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Chronic Obstructive Pulmonary Disease (COPD)

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

Type
Disease or Syndrome
ID
PH513
Version ID
1026
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 OXMIS codes
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: 41
Code Description Entity type Coding System (OXMIS Read) Category
H3...00 Chronic obstructive pulmonary disease res21: COPD Read diagnostic
H31..00 Chronic bronchitis res21: COPD Read diagnostic
H310.00 Simple chronic bronchitis res21: COPD Read diagnostic
H310000 Chronic catarrhal bronchitis res21: COPD Read diagnostic
H310z00 Simple chronic bronchitis NOS res21: COPD Read diagnostic
H311.00 Mucopurulent chronic bronchitis res21: COPD Read diagnostic
H311000 Purulent chronic bronchitis res21: COPD Read diagnostic
H311100 Fetid chronic bronchitis res21: COPD Read diagnostic
H311z00 Mucopurulent chronic bronchitis NOS res21: COPD Read diagnostic
H312.00 Obstructive chronic bronchitis res21: COPD Read diagnostic
H312000 Chronic asthmatic bronchitis res21: COPD Read diagnostic
H312011 Chronic wheezy bronchitis res21: COPD Read diagnostic
H312100 Emphysematous bronchitis res21: COPD Read diagnostic
H312300 Bronchiolitis obliterans res21: COPD Read diagnostic
H312z00 Obstructive chronic bronchitis NOS res21: COPD Read diagnostic
H313.00 Mixed simple and mucopurulent chronic bronchitis res21: COPD Read diagnostic
H31y.00 Other chronic bronchitis res21: COPD Read diagnostic
H31y100 Chronic tracheobronchitis res21: COPD Read diagnostic
H31yz00 Other chronic bronchitis NOS res21: COPD Read diagnostic
H31z.00 Chronic bronchitis NOS res21: COPD Read diagnostic
H32..00 Emphysema res21: COPD Read diagnostic
H320.00 Chronic bullous emphysema res21: COPD Read diagnostic
H320000 Segmental bullous emphysema res21: COPD Read diagnostic
H320100 Zonal bullous emphysema res21: COPD Read diagnostic
H320200 Giant bullous emphysema res21: COPD Read diagnostic
H320300 Bullous emphysema with collapse res21: COPD Read diagnostic
H320z00 Chronic bullous emphysema NOS res21: COPD Read diagnostic
H321.00 Panlobular emphysema res21: COPD Read diagnostic
H322.00 Centrilobular emphysema res21: COPD Read diagnostic
H32y.00 Other emphysema res21: COPD Read diagnostic
H32y000 Acute vesicular emphysema res21: COPD Read diagnostic
H32y100 Atrophic (senile) emphysema res21: COPD Read diagnostic
H32y111 Acute interstitial emphysema res21: COPD Read diagnostic
H32y200 MacLeod's unilateral emphysema res21: COPD Read diagnostic
H32yz00 Other emphysema NOS res21: COPD Read diagnostic
H32z.00 Emphysema NOS res21: COPD Read diagnostic
H36..00 Mild chronic obstructive pulmonary disease res21: COPD Read diagnostic
H37..00 Moderate chronic obstructive pulmonary disease res21: COPD Read diagnostic
H38..00 Severe chronic obstructive pulmonary disease res21: COPD Read diagnostic
H3y..11 Other specified chronic obstructive pulmonary disease res21: COPD Read diagnostic
H3z..11 Chronic obstructive pulmonary disease NOS res21: COPD Read diagnostic
Rows: 7
Code Description Entity type Coding System (OXMIS Read) Category
491 CHRONIC BRONCHITIS res21: COPD OXMIS diagnostic
491 E CHRONIC BRONCHITIS WITH EMPHYSEMA res21: COPD OXMIS diagnostic
492 EMPHYSEMA PULMONARY res21: COPD OXMIS diagnostic
492 AC EMPHYSEMA APICAL BULLAE res21: COPD OXMIS diagnostic
5199G OBSTRUCTIVE AIRWAYS DISEASE CHRONIC res21: COPD OXMIS diagnostic
5199GL COLD (CHRONIC OBSTRUCTIVE LUNG DISEASE) res21: COPD OXMIS diagnostic
5199GP COPD (CHRONIC OBSTRUCTIVE PULMONARY DISE res21: COPD OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH513/version/1026/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH513/version/1026/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('PH513', '1026', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH513/version/1026/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH513/version/1026/export/codes/?format=json
CSV site_root/phenotypes/PH513/version/1026/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('PH513', '1026', api_client=client)

Version History

Version
ID
Name Owner Publish date
1026 Chronic Obstructive Pulmonary Disease (COPD) ieuan.scanlon 2021-10-06 currently shown

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