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Coronary Heart Disease

Evangelos Kontopantelis, Ivan Olier, Claire Planner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Sioban Reilly

Type
Disease or Syndrome
ID
PH507
Version ID
1014
Data Sources
Valid event data range
01/04/2000 - 31/03/2012
Sex
Female, Male
Agreement Date
2015-12-16
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

The database:

The 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.

Defining people with SMI and controls:

Information 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.

Defining consultation type:

We 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.

Publications

  • 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.

Clinical Code List

Rows: 62
Code Description Entity type Category Coding System (Read)
G3...00 Ischaemic heart disease res21: CHD diagnostic Read
G3...11 Arteriosclerotic heart disease res21: CHD diagnostic Read
G3...12 Atherosclerotic heart disease res21: CHD diagnostic Read
G3...13 IHD - Ischaemic heart disease res21: CHD diagnostic Read
G31..00 Other acute and subacute ischaemic heart disease res21: CHD diagnostic Read
G310.00 Postmyocardial infarction syndrome res21: CHD diagnostic Read
G310.11 Dressler's syndrome res21: CHD diagnostic Read
G311.00 Preinfarction syndrome res21: CHD diagnostic Read
G311.11 Crescendo angina res21: CHD diagnostic Read
G311.12 Impending infarction res21: CHD diagnostic Read
G311.13 Unstable angina res21: CHD diagnostic Read
G311.14 Angina at rest res21: CHD diagnostic Read
G311100 Unstable angina res21: CHD diagnostic Read
G311200 Angina at rest res21: CHD diagnostic Read
G311300 Refractory angina res21: CHD diagnostic Read
G311500 Acute coronary syndrome res21: CHD diagnostic Read
G311z00 Preinfarction syndrome NOS res21: CHD diagnostic Read
G31y.00 Other acute and subacute ischaemic heart disease res21: CHD diagnostic Read
G31y000 Acute coronary insufficiency res21: CHD diagnostic Read
G31y200 Subendocardial ischaemia res21: CHD diagnostic Read
G31y300 Transient myocardial ischaemia res21: CHD diagnostic Read
G31yz00 Other acute and subacute ischaemic heart disease NOS res21: CHD diagnostic Read
G32..00 Old myocardial infarction res21: CHD diagnostic Read
G32..11 Healed myocardial infarction res21: CHD diagnostic Read
G32..12 Personal history of myocardial infarction res21: CHD diagnostic Read
G33..00 Angina pectoris res21: CHD diagnostic Read
G330.00 Angina decubitus res21: CHD diagnostic Read
G330000 Nocturnal angina res21: CHD diagnostic Read
G330z00 Angina decubitus NOS res21: CHD diagnostic Read
G331.00 Prinzmetal's angina res21: CHD diagnostic Read
G331.11 Variant angina pectoris res21: CHD diagnostic Read
G332.00 Coronary artery spasm res21: CHD diagnostic Read
G33z.00 Angina pectoris NOS res21: CHD diagnostic Read
G33z000 Status anginosus res21: CHD diagnostic Read
G33z100 Stenocardia res21: CHD diagnostic Read
G33z200 Syncope anginosa res21: CHD diagnostic Read
G33z300 Angina on effort res21: CHD diagnostic Read
G33z400 Ischaemic chest pain res21: CHD diagnostic Read
G33z500 Post infarct angina res21: CHD diagnostic Read
G33z600 New onset angina res21: CHD diagnostic Read
G33z700 Stable angina res21: CHD diagnostic Read
G33zz00 Angina pectoris NOS res21: CHD diagnostic Read
G34..00 Other chronic ischaemic heart disease res21: CHD diagnostic Read
G340.00 Coronary atherosclerosis res21: CHD diagnostic Read
G340.11 Triple vessel disease of the heart res21: CHD diagnostic Read
G340.12 Coronary artery disease res21: CHD diagnostic Read
G340000 Single coronary vessel disease res21: CHD diagnostic Read
G340100 Double coronary vessel disease res21: CHD diagnostic Read
G342.00 Atherosclerotic cardiovascular disease res21: CHD diagnostic Read
G343.00 Ischaemic cardiomyopathy res21: CHD diagnostic Read
G344.00 Silent myocardial ischaemia res21: CHD diagnostic Read
G34y.00 Other specified chronic ischaemic heart disease res21: CHD diagnostic Read
G34y000 Chronic coronary insufficiency res21: CHD diagnostic Read
G34y100 Chronic myocardial ischaemia res21: CHD diagnostic Read
G34yz00 Other specified chronic ischaemic heart disease NOS res21: CHD diagnostic Read
G34z.00 Other chronic ischaemic heart disease NOS res21: CHD diagnostic Read
G34z000 Asymptomatic coronary heart disease res21: CHD diagnostic Read
G3y..00 Other specified ischaemic heart disease res21: CHD diagnostic Read
G3z..00 Ischaemic heart disease NOS res21: CHD diagnostic Read
Gyu3.00 [X]Ischaemic heart diseases res21: CHD diagnostic Read
Gyu3200 [X]Other forms of acute ischaemic heart disease res21: CHD diagnostic Read
Gyu3300 [X]Other forms of chronic ischaemic heart disease res21: CHD diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH507/version/1014/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH507/version/1014/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH507', '1014', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH507/version/1014/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH507/version/1014/export/codes/?format=json
CSV site_root/phenotypes/PH507/version/1014/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH507', '1014', api_client=client)

Version History

Version
ID
Name Owner Publish date
1014 Coronary Heart Disease ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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