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Comorbidities

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

Type
Disease or Syndrome
ID
PH646
Version ID
1292
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: 234
Code Description Entity type Category Coding System (Read)
14A3.00 H/O: myocardial infarct <60 res24: comorbidities diagnostic Read
14A4.00 H/O: myocardial infarct >60 res24: comorbidities diagnostic Read
14A5.00 H/O: angina pectoris res24: comorbidities diagnostic Read
14A6.00 H/O: heart failure res24: comorbidities diagnostic Read
14A7.00 H/O: CVA/stroke res24: comorbidities diagnostic Read
14AB.00 H/O: TIA res24: comorbidities diagnostic Read
14AH.00 H/O: Myocardial infarction in last year res24: comorbidities diagnostic Read
14AJ.00 H/O: Angina in last year res24: comorbidities diagnostic Read
14AK.00 H/O: Stroke in last year res24: comorbidities diagnostic Read
14AL.00 H/O: Treatment for ischaemic heart disease res24: comorbidities diagnostic Read
14AM.00 H/O: Heart failure in last year res24: comorbidities diagnostic Read
14AN.00 H/O: atrial fibrillation res24: comorbidities diagnostic Read
14B3.00 H/O: chr.obstr. airway disease res24: comorbidities diagnostic Read
14B4.00 H/O: asthma res24: comorbidities diagnostic Read
14V2.00 H/O: renal dialysis res24: comorbidities diagnostic Read
173A.00 Exercise induced asthma res24: comorbidities diagnostic Read
1O2..00 Asthma confirmed res24: comorbidities diagnostic Read
322..00 ECG: myocardial ischaemia res24: comorbidities diagnostic Read
3222 ECG:shows myocardial ischaemia res24: comorbidities diagnostic Read
322Z.00 ECG: myocardial ischaemia NOS res24: comorbidities diagnostic Read
323..00 ECG: myocardial infarction res24: comorbidities diagnostic Read
3232 ECG: old myocardial infarction res24: comorbidities diagnostic Read
3233 ECG: antero-septal infarct. res24: comorbidities diagnostic Read
3234 ECG:posterior/inferior infarct res24: comorbidities diagnostic Read
3235 ECG: subendocardial infarct res24: comorbidities diagnostic Read
3236 ECG: lateral infarction res24: comorbidities diagnostic Read
323Z.00 ECG: myocardial infarct NOS res24: comorbidities diagnostic Read
662K.00 Angina control res24: comorbidities diagnostic Read
792..00 Coronary artery operations res24: comorbidities diagnostic Read
7920 Saphenous vein graft replacement of coronary artery res24: comorbidities diagnostic Read
7920000 Saphenous vein graft replacement of one coronary artery res24: comorbidities diagnostic Read
7920100 Saphenous vein graft replacement of two coronary arteries res24: comorbidities diagnostic Read
7920200 Saphenous vein graft replacement of three coronary arteries res24: comorbidities diagnostic Read
7920300 Saphenous vein graft replacement of four+ coronary arteries res24: comorbidities diagnostic Read
7920y00 Saphenous vein graft replacement of coronary artery OS res24: comorbidities diagnostic Read
7920z00 Saphenous vein graft replacement coronary artery NOS res24: comorbidities diagnostic Read
7921 Other autograft replacement of coronary artery res24: comorbidities diagnostic Read
7921000 Autograft replacement of one coronary artery NEC res24: comorbidities diagnostic Read
7921100 Autograft replacement of two coronary arteries NEC res24: comorbidities diagnostic Read
7921200 Autograft replacement of three coronary arteries NEC res24: comorbidities diagnostic Read
7921300 Autograft replacement of four of more coronary arteries NEC res24: comorbidities diagnostic Read
7921y00 Other autograft replacement of coronary artery OS res24: comorbidities diagnostic Read
7921z00 Other autograft replacement of coronary artery NOS res24: comorbidities diagnostic Read
7922 Allograft replacement of coronary artery res24: comorbidities diagnostic Read
7922000 Allograft replacement of one coronary artery res24: comorbidities diagnostic Read
7922100 Allograft replacement of two coronary arteries res24: comorbidities diagnostic Read
7922200 Allograft replacement of three coronary arteries res24: comorbidities diagnostic Read
7922300 Allograft replacement of four or more coronary arteries res24: comorbidities diagnostic Read
