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Hypothyroidism

Evengelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran

Type
Disease or Syndrome
ID
PH535
Version ID
1070
Data Sources
Valid event data range
01/01/2000 - 31/12/2007
Sex
Female, Male
Agreement Date
2012-08-22
Coding system
Read codes v2 OXMIS codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

The UK’s Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics.

Methods:

Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653 500 patients in which 23 920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design.

Results:

Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7–14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7–8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence.

Conclusions:

The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.

Publications

  • Evangelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran, Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme a longitudinal observational study. BMJ Qual Saf, 22, 53-64, 2013.

Clinical Code List

Rows: 35
Code Description Entity type Coding System (OXMIS Read) Category
C03..00 Congenital hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C03y.00 Other specified congenital hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C03y000 Congenital hypothyroidism with diffuse goitre res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C03y100 Congenital hypothyroidism without goitre res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C03z.00 Congenital hypothyroidism NOS res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04..00 Acquired hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04..11 Myxoedema res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04..12 Thyroid deficiency res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04..13 Hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C040.00 Postsurgical hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C040.11 Post ablative hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C041.00 Other postablative hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C041000 Irradiation hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C041z00 Postablative hypothyroidism NOS res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C042.00 Iodine hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C043.00 Other iatrogenic hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C043000 Hypothyroidism resulting from para-aminosalicylic acid res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C043100 Hypothyroidism resulting from phenylbutazone res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C043200 Hypothyroidism resulting from resorcinol res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C043z00 Iatrogenic hypothyroidism NOS res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C044.00 Postinfectious hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C045.00 Acquired atrophy of thyroid res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C046.00 Autoimmune myxoedema res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04y.00 Other acquired hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z.00 Hypothyroidism NOS res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z.11 Pretibial myxoedema - hypothyroid res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z.12 Thyroid insufficiency res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z.13 Hypothyroid goitre, acquired res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z000 Premature puberty due to hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
C04z100 Myxoedema coma res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
Cyu1100 [X]Other sp cified hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read diagnostic
F381400 Myasthenic syndrome due to hypothyroidism res43: hypoth_kontopantelis_bmjqs2012 Read symptom
f921.00 THYROXINE res43: hypoth_kontopantelis_bmjqs2012 Read drug
f922.00 THYROXINE tabs 50micrograms res43: hypoth_kontopantelis_bmjqs2012 Read drug
f923.00 THYROXINE tabs 100micrograms res43: hypoth_kontopantelis_bmjqs2012 Read drug
Rows: 3
Code Description Entity type Coding System (OXMIS Read) Category
243 HYPOTHYROIDISM CONGENITAL res43: hypoth_kontopantelis_bmjqs2012 OXMIS diagnostic
244 AC HYPOTHYROIDISM ACQUIRED res43: hypoth_kontopantelis_bmjqs2012 OXMIS diagnostic
244 AG HYPOTHYROIDISM COMPENSATED res43: hypoth_kontopantelis_bmjqs2012 OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH535/version/1070/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH535/version/1070/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('PH535', '1070', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH535/version/1070/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH535/version/1070/export/codes/?format=json
CSV site_root/phenotypes/PH535/version/1070/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('PH535', '1070', api_client=client)

Version History

Version
ID
Name Owner Publish date
1070 Hypothyroidism 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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