed and a consensus on Red, definite clinically significant alcohol misuse, was established. We opted not to investigate co-morbid PD and illicit drug use due to suspected classification issues, and because the number of suicide cases with such comorbidity was expected to be very small in the CPRD. The diagnoses of PD, any mental health disorder and the alcohol misuse definition are defined as ‘lifetime’ definitions in the sense that they are recorded at some point in their CPRD GP clinical records. The codes contained in the Read ‘E’ category cover every type of diagnosable mental illness across the full spectrum of psychopathology, irrespective of levels of severity and chronicity. In their meta-analysis of suicide risk in persons with a mental disorder, Harris and Barraclough reported that virtually all mental disorders, except for intellectual disability and dementia, are associated with an increased risk of suicide. We therefore combined all categories of mental illness other than personality disorders and analysed them together as a single category.\n\n\nIn the UK, general practitioners typically diagnose and treat less severe disorders such as depression, anxiety and stress, whereas more series conditions such as psychotic disorders and PDs will be mostly treated by psychiatrists in inpatient or outpatient facilities. The great majority of persons with a diagnosed mental disorder in the study dataset were diagnosed with depression and/or anxiety disorders, and this applied to people who died by suicide as well as the living control patients. Mental illness diagnoses, whether made by a GP or by a psychiatrist, are entered into the patient’s primary care clinical record and are therefore recorded in the CPRD.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Michael Doyle, David While, Pearl L H Mok, Kirsten Windfuhr, Darren M. Ashcroft, Evangelos Kontopantelis, Carolyn A Chew-Graham, Lous Appleby, Jenny Shaw, Roger T Webb, Suicide risk in primary care patients diagnosed with a personality disorder a nested case control study. BMC Family Practice, 17(106), 2016." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:19:37.365311Z", "author": "Michael Doyle, David While, Pearl L H Mok, Kirsten Windfuhr, Darren M Aschroft, Evangelos Kontopantelis, Carolyn A Chew-Graham, Louis Appleby, Jenny Shaw, Roger T Webb", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:19:37.365338Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Lifestyle risk factor", "value": "4" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/2002 - 31/12/2011", "concept_information": [ { "concept_id": 1803, "concept_version_id": 4744, "concept_name": "Clinically Significant Alcohol Misuse - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH444", "phenotype_version_id": 888, "phenotype_name": "Clinically Significant Alcohol Misuse", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "1282", "description": "fh: alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1366", "description": "Very heavy drinker - >9u/day", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "136Q.00", "description": "Very heavy drinker", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "136T.00", "description": "harmful alcohol use", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1462", "description": "h/o: alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1B1c.00", "description": "alcohol induced hallucinations", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "66e0.00", "description": "alcohol abuse monitoring", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "7P22100", "description": "delivery of rehabilitation for alcohol addiction", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8BA8.00", "description": "alcohol detoxification", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8CAv.00", "description": "advised to contact primary care alcohol worker", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8G32.00", "description": "aversion therapy - alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8H35.00", "description": "admitted to alcohol detoxification centre", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8HkG.00", "description": "referral to specialist alcohol treatment service", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8IAF.00", "description": "brief intervention for excessive alcohol consumptn declined", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8IAJ.00", "description": "declined referral to specialist alcohol treatment service", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8IAt.00", "description": "extended interven for excessive alcohol consumption declined", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "9k1B.00", "description": "extended intervention for excessive alcohol consumptn complt", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "9NN2.00", "description": "under care of community alcohol team", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C150500", "description": "alcohol-induced pseudo-cushing's syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E01..00", "description": "alcoholic psychoses", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E010.00", "description": "alcohol withdrawal delirium", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E011000", "description": "korsakov's alcoholic psychosis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E011100", "description": "korsakov's alcoholic psychosis with peripheral neuritis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E011200", "description": "Wernicke-Korsakov syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E011z00", "description": "alcohol amnestic syndrome nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E012.00", "description": "other alcoholic dementia", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E012000", "description": "chronic alcoholic brain syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E012.11", "description": "alcoholic dementia nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E013.00", "description": "alcohol withdrawal hallucinosis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E014.00", "description": "pathological alcohol intoxication", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E015.00", "description": "alcoholic paranoia", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E01y.00", "description": "other alcoholic psychosis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E01y000", "description": "alcohol withdrawal syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E01yz00", "description": "other alcoholic psychosis nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E01z.00", "description": "alcoholic psychosis nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E23..00", "description": "alcohol dependence syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230.00", "description": "acute alcoholic intoxication in alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230000", "description": "acute alcoholic intoxication; unspecified; in alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230100", "description": "continuous acute alcoholic intoxication in alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230.11", "description": "alcohol dependence with acute alcoholic intoxication", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230200", "description": "episodic acute alcoholic intoxication in alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230300", "description": "acute alcoholic intoxication in remission; in alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E230z00", "description": "acute alcoholic intoxication in alcoholism nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231.00", "description": "chronic alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231000", "description": "unspecified chronic alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E23..11", "description": "alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231100", "description": "continuous chronic alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231200", "description": "episodic chronic alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231300", "description": "chronic alcoholism in remission", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E231z00", "description": "chronic alcoholism nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E23z.00", "description": "alcohol dependence syndrome nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E250300", "description": "nondependent alcohol abuse in remission", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10.00", "description": "[x]mental and behavioural disorders due to use of alcohol", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10100", "description": "[x]mental and behav dis due to use of alcohol: harmful use", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10200", "description": "[x]mental and behav dis due to use alcohol: dependence syndr", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10211", "description": "[x]alcohol addiction", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10212", "description": "[x]chronic alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10300", "description": "[x]mental and behav dis due to use alcohol: withdrawal state", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10400", "description": "[X]Men & behav dis due alcohl: withdrawl state with delirium", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10411", "description": "[x]delirium tremens; alcohol induced", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10500", "description": "[x]mental & behav dis due to use alcohol: psychotic disorder", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10511", "description": "[x]alcoholic hallucinosis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10512", "description": "[x]alcoholic jealousy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10513", "description": "[x]alcoholic paranoia", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10514", "description": "[x]alcoholic psychosis nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10600", "description": "[x]mental and behav dis due to use alcohol: amnesic syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10611", "description": "[x]korsakov's psychosis; alcohol induced", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10700", "description": "[X]Men & behav dis due alcoh: resid & late-onset psychot dis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10711", "description": "[x]alcoholic dementia nos", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10712", "description": "[x]chronic alcoholic brain syndrome", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10800", "description": "[x]alcohol withdrawal-induced seizure", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10y00", "description": "[x]men & behav dis due to use alcohol: oth men & behav dis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu10z00", "description": "[x]ment & behav dis due use alcohol: unsp ment & behav dis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F11x000", "description": "cerebral degeneration due to alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F11x011", "description": "alcoholic encephalopathy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F144000", "description": "cerebellar ataxia due to alcoholism", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F25B.00", "description": "alcohol-induced epilepsy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F375.00", "description": "alcoholic polyneuropathy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F394100", "description": "alcoholic myopathy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G555.00", "description": "alcoholic cardiomyopathy", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G852300", "description": "oesophageal varices in alcoholic cirrhosis of the liver", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "J610.00", "description": "alcoholic fatty liver", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "J611.00", "description": "acute alcoholic hepatitis", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "J612.00", "description": "alcoholic cirrhosis of liver", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "J612000", "description": "alcoholic fibrosis and sclerosis of liver", "attributes": { "Entity type": "res32: Clinically Significant Alcohol Misuse", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "J613.00", "description": "alcoholic liver damage unspecified", "attributes": { "Entity type": "res32: Clinically Significant 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