Other respiratory (excluding asthma and cystic fibrosis)

This code list is part of a set of harmonised code lists to identify chronic paediatric conditions across primary and secondary care datasets across the UK.

• ICD-10 respiratory conditions as per Hardelid 2014 (asthma and cystic fibrosis excluded) mapped to SNOMED and Read v2 using CALIBER.
• Excludes asthma and cystic fibrosis (covered in separate code lists)
• Includes other chronic paediatric respiratory conditions (e.g., bronchiectasis, interstitial lung disease and respiratory conditions due to external agents), chronic respiratory disease of the perinatal period, presence of a tracheostomy or dependence on respiratory support / oxygen.
• Includes congenital respiratory conditions (nose, palate, larynx, trachea and lungs).
• Further separated into three subgroups i) congenital respiratory conditions, ii) non-congenital respiratory conditions and iii) respiratory devices.

Methods

Chronic paediatric conditions were defined as health problems requiring medical follow-up for more than 12 months in 50% or more of cases. Code lists were produced by mapping existing ICD-10 codes for chronic paediatric conditions to SNOMED and Read v2 codes using the CALIBER R package, with review by paediatric sub-specialists.

An established ICD-10 code list of chronic paediatric conditions (Hardelid 2014) was used as the basis for the new lists.1 Chronic paediatric conditions were defined as any health problem requiring medical follow-up (hospital admission, outpatient follow up or use of support services such as physiotherapy) for more than 12 months in 50% or more of cases.[1] A Chronic Paediatric Conditions Committee of paediatric sub-specialists was established. The original ICD-10 list was screened by two paediatricians and acute conditions removed, with disagreements resolved by a third paediatrician. Conditions which were likely acute and would not fulfil our chronic disease definition were excluded, including skeletal injuries and self-harm. Drug-induced conditions were excluded as chronicity was not known. Infections other than human immunodeficiency virus (HIV), hepatitis B or C, or congenital infections (syphilis / toxoplasmosis / rubella / herpes simplex virus / cytomegalovirus) were excluded. Chronic sequelae of infections were retained.

Published code lists were then identified for Read v2 and SNOMED codes for well-characterised conditions including asthma, diabetes, cystic fibrosis and cancer. The remaining ICD-10 codes were mapped to SNOMED and Read v2 codes using the CALIBER R package and Technology Reference Update Distribution NHS Data Migration tables [2] to produce new code lists suitable for primary care data. These resulting code lists were screened by two sub-specialists to ensure conditions were chronic and in the correct subgroup with disagreements resolved by a third clinician.

References:

1. Hardelid P, Dattani N, Gilbert R. Estimating the prevalence of chronic conditions in children who die in England, Scotland and Wales: a data linkage cohort study. BMJ Open 2014; 4: e005331.
2. CALIBER codelists-package: Generate ICD, Read and OPCS codelists in CALIBER codelists: Generate ICD10, Read and OPCS codelists, https://rdrr.io/rforge/CALIBERcodelists/man/CALIBERcodelists-package.html (accessed 19 October 2022).

We have considered conditions to be active if they had been coded for in the preceding five years. In addition, conditions from the following subgroups were considered to be permanent, therefore active if coded for at any time: metabolic, diabetes, cystic fibrosis, transplant, receiving palliative care, other congenital multisystem syndromes and chromosomal abnormalities, immunological and cerebral palsy / paralysis (a subgroup of "Other neurology" code list).