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Breast Cancer

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

Type
Disease or Syndrome
ID
PH643
Version ID
1286
Data Sources
CPRD GOLD , Doctors Independent Network
Valid event data range
01/01/19997 - 31/12/2006
Sex
Female, Male
Agreement Date
2020-10-08
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

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.

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.

Clinical Code List

Rows: 16
Code Description Entity type Category Coding System (Read)
B34..00 Malig neop female breast (f) res24: breast cancer diagnostic Read
B340.00 Malig neop nipple/areola (f) res24: breast cancer diagnostic Read
B340000 Malig neop nipple of breast(f) res24: breast cancer diagnostic Read
B340100 Malig neop areola of breast(f) res24: breast cancer diagnostic Read
B340z00 Malig neop nippl/areol (f) NOS res24: breast cancer diagnostic Read
B341.00 Malig neop cent part breast(f) res24: breast cancer diagnostic Read
B342.00 Malig neop upp-inner quad (f) res24: breast cancer diagnostic Read
B343.00 Malig neop low-inner quad (f) res24: breast cancer diagnostic Read
B344.00 Malig neop upp-outer quad (f) res24: breast cancer diagnostic Read
B345.00 Malig neop low-outer quad (f) res24: breast cancer diagnostic Read
B346.00 Malig neop axillary tail (f) res24: breast cancer diagnostic Read
B347.00 Mal neopl - overlapping breast res24: breast cancer diagnostic Read
B34y.00 Malig neop oth site breast (f) res24: breast cancer diagnostic Read
B34y000 Malig neop ectopic breast (f) res24: breast cancer diagnostic Read
B34yz00 Malig neop oth breast (f) NOS res24: breast cancer diagnostic Read
B34z.00 Malig neop female breast NOS res24: breast cancer diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH643/version/1286/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH643/version/1286/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('PH643', '1286', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH643/version/1286/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH643/version/1286/export/codes/?format=json
CSV site_root/phenotypes/PH643/version/1286/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('PH643', '1286', api_client=client)

Version History

Version
ID
Name Owner Publish date
1286 Breast Cancer 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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