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Stroke

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

Type
Disease or Syndrome
ID
PH563
Version ID
1126
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: 94
Code Description Entity type Coding System (OXMIS Read) Category
14A7.00 H/O: CVA/stroke res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
14A7.12 H/O: stroke res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
14AB.00 H/O: TIA res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
14AK.00 H/O: Stroke in last year res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
662M.00 Stroke monitoring res43: stroke_kontopantelis_bmjqs2012 Read test
662e.00 Stroke/CVA annual review res43: stroke_kontopantelis_bmjqs2012 Read test
662o.00 Haemorrhagic stroke monitoring res43: stroke_kontopantelis_bmjqs2012 Read test
7P24200 Delivery of rehabilitation for stroke res43: stroke_kontopantelis_bmjqs2012 Read test
8HBJ.00 Stroke / transient ischaemic attack referral res43: stroke_kontopantelis_bmjqs2012 Read test
8HHM.00 Ref to multidisciplinary stroke function improvement service res43: stroke_kontopantelis_bmjqs2012 Read test
8HTQ.00 Referral to stroke clinic res43: stroke_kontopantelis_bmjqs2012 Read test
9N0p.00 Seen in stroke clinic res43: stroke_kontopantelis_bmjqs2012 Read test
F423600 Amaurosis fugax res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61..00 Intracerebral haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61..11 CVA - cerebrovascular accid due to intracerebral haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61..12 Stroke due to intracerebral haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G610.00 Cortical haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G611.00 Internal capsule haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G612.00 Basal nucleus haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G613.00 Cerebellar haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G614.00 Pontine haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G615.00 Bulbar haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G616.00 External capsule haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G618.00 Intracerebral haemorrhage, multiple localized res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61X.00 Intracerebral haemorrhage in hemisphere, unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61X000 Left sided intracerebral haemorrhage, unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61X100 Right sided intracerebral haemorrhage, unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G61z.00 Intracerebral haemorrhage NOS res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G63y000 Cerebral infarct due to thrombosis of precerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G63y100 Cerebral infarction due to embolism of precerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64..00 Cerebral arterial occlusion res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64..11 CVA - cerebral artery occlusion res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64..12 Infarction - cerebral res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64..13 Stroke due to cerebral arterial occlusion res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G640.00 Cerebral thrombosis res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G640000 Cerebral infarction due to thrombosis of cerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G641.00 Cerebral embolism res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G641.11 Cerebral embolus res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G641000 Cerebral infarction due to embolism of cerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z.00 Cerebral infarction NOS res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z.11 Brainstem infarction NOS res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z.12 Cerebellar infarction res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z000 Brainstem infarction res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z100 Wallenberg syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z111 Lateral medullary syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z200 Left sided cerebral infarction res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z300 Right sided cerebral infarction res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G64z400 Infarction of basal ganglia res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65..00 Transient cerebral ischaemia res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65..11 Drop attack res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65..12 Transient ischaemic attack res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65..13 Vertebro-basilar insufficiency res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G650.00 Basilar artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G650.11 Insufficiency - basilar artery res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G651.00 Vertebral artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G651000 Vertebro-basilar artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G652.00 Subclavian steal syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G653.00 Carotid artery syndrome hemispheric res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G654.00 Multiple and bilateral precerebral artery syndromes res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G656.00 Vertebrobasilar insufficiency res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65y.00 Other transient cerebral ischaemia res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65z.00 Transient cerebral ischaemia NOS res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65z000 Impending cerebral ischaemia res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65z100 Intermittent cerebral ischaemia res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G65zz00 Transient cerebral ischaemia NOS res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G66..00 Stroke and cerebrovascular accident unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G66..11 CVA unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G66..12 Stroke unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G66..13 CVA - Cerebrovascular accident unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G660.00 Middle cerebral artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G661.00 Anterior cerebral artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G662.00 Posterior cerebral artery syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G663.00 Brain stem stroke syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G664.00 Cerebellar stroke syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G665.00 Pure motor lacunar syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G666.00 Pure sensory lacunar syndrome res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G667.00 Left sided CVA res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G668.00 Right sided CVA res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G68X.00 Sequelae of stroke,not specfd as h'morrhage or infarction res43: stroke_kontopantelis_bmjqs2012 Read symptom
G6W..00 Cereb infarct due unsp occlus/stenos precerebr arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
G6X..00 Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6200 [X]Other intracerebral haemorrhage res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6300 [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6400 [X]Other cerebral infarction res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6500 [X]Occlusion and stenosis of other precerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6600 [X]Occlusion and stenosis of other cerebral arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6C00 [X]Sequelae of stroke,not specfd as h'morrhage or infarction res43: stroke_kontopantelis_bmjqs2012 Read symptom
Gyu6D00 [X]Sequelae/other + unspecified cerebrovascular diseases res43: stroke_kontopantelis_bmjqs2012 Read symptom
Gyu6F00 [X]Intracerebral haemorrhage in hemisphere, unspecified res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Gyu6G00 [X]Cereb infarct due unsp occlus/stenos precerebr arteries res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
L440.11 CVA - cerebrovascular accident in the puerperium res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
L440.12 Stroke in the puerperium res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
ZV12511 [V]Personal history of stroke res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
ZV12512 [V]Personal history of cerebrovascular accident (CVA) res43: stroke_kontopantelis_bmjqs2012 Read diagnostic
Rows: 11
Code Description Entity type Coding System (OXMIS Read) Category
4350AT TRANSIENT ISCHAEMIC ATTACKS WITH HYPERTE res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4359AT TRANSIENT ISCHAEMIC ATTACKS res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4360A CEREBROVASCULAR ACCIDENT WITH HYPERTENSI res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4360B STROKE WITH HYPERTENSION res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4369A CVA (CEREBROVASCULAR ACCIDENT) res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4369AL CEREBROVASCULAR ACCIDENT LEFT res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4369AR CEREBROVASCULAR ACCIDENT RIGHT res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4369B STROKE res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4369BN SYNDROME STROKE res43: stroke_kontopantelis_bmjqs2012 OXMIS diagnostic
4389PN SYNDROME POSTSTROKE res43: stroke_kontopantelis_bmjqs2012 OXMIS symptom
4389PP POSTSTROKE PARALYSIS res43: stroke_kontopantelis_bmjqs2012 OXMIS symptom

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH563/version/1126/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH563/version/1126/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('PH563', '1126', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH563/version/1126/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH563/version/1126/export/codes/?format=json
CSV site_root/phenotypes/PH563/version/1126/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('PH563', '1126', api_client=client)

Version History

Version
ID
Name Owner Publish date
1126 Stroke 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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