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Lung Cancer

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

Type
Disease or Syndrome
ID
PH648
Version ID
1296
Data Sources
Doctors Independent Network , CPRD GOLD
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: 24
Code Description Entity type Category Coding System (Read)
B22..00 Malig neop trachea/bronch/lung res24: lung cancer diagnostic Read
B220.00 Malig neop trachea res24: lung cancer diagnostic Read
B220100 Malig neop mucosa of trachea res24: lung cancer diagnostic Read
B220z00 Malig neop trachea NOS res24: lung cancer diagnostic Read
B221.00 Malig neop main bronchus res24: lung cancer diagnostic Read
B221000 Malig neop carina of bronchus res24: lung cancer diagnostic Read
B221100 Malig neop hilus of lung res24: lung cancer diagnostic Read
B221z00 Malig neop main bronchus NOS res24: lung cancer diagnostic Read
B222.00 Malig neop upp lobe bronc/lung res24: lung cancer diagnostic Read
B222000 Malig neop upper lobe bronchus res24: lung cancer diagnostic Read
B222100 Malig neop upper lobe of lung res24: lung cancer diagnostic Read
B222z00 Malig neop upp bronc/lung NOS res24: lung cancer diagnostic Read
B223.00 Malig neop mid lobe bronc/lung res24: lung cancer diagnostic Read
B223000 Malig neop mid lobe bronchus res24: lung cancer diagnostic Read
B223100 Malig neop middle lobe of lung res24: lung cancer diagnostic Read
B223z00 Malig neop mid lobe bronc/lung res24: lung cancer diagnostic Read
B224.00 Malig neop low lobe bronc/lung res24: lung cancer diagnostic Read
B224000 Malig neop lower bronchus res24: lung cancer diagnostic Read
B224100 Malig neop lower lobe of lung res24: lung cancer diagnostic Read
B224z00 Malig neop low lobe bronc/lung res24: lung cancer diagnostic Read
B225.00 Mal neop overlap les bron/lung res24: lung cancer diagnostic Read
B226.00 Mesothelioma res24: lung cancer diagnostic Read
B22y.00 Malig neop oth site bronc/lung res24: lung cancer diagnostic Read
B22z.00 Malig neop bronchus/lung NOS res24: lung cancer diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH648/version/1296/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH648/version/1296/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('PH648', '1296', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH648/version/1296/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH648/version/1296/export/codes/?format=json
CSV site_root/phenotypes/PH648/version/1296/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('PH648', '1296', api_client=client)

Version History

Version
ID
Name Owner Publish date
1296 Lung 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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