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Heart Failure

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

Type
Disease or Syndrome
ID
PH531
Version ID
1062
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: 25
Code Description Entity type Coding System (OXMIS Read) Category
1O1..00 Heart failure confirmed res21: HF Read diagnostic
G1yz100 Rheumatic left ventricular failure res21: HF Read diagnostic
G232.00 Hypertensive heart&renal dis wth (congestive) heart failure res21: HF Read diagnostic
G234.00 Hyperten heart&renal dis+both(congestv)heart and renal fail res21: HF Read diagnostic
G58..00 Heart failure res21: HF Read diagnostic
G58..11 Cardiac failure res21: HF Read diagnostic
G580.00 Congestive heart failure res21: HF Read diagnostic
G580.11 Congestive cardiac failure res21: HF Read diagnostic
G580.12 Right heart failure res21: HF Read diagnostic
G580.13 Right ventricular failure res21: HF Read diagnostic
G580.14 Biventricular failure res21: HF Read diagnostic
G580000 Acute congestive heart failure res21: HF Read diagnostic
G580100 Chronic congestive heart failure res21: HF Read diagnostic
G580200 Decompensated cardiac failure res21: HF Read diagnostic
G580300 Compensated cardiac failure res21: HF Read diagnostic
G581.00 Left ventricular failure res21: HF Read diagnostic
G581.11 Asthma - cardiac res21: HF Read diagnostic
G581.12 Pulmonary oedema - acute res21: HF Read diagnostic
G581.13 Impaired left ventricular function res21: HF Read diagnostic
G581000 Acute left ventricular failure res21: HF Read diagnostic
G582.00 Acute heart failure res21: HF Read diagnostic
G58z.00 Heart failure NOS res21: HF Read diagnostic
G58z.12 Cardiac failure NOS res21: HF Read diagnostic
Q48y100 Congenital cardiac failure res21: HF Read diagnostic
Q490.00 Neonatal cardiac failure res21: HF Read diagnostic
Rows: 16
Code Description Entity type Coding System (OXMIS Read) Category
402 C HYPERTENSION CONGESTIVE HEART FAILURE res21: HF OXMIS diagnostic
4270 CONGESTIVE HEART FAILURE res21: HF OXMIS diagnostic
4270C CONGESTIVE CARDIAC FAILURE res21: HF OXMIS diagnostic
4270CC CONGESTIVE HEART FAILURE COMPENSATED res21: HF OXMIS diagnostic
4270D CONGESTIVE HEART FAILURE DECOMPENSATED res21: HF OXMIS diagnostic
4270DR DROPSY CARDIAC res21: HF OXMIS diagnostic
4270LW SYNDROME LOW-OUTPUT res21: HF OXMIS diagnostic
4270R HEART FAILURE RIGHT-SIDED res21: HF OXMIS diagnostic
4271 LVF (LEFT VENTRICULAR FAILURE) res21: HF OXMIS diagnostic
4271A LEFT VENTRICULAR FAILURE ACUTE res21: HF OXMIS diagnostic
4271H HEART FAILURE LEFT-SIDED res21: HF OXMIS diagnostic
428 A INSUFFICIENCY CARDIAC res21: HF OXMIS diagnostic
7824A HIGH OUTPUT FAILURE (CARDIAC) res21: HF OXMIS diagnostic
7824AC HEART FAILURE ACUTE res21: HF OXMIS diagnostic
7824FC FAILURE CARDIAC res21: HF OXMIS diagnostic
7824FH HEART FAILURE res21: HF OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH531/version/1062/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH531/version/1062/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('PH531', '1062', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH531/version/1062/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH531/version/1062/export/codes/?format=json
CSV site_root/phenotypes/PH531/version/1062/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('PH531', '1062', api_client=client)

Version History

Version
ID
Name Owner Publish date
1062 Heart Failure ieuan.scanlon 2021-10-06 currently shown

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