[ { "phenotype_id": "PH507", "phenotype_version_id": 1014, "name": "Coronary Heart Disease", "definition": "The database:\n\nThe CPRD is a large computerised database of anonymised primary care medical records. It contains complete patient information for participating practices, with the healthcare events (diagnoses, treatments, referrals, tests and prescriptions) recorded using coding systems (Read coding for diagnoses). Practice characteristics are described in detail elsewhere. The database is broadly representative of the UK population, although larger practices are over-represented. Practices need to meet prespecified data entry quality criteria to be defined as ‘up to research standard’, and for each study year, our main sample included all CPRD practices that were classed as such for the whole year. We also generated two data sets to test the sensitivity of our findings. First, we included all practices contributing data across the entire study period. Second, we included a subsample of 50 practices, representative of UK practices in terms of area deprivation, and practice list size.\n\n\nDefining people with SMI and controls:\n\nInformation was extracted for the period 1 April 2000 to 31 March 2012 and aggregated into 12 yearly ‘bins’, to correspond with financial years 2000/2001–2011/2012. We used Read codes to identify the presence of SMI. First, we identified relevant keywords (or key-stubs) and codes, for example ‘paranoi’ and ‘E100.00’ (simple schizophrenia). Next, the CPRD was searched for codes that matched the list in either the code or the description field. Finally, the matched code list was reviewed by clinical experts and a final conservative list of codes was agreed. A similar process was used to define comorbidities (hypertension, asthma, hypothyroidism, osteoarthritis, chronic kidney disease, coronary heart disease, epilepsy, chronic obstructive pulmonary disease, cancer, stroke, heart failure, rheumatoid arthritis, dementia and psoriasis). All code lists we used are available from http://www.clinicalcodes.org. All conditions, bar asthma, were treated as unresolvable (ie, permanent). Within each year, all patients registered with a CPRD practice for the whole year and aged 18 or over were eligible for inclusion. The final SMI Read code list was used to identify cases of SMI, which were then grouped into three broad subcategories, in line with the diagnoses used when compiling primary care QOF SMI registers: schizophrenia; affective psychoses (bipolar disorder or other unspecified affective psychosis); other types of psychosis. In the event that an individual received more than one SMI diagnosis over the study period, we used the last available diagnosis to retrospectively ‘correct’ the original diagnosis (ie, we assumed that the latest diagnosis was the correct one). Within each year, each SMI case was then matched on age, sex and practice to five randomly selected patients not associated with SMI up until that time point. More details on the extraction of the cohort have been provided elsewhere,21 and a flow chart of the data extraction process is available in the online appendix figure A2.\n\n\nDefining consultation type:\n\nWe defined a ‘consultation’ as involving direct contact between a patient and a healthcare professional within the primary care setting. We divided consultations into two main categories: face-to-face (our primary outcome), and by telephone (see online appendix table A1). We also constructed a third ‘other’ grouping of all other activities that are captured by the ‘consultation type’ codes within the CPRD. This includes mail/email contact, third party consultations (including referrals), secondary care episodes, other administrative tasks and consultations of unknown content. This group is highly heterogeneous and includes many activities that cannot be classed as consultations. However, we decided to use this grouping as an aggregate secondary outcome since it can potentially provide insight into the overall workload associated with patient care in the primary care context. We decided against breaking down the ‘other’ group in more subcategories as we are very doubtful regarding the reliability and across practice consistency of the coding within these ‘other’ categories. In instances where a patient had two or more consultations within a day, we conservatively assumed a single consultation took place, to reduce the likelihood of including duplicate records.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Evangelos Kontopantelis, Ivan Olier, Claire Panner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Siobhan Reilly, Primary care consultation rates among people with and without severe mental illness a UK cohort study using the Clinical Practice Research Datalink. BMJ Open, 5 (e008650), 2015." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:23:02.270232Z", "author": "Evangelos Kontopantelis, Ivan Olier, Claire Planner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Sioban Reilly", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:23:02.270261Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "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": "01/04/2000 - 31/03/2012", "concept_information": [ { "concept_id": 1877, "concept_version_id": 4892, "concept_name": "Coronary Heart Disease - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH507", "phenotype_version_id": 1014, "phenotype_name": "Coronary Heart Disease", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "G3...00", "description": "Ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31..00", "description": "Other acute and subacute ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G310.00", "description": "Postmyocardial infarction syndrome", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G310.11", "description": "Dressler's syndrome", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G3...11", "description": "Arteriosclerotic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311.00", "description": "Preinfarction syndrome", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311100", "description": "Unstable angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311.11", "description": "Crescendo angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311.12", "description": "Impending infarction", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311.13", "description": "Unstable angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311.14", "description": "Angina at rest", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311200", "description": "Angina at rest", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311300", "description": "Refractory angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311500", "description": "Acute coronary syndrome", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G311z00", "description": "Preinfarction syndrome NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G3...12", "description": "Atherosclerotic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G3...13", "description": "IHD - Ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31y.00", "description": "Other acute and subacute ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31y000", "description": "Acute coronary insufficiency", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31y200", "description": "Subendocardial ischaemia", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31y300", "description": "Transient myocardial ischaemia", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G31yz00", "description": "Other acute and subacute ischaemic heart disease NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G32..00", "description": "Old myocardial infarction", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G32..11", "description": "Healed myocardial infarction", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G32..12", "description": "Personal history of myocardial infarction", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33..00", "description": "Angina pectoris", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G330.00", "description": "Angina decubitus", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G330000", "description": "Nocturnal angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G330z00", "description": "Angina decubitus NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G331.00", "description": "Prinzmetal's angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G331.11", "description": "Variant angina pectoris", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G332.00", "description": "Coronary artery spasm", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z.00", "description": "Angina pectoris NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z000", "description": "Status anginosus", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z100", "description": "Stenocardia", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z200", "description": "Syncope anginosa", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z300", "description": "Angina on effort", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z400", "description": "Ischaemic chest pain", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z500", "description": "Post infarct angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z600", "description": "New onset angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33z700", "description": "Stable angina", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G33zz00", "description": "Angina pectoris NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34..00", "description": "Other chronic ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G340.00", "description": "Coronary atherosclerosis", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G340000", "description": "Single coronary vessel disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G340100", "description": "Double coronary vessel disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G340.11", "description": "Triple vessel disease of the heart", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G340.12", "description": "Coronary artery disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G342.00", "description": "Atherosclerotic cardiovascular disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G343.00", "description": "Ischaemic cardiomyopathy", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G344.00", "description": "Silent myocardial ischaemia", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34y.00", "description": "Other specified chronic ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34y000", "description": "Chronic coronary insufficiency", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34y100", "description": "Chronic myocardial ischaemia", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34yz00", "description": "Other specified chronic ischaemic heart disease NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34z.00", "description": "Other chronic ischaemic heart disease NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G34z000", "description": "Asymptomatic coronary heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G3y..00", "description": "Other specified ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "G3z..00", "description": "Ischaemic heart disease NOS", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Gyu3.00", "description": "[X]Ischaemic heart diseases", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Gyu3200", "description": "[X]Other forms of acute ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Gyu3300", "description": "[X]Other forms of chronic ischaemic heart disease", "attributes": { "Entity type": "res21: CHD", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/ners-rm92", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1014, "version_name": "Coronary Heart Disease", "version_date": "2021-10-06T16:23:02.292679Z", "is_published": true, "is_latest": true } ] } ]