7922y00 Other specified allograft replacement of coronary artery res24: comorbidities diagnostic Read
7922z00 Allograft replacement of coronary artery NOS res24: comorbidities diagnostic Read
7923 Prosthetic replacement of coronary artery res24: comorbidities diagnostic Read
7923000 Prosthetic replacement of one coronary artery res24: comorbidities diagnostic Read
7923100 Prosthetic replacement of two coronary arteries res24: comorbidities diagnostic Read
7923200 Prosthetic replacement of three coronary arteries res24: comorbidities diagnostic Read
7923300 Prosthetic replacement of four or more coronary arteries res24: comorbidities diagnostic Read
7923z00 Prosthetic replacement of coronary artery NOS res24: comorbidities diagnostic Read
7924 Revision of bypass for coronary artery res24: comorbidities diagnostic Read
7924000 Revision of bypass for one coronary artery res24: comorbidities diagnostic Read
7924100 Revision of bypass for two coronary arteries res24: comorbidities diagnostic Read
7924200 Revision of bypass for three coronary arteries res24: comorbidities diagnostic Read
7924300 Revision of bypass for four or more coronary arteries res24: comorbidities diagnostic Read
7924500 Revision of implantation of thoracic artery into heart res24: comorbidities diagnostic Read
7924y00 Other specified revision of bypass for coronary artery res24: comorbidities diagnostic Read
7924z00 Revision of bypass for coronary artery NOS res24: comorbidities diagnostic Read
7925 Connection of mammary artery to coronary artery res24: comorbidities diagnostic Read
7925000 Double anastomosis of mammary arteries to coronary arteries res24: comorbidities diagnostic Read
7925100 Double implant of mammary arteries into coronary arteries res24: comorbidities diagnostic Read
7925200 Single anast mammary art to left ant descend coronary art res24: comorbidities diagnostic Read
7925300 Single anastomosis of mammary artery to coronary artery NEC res24: comorbidities diagnostic Read
7925400 Single implantation of mammary artery into coronary artery res24: comorbidities diagnostic Read
7925y00 Connection of mammary artery to coronary artery OS res24: comorbidities diagnostic Read
7925z00 Connection of mammary artery to coronary artery NOS res24: comorbidities diagnostic Read
7926 Connection of other thoracic artery to coronary artery res24: comorbidities diagnostic Read
7926000 Double anastom thoracic arteries to coronary arteries NEC res24: comorbidities diagnostic Read
7926200 Single anastomosis of thoracic artery to coronary artery NEC res24: comorbidities diagnostic Read
7926300 Single implantation thoracic artery into coronary artery NEC res24: comorbidities diagnostic Read
7926z00 Connection of other thoracic artery to coronary artery NOS res24: comorbidities diagnostic Read
7927 Other open operations on coronary artery res24: comorbidities diagnostic Read
7927500 Open angioplasty of coronary artery res24: comorbidities diagnostic Read
7927y00 Other specified other open operation on coronary artery res24: comorbidities diagnostic Read
7927z00 Other open operation on coronary artery NOS res24: comorbidities diagnostic Read
7928 Transluminal balloon angioplasty of coronary artery res24: comorbidities diagnostic Read
7928000 Percut transluminal balloon angioplasty one coronary artery res24: comorbidities diagnostic Read
7928100 Percut translum balloon angioplasty mult coronary arteries res24: comorbidities diagnostic Read
7928200 Percut translum balloon angioplasty bypass graft coronary a res24: comorbidities diagnostic Read
7928y00 Transluminal balloon angioplasty of coronary artery OS res24: comorbidities diagnostic Read
7928z00 Transluminal balloon angioplasty of coronary artery NOS res24: comorbidities diagnostic Read
7929 Other therapeutic transluminal operations on coronary artery res24: comorbidities diagnostic Read
7929000 Percutaneous transluminal laser coronary angioplasty res24: comorbidities diagnostic Read
7929100 Percut transluminal coronary thrombolysis with streptokinase res24: comorbidities diagnostic Read
7929200 Percut translum inject therap subst to coronary artery NEC res24: comorbidities diagnostic Read
