[ { "phenotype_id": "PH536", "phenotype_version_id": 1072, "name": "Hypothyroidism", "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": "2021-10-06T16:24:08.319936Z", "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": "2021-10-06T16:24:08.319964Z", "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 }, { "name": "OXMIS codes", "value": 15 } ], "event_date_range": "01/04/2000 - 31/03/2012", "concept_information": [ { "concept_id": 1923, "concept_version_id": 4984, "concept_name": "Hypothyroidism - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH536", "phenotype_version_id": 1072, "phenotype_name": "Hypothyroidism", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "C03..00", "description": "Congenital hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C03y.00", "description": "Other specified congenital hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C03y000", "description": "Congenital hypothyroidism with diffuse goitre", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C03y100", "description": "Congenital hypothyroidism without goitre", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C03z.00", "description": "Congenital hypothyroidism NOS", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04..00", "description": "Acquired hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C040.00", "description": "Postsurgical hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C040.11", "description": "Post ablative hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C041.00", "description": "Other postablative hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C041000", "description": "Irradiation hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04..11", "description": "Myxoedema", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04..12", "description": "Thyroid deficiency", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04..13", "description": "Hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C041z00", "description": "Postablative hypothyroidism NOS", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C042.00", "description": "Iodine hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C043.00", "description": "Other iatrogenic hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C043000", "description": "Hypothyroidism resulting from para-aminosalicylic acid", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C043100", "description": "Hypothyroidism resulting from phenylbutazone", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C043200", "description": "Hypothyroidism resulting from resorcinol", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C043z00", "description": "Iatrogenic hypothyroidism NOS", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C044.00", "description": "Postinfectious hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C045.00", "description": "Acquired atrophy of thyroid", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C046.00", "description": "Autoimmune myxoedema", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04y.00", "description": "Other acquired hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z.00", "description": "Hypothyroidism NOS", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z000", "description": "Premature puberty due to hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z100", "description": "Myxoedema coma", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z.11", "description": "Pretibial myxoedema - hypothyroid", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z.12", "description": "Thyroid insufficiency", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "C04z.13", "description": "Hypothyroid goitre, acquired", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "Cyu1100", "description": "[X]Other sp cified hypothyroidism", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } } ] }, { "concept_id": 1924, "concept_version_id": 4986, "concept_name": "Hypothyroidism - Primary Care", "coding_system": { "id": 15, "name": "OXMIS codes", "description": "OXMIS codes" }, "phenotype_id": "PH536", "phenotype_version_id": 1072, "phenotype_name": "Hypothyroidism", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "243", "description": "HYPOTHYROIDISM CONGENITAL", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "OXMIS", "Category": "diagnostic" } }, { "code": "244 AC", "description": "HYPOTHYROIDISM ACQUIRED", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "OXMIS", "Category": "diagnostic" } }, { "code": "244 AG", "description": "HYPOTHYROIDISM COMPENSATED", "attributes": { "Entity type": "res21: Hypothyroidism", "Coding System (OXMIS Read)": "OXMIS", "Category": "diagnostic" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/d2xh-2m58", "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": 1072, "version_name": "Hypothyroidism", "version_date": "2021-10-06T16:24:08.343297Z", "is_published": true, "is_latest": true } ] } ]