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Learning Disability

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

Type
Disease or Syndrome
ID
PH539
Version ID
1078
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: 36
Code Description Entity type Coding System (OXMIS Read) Category
13Z4E00 Learning difficulties res21: LearningDis Read diagnostic
E2F2.00 Other specific learning difficulty res21: LearningDis Read diagnostic
E3...00 Mental retardation res21: LearningDis Read diagnostic
E30..00 Mild mental retardation, IQ in range 50-70 res21: LearningDis Read diagnostic
E31..00 Other specified mental retardation res21: LearningDis Read diagnostic
E310.00 Moderate mental retardation, IQ in range 35-49 res21: LearningDis Read diagnostic
E311.00 Severe mental retardation, IQ in range 20-34 res21: LearningDis Read diagnostic
E312.00 Profound mental retardation with IQ less than 20 res21: LearningDis Read diagnostic
E31z.00 Other specified mental retardation NOS res21: LearningDis Read diagnostic
E3y..00 Other specified mental retardation res21: LearningDis Read diagnostic
E3z..00 Mental retardation NOS res21: LearningDis Read diagnostic
Eu7..00 [X]Mental retardation res21: LearningDis Read diagnostic
Eu70.00 [X]Mild mental retardation res21: LearningDis Read diagnostic
Eu70y00 [X]Mild mental retardation, other impairments of behaviour res21: LearningDis Read diagnostic
Eu70z00 [X]Mild mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu71.00 [X]Moderate mental retardation res21: LearningDis Read diagnostic
Eu71z00 [X]Mod mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu72.00 [X]Severe mental retardation res21: LearningDis Read diagnostic
Eu72y00 [X]Severe mental retardation, other impairments of behaviour res21: LearningDis Read diagnostic
Eu72z00 [X]Sev mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu73.00 [X]Profound mental retardation res21: LearningDis Read diagnostic
Eu73y00 [X]Profound mental retardation, other impairments of behavr res21: LearningDis Read diagnostic
Eu73z00 [X]Prfnd mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu7y.00 [X]Other mental retardation res21: LearningDis Read diagnostic
Eu7yy00 [X]Other mental retardation, other impairments of behaviour res21: LearningDis Read diagnostic
Eu7yz00 [X]Other mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu7z.00 [X]Unspecified mental retardation res21: LearningDis Read diagnostic
Eu7zz00 [X]Unsp mental retardation without mention impairment behav res21: LearningDis Read diagnostic
Eu81.00 [X]Specific developmental disorders of scholastic skills res21: LearningDis Read diagnostic
Eu81y00 [X]Other developmental disorders of scholastic skills res21: LearningDis Read diagnostic
Eu81z00 [X]Developmental disorder of scholastic skills, unspecified res21: LearningDis Read diagnostic
Eu81z11 [X]Learning disability NOS res21: LearningDis Read diagnostic
Eu84112 [X]Mental retardation with autistic features res21: LearningDis Read diagnostic
Z7CD200 Learning difficulties res21: LearningDis Read diagnostic
ZS34.00 Developmental disorder of scholastic skill res21: LearningDis Read diagnostic
ZS34.11 Learning disability res21: LearningDis Read diagnostic
Rows: 6
Code Description Entity type Coding System (OXMIS Read) Category
3061LF LEARNING DIFFICULTY res21: LearningDis OXMIS diagnostic
311 MENTAL RETARDATION MILD res21: LearningDis OXMIS diagnostic
312 MENTAL RETARDATION MODERATE res21: LearningDis OXMIS diagnostic
313 MENTAL RETARDATION SEVERE res21: LearningDis OXMIS diagnostic
315 RETARDATION MENTAL res21: LearningDis OXMIS diagnostic
315 HC MENTAL HANDICAP res21: LearningDis OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH539/version/1078/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH539/version/1078/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('PH539', '1078', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH539/version/1078/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH539/version/1078/export/codes/?format=json
CSV site_root/phenotypes/PH539/version/1078/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('PH539', '1078', api_client=client)

Version History

Version
ID
Name Owner Publish date
1078 Learning Disability ieuan.scanlon 2021-10-06 currently shown

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