7929300 Rotary blade coronary angioplasty res24: comorbidities diagnostic Read
7929400 Insertion of coronary artery stent res24: comorbidities diagnostic Read
7929500 Insertion of drug-eluting coronary artery stent res24: comorbidities diagnostic Read
7929600 Percutaneous transluminal atherectomy of coronary artery res24: comorbidities diagnostic Read
7929y00 Other therapeutic transluminal op on coronary artery OS res24: comorbidities diagnostic Read
7929z00 Other therapeutic transluminal op on coronary artery NOS res24: comorbidities diagnostic Read
792A.00 Diagnostic transluminal operations on coronary artery res24: comorbidities diagnostic Read
792A000 Percutaneous transluminal angioscopy res24: comorbidities diagnostic Read
792A100 Intravascular ultrasound of coronary artery res24: comorbidities diagnostic Read
792Ay00 Diagnostic transluminal operation on coronary artery OS res24: comorbidities diagnostic Read
792Az00 Diagnostic transluminal operation on coronary artery NOS res24: comorbidities diagnostic Read
792B.00 Repair of coronary artery NEC res24: comorbidities diagnostic Read
792B000 Endarterectomy of coronary artery NEC res24: comorbidities diagnostic Read
792By00 Other specified repair of coronary artery res24: comorbidities diagnostic Read
792Bz00 Repair of coronary artery NOS res24: comorbidities diagnostic Read
792C.00 Other replacement of coronary artery res24: comorbidities diagnostic Read
792C000 Replacement of coronary arteries using multiple methods res24: comorbidities diagnostic Read
792Cy00 Other specified replacement of coronary artery res24: comorbidities diagnostic Read
792Cz00 Replacement of coronary artery NOS res24: comorbidities diagnostic Read
792D.00 Other bypass of coronary artery res24: comorbidities diagnostic Read
792Dy00 Other specified other bypass of coronary artery res24: comorbidities diagnostic Read
792Dz00 Other bypass of coronary artery NOS res24: comorbidities diagnostic Read
792y.00 Other specified operations on coronary artery res24: comorbidities diagnostic Read
792z.00 Coronary artery operations NOS res24: comorbidities diagnostic Read
F423600 Amaurosis fugax res24: comorbidities diagnostic Read
G3...00 Ischaemic heart disease res24: comorbidities diagnostic Read
G30..00 Acute myocardial infarction res24: comorbidities diagnostic Read
G300.00 Acute anterolateral infarction res24: comorbidities diagnostic Read
G301.00 Other specified anterior myocardial infarction res24: comorbidities diagnostic Read
G301000 Acute anteroapical infarction res24: comorbidities diagnostic Read
G301100 Acute anteroseptal infarction res24: comorbidities diagnostic Read
G301z00 Anterior myocardial infarction NOS res24: comorbidities diagnostic Read
G302.00 Acute inferolateral infarction res24: comorbidities diagnostic Read
G303.00 Acute inferoposterior infarction res24: comorbidities diagnostic Read
G304.00 Posterior myocardial infarction NOS res24: comorbidities diagnostic Read
G305.00 Lateral myocardial infarction NOS res24: comorbidities diagnostic Read
G306.00 True posterior myocardial infarction res24: comorbidities diagnostic Read
G307.00 Acute subendocardial infarction res24: comorbidities diagnostic Read
G307000 Acute non-Q wave infarction res24: comorbidities diagnostic Read
G307100 Acute non-ST segment elevation myocardial infarction res24: comorbidities diagnostic Read
G308.00 Inferior myocardial infarction NOS res24: comorbidities diagnostic Read
G309.00 Acute Q-wave infarct res24: comorbidities diagnostic Read
G30A.00 Mural thrombosis res24: comorbidities diagnostic Read
G30B.00 Acute posterolateral myocardial infarction res24: comorbidities diagnostic Read
G30X.00 Acute transmural myocardial infarction of unspecif site res24: comorbidities diagnostic Read
G30X000 Acute ST segment elevation myocardial infarction res24: comorbidities diagnostic Read
G30y.00 Other acute myocardial infarction res24: comorbidities diagnostic Read
G30y000 Acute atrial infarction res24: comorbidities diagnostic Read
G30y100 Acute papillary muscle infarction res24: comorbidities diagnostic Read
G30y200 Acute septal infarction res24: comorbidities diagnostic Read
G30yz00 Other acute myocardial infarction NOS res24: comorbidities diagnostic Read
