Beta Blockers

David A Springate, Darren M Aschroft, Evangelos Kontopantelis, Tim Doran, Ronan Ryan, David Reeves

PH642 / 1284 Clinical-Coded Phenotype

  1. Overview

    Phenotype Type
    Drug
    Phenotype UUID
    BKsQQFgHG76e2DiKmfi6Dz
    Sex
    Both
    Valid Event Date Range
    01/01/19997 - 31/12/2006
    Coding System
    GPRD product codes
    Data Sources
    CPRD GOLD
    Doctors Independent Network
    Collections
    ClinicalCodes RepositoryPhenotype Library
    Tags
    No data
    Ontology
    No data

  2. Definition

    Objectives:

    To conduct a fully independent, external validation of a research study based on one electronic health record database using a different database sampling from the same population.

    Design:

    Retrospective cohort analysis of β-blocker therapy and all-cause mortality in patients with cancer.

    Setting:

    Two UK national primary care databases (PCDs): the Clinical Practice Research Datalink (CPRD) and Doctors’ Independent Network (DIN).

    Participants:

    CPRD data for 11 302 patients with cancer compared with published results from DIN for 3462 patients; study period January 1997 to December 2006.

    Primary and secondary outcome measures:

    All-cause mortality: overall; by treatment subgroup (β-blockers only, β-blockers plus other blood pressure lowering medicines (BPLM), other BPLMs only); and by cancer site.

    Results:

    Using CPRD, β-blocker use was not associated with mortality (HR=1.03, 95% CI 0.93 to 1.14, vs patients prescribed other BPLMs only), but DIN β-blocker users had significantly higher mortality (HR=1.18, 95% CI 1.04 to 1.33). However, these HRs were not statistically different (p=0.063), but did differ for patients on β-blockers alone (CPRD=0.94, 95% CI 0.82 to 1.07; DIN=1.37, 95% CI 1.16 to 1.61; p<0.001). Results for individual cancer sites differed by study, but only significantly for prostate and pancreas cancers. Results were robust under sensitivity analyses, but we could not be certain that mortality was identically defined in both databases.

    Conclusions:

    We found a complex pattern of similarities and differences between databases. Overall treatment effect estimates were not statistically different, adding to a growing body of evidence that different UK PCDs produce comparable effect estimates. However, individually the two studies lead to different conclusions regarding the safety of β-blockers and some subgroup effects differed significantly. Single studies using even internally wellvalidated databases do not guarantee generalisable results, especially for subgroups, and confirmatory studies using at least one other independent data source are strongly recommended.

  3. Implementation

    Implementation

    No data

  4. Clinical Code List

  5. Publication

    Related publications

    • David A Springate, Darrent M Aschroft, Evangelos Kontopantelis, Tim Doran, Ronan Ryan, David Reeves, Can analyses of electronic patient records be independently and externally validated? Study 2—the effect of β-adrenoceptor blocker therapy on cancer survival a retrospective cohort study. BMJ Open, 5(e007299), 2014.

    Citation Example

    David A Springate, Darren M Aschroft, Evangelos Kontopantelis, Tim Doran, Ronan Ryan, David Reeves. PH642 / 1284 - Beta Blockers. Phenotype Library [Online]. 06 October 2021. Available from: http://phenotypes.healthdatagateway.org/phenotypes/PH642/version/1284/detail/. [Accessed 21 May 2025]

  6. Permissions

  7. API

    To Export Phenotype Details:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH642/version/1284/detail/?format=json
    R Package

    # Download here

    library(ConceptLibraryClient)


    # Connect to API

    client = ConceptLibraryClient::Connection$new(public=TRUE)


    # Get details of phenotype

    phenotype_details = client$phenotypes$get_detail(
     'PH642',
     version_id=1284
    )

    Py Package

    # Download here

    from pyconceptlibraryclient import Client


    # Connect to API

    client = Client(public=True)


    # Get codelist of phenotype

    phenotype_codelist = client.phenotypes.get_detail(
     'PH642',
     version_id=1284
    )

    To Export Phenotype Code List:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH642/version/1284/export/codes/?format=json
    R Package

    # Download here

    library(ConceptLibraryClient)


    # Connect to API

    client = ConceptLibraryClient::Connection$new(public=TRUE)


    # Get codelist of phenotype

    phenotype_codelist = client$phenotypes$get_codelist(
     'PH642',
     version_id=1284
    )

    Py Package

    # Download here

    from pyconceptlibraryclient import Client


    # Connect to API

    client = Client(public=True)


    # Get codelist of phenotype

    phenotype_codelist = client.phenotypes.get_codelist(
     'PH642',
     version_id=1284
    )

  8. Version History

    Version IDNameOwnerPublish date
    Beta Blockers ieuan.scanlon2021-10-06 16:28