Phenotype Library | phenotype: Pancreas Cancer

Pancreas Cancer

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

PH652

Version ID

1304

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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C2072/5282 Pancreas Cancer - Primary Care - Read codes v2

Rows: 11

Code	Description	Entity type	Category	Coding System (Read)
B17..00	Malignant neoplasm of pancreas	res24: pancreas cancer	diagnostic	Read
B170.00	Malig neop head of pancreas	res24: pancreas cancer	diagnostic	Read
B171.00	Malig neop body of pancreas	res24: pancreas cancer	diagnostic	Read
B172.00	Malig neop tail of pancreas	res24: pancreas cancer	diagnostic	Read
B173.00	Malig neop pancreatic duct	res24: pancreas cancer	diagnostic	Read
B174.00	Malig neop Islets Langerhans	res24: pancreas cancer	diagnostic	Read
B175.00	Malig neopl overlap lesn pancr	res24: pancreas cancer	diagnostic	Read
B17y.00	Malig neop oth spec pancreas	res24: pancreas cancer	diagnostic	Read
B17y000	Malig neop ectop pancreat tiss	res24: pancreas cancer	diagnostic	Read
B17yz00	Malig neop spec site panc NOS	res24: pancreas cancer	diagnostic	Read
B17z.00	Malig neop of pancreas NOS	res24: pancreas cancer	diagnostic	Read

API

To Export Phenotype Details:

Format	API
XML	site_root/api/v1/public/phenotypes/PH652/version/1304/detail/?format=xml
JSON	site_root/api/v1/public/phenotypes/PH652/version/1304/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('PH652', '1304', api_client=client)`

To Export Phenotype Code List:

Format	API
XML	site_root/api/v1/public/phenotypes