G30z.00 Acute myocardial infarction NOS res24: comorbidities diagnostic Read
G31..00 Other acute and subacute ischaemic heart disease res24: comorbidities diagnostic Read
G310.00 Postmyocardial infarction syndrome res24: comorbidities diagnostic Read
G311.00 Preinfarction syndrome res24: comorbidities diagnostic Read
G311000 Myocardial infarction aborted res24: comorbidities diagnostic Read
G311100 Unstable angina res24: comorbidities diagnostic Read
G311200 Angina at rest res24: comorbidities diagnostic Read
G311300 Refractory angina res24: comorbidities diagnostic Read
G311400 Worsening angina res24: comorbidities diagnostic Read
G311500 Acute coronary syndrome res24: comorbidities diagnostic Read
G311z00 Preinfarction syndrome NOS res24: comorbidities diagnostic Read
G312.00 Coronary thrombosis not resulting in myocardial infarction res24: comorbidities diagnostic Read
G31y.00 Other acute and subacute ischaemic heart disease res24: comorbidities diagnostic Read
G31y000 Acute coronary insufficiency res24: comorbidities diagnostic Read
G31y100 Microinfarction of heart res24: comorbidities diagnostic Read
G31y200 Subendocardial ischaemia res24: comorbidities diagnostic Read
G31y300 Transient myocardial ischaemia res24: comorbidities diagnostic Read
G31yz00 Other acute and subacute ischaemic heart disease NOS res24: comorbidities diagnostic Read
G32..00 Old myocardial infarction res24: comorbidities diagnostic Read
G33..00 Angina pectoris res24: comorbidities diagnostic Read
G330.00 Angina decubitus res24: comorbidities diagnostic Read
G330000 Nocturnal angina res24: comorbidities diagnostic Read
G330z00 Angina decubitus NOS res24: comorbidities diagnostic Read
G331.00 Prinzmetal's angina res24: comorbidities diagnostic Read
G332.00 Coronary artery spasm res24: comorbidities diagnostic Read
G33z.00 Angina pectoris NOS res24: comorbidities diagnostic Read
G33z000 Status anginosus res24: comorbidities diagnostic Read
G33z100 Stenocardia res24: comorbidities diagnostic Read
G33z200 Syncope anginosa res24: comorbidities diagnostic Read
G33z300 Angina on effort res24: comorbidities diagnostic Read
G33z400 Ischaemic chest pain res24: comorbidities diagnostic Read
G33z500 Post infarct angina res24: comorbidities diagnostic Read
G33z600 New onset angina res24: comorbidities diagnostic Read
G33z700 Stable angina res24: comorbidities diagnostic Read
G33zz00 Angina pectoris NOS res24: comorbidities diagnostic Read
G34..00 Other chronic ischaemic heart disease res24: comorbidities diagnostic Read
G340.00 Coronary atherosclerosis res24: comorbidities diagnostic Read
G340000 Single coronary vessel disease res24: comorbidities diagnostic Read
G340100 Double coronary vessel disease res24: comorbidities diagnostic Read
G342.00 Atherosclerotic cardiovascular disease res24: comorbidities diagnostic Read
G343.00 Ischaemic cardiomyopathy res24: comorbidities diagnostic Read
G344.00 Silent myocardial ischaemia res24: comorbidities diagnostic Read
G34y.00 Other specified chronic ischaemic heart disease res24: comorbidities diagnostic Read
G34y000 Chronic coronary insufficiency res24: comorbidities diagnostic Read
G34y100 Chronic myocardial ischaemia res24: comorbidities diagnostic Read
G34yz00 Other specified chronic ischaemic heart disease NOS res24: comorbidities diagnostic Read
G34z.00 Other chronic ischaemic heart disease NOS res24: comorbidities diagnostic Read
G34z000 Asymptomatic coronary heart disease res24: comorbidities diagnostic Read
G35..00 Subsequent myocardial infarction res24: comorbidities diagnostic Read
G350.00 Subsequent myocardial infarction of anterior wall res24: comorbidities diagnostic Read
G351.00 Subsequent myocardial infarction of inferior wall res24: comorbidities diagnostic Read
G353.00 Subsequent myocardial infarction of other sites res24: comorbidities diagnostic Read
G35X.00 Subsequent myocardial infarction of unspecified site res24: comorbidities diagnostic Read
G36..00 Certain current complication follow acute myocardial infarct res24: comorbidities diagnostic Read
G360.00 Haemopericardium/current comp folow acut myocard infarct res24: comorbidities diagnostic Read
