Phenotype Library | phenotype: Lung Cancer

Lung Cancer

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

PH648

Version ID

1296

Type

Disease or Syndrome

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

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

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C2068/5274 Lung Cancer - Primary Care - Read codes v2

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