G361.00 Atrial septal defect/curr comp folow acut myocardal infarct res24: comorbidities diagnostic Read
G362.00 Ventric septal defect/curr comp fol acut myocardal infarctn res24: comorbidities diagnostic Read
G363.00 Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI res24: comorbidities diagnostic Read
G364.00 Ruptur chordae tendinae/curr comp fol acute myocard infarct res24: comorbidities diagnostic Read
G365.00 Rupture papillary muscle/curr comp fol acute myocard infarct res24: comorbidities diagnostic Read
G366.00 Thrombosis atrium; auric append&vent/curr comp foll acute MI res24: comorbidities diagnostic Read
G38..00 Postoperative myocardial infarction res24: comorbidities diagnostic Read
G380.00 Postoperative transmural myocardial infarction anterior wall res24: comorbidities diagnostic Read
G381.00 Postoperative transmural myocardial infarction inferior wall res24: comorbidities diagnostic Read
G384.00 Postoperative subendocardial myocardial infarction res24: comorbidities diagnostic Read
G38z.00 Postoperative myocardial infarction; unspecified res24: comorbidities diagnostic Read
G3y..00 Other specified ischaemic heart disease res24: comorbidities diagnostic Read
G3z..00 Ischaemic heart disease NOS res24: comorbidities diagnostic Read
G63y000 Cerebral infarct due to thrombosis of precerebral arteries res24: comorbidities diagnostic Read
G63y100 Cerebral infarction due to embolism of precerebral arteries res24: comorbidities diagnostic Read
G676000 Cereb infarct due cerebral venous thrombosis; nonpyogenic res24: comorbidities diagnostic Read
G6W..00 Cereb infarct due unsp occlus/stenos precerebr arteries res24: comorbidities diagnostic Read
G6X..00 Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs res24: comorbidities diagnostic Read
Gyu3.00 [X]Ischaemic heart diseases res24: comorbidities diagnostic Read
Gyu3000 [X]Other forms of angina pectoris res24: comorbidities diagnostic Read
Gyu3200 [X]Other forms of acute ischaemic heart disease res24: comorbidities diagnostic Read
Gyu3300 [X]Other forms of chronic ischaemic heart disease res24: comorbidities diagnostic Read
Gyu3400 [X]Acute transmural myocardial infarction of unspecif site res24: comorbidities diagnostic Read
Gyu3600 [X]Subsequent myocardial infarction of unspecified site res24: comorbidities diagnostic Read
Gyu6200 [X]Other intracerebral haemorrhage res24: comorbidities diagnostic Read
Gyu6300 [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs res24: comorbidities diagnostic Read
Gyu6400 [X]Other cerebral infarction res24: comorbidities diagnostic Read
Gyu6500 [X]Occlusion and stenosis of other precerebral arteries res24: comorbidities diagnostic Read
Gyu6600 [X]Occlusion and stenosis of other cerebral arteries res24: comorbidities diagnostic Read
Gyu6F00 [X]Intracerebral haemorrhage in hemisphere; unspecified res24: comorbidities diagnostic Read
Gyu6G00 [X]Cereb infarct due unsp occlus/stenos precerebr arteries res24: comorbidities diagnostic Read
K0C0.00 Analgesic nephropathy res24: comorbidities diagnostic Read
K0z..00 Nephritis; nephrosis and nephrotic syndrome NOS res24: comorbidities diagnostic Read
ZV45700 [V]Presence of aortocoronary bypass graft res24: comorbidities diagnostic Read
ZV45800 [V]Presence of coronary angioplasty implant and graft res24: comorbidities diagnostic Read
ZV45K00 [V]Presence of coronary artery bypass graft res24: comorbidities diagnostic Read
ZV45L00 [V]Status following coronary angioplasty NOS res24: comorbidities diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH646/version/1292/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH646/version/1292/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('PH646', '1292', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH646/version/1292/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH646/version/1292/export/codes/?format=json
CSV site_root/phenotypes/PH646/version/1292/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('PH646', '1292', api_client=client)

Version History

Version
ID
Name Owner Publish date
1292 Comorbidities ieuan.scanlon 2021-10-06 currently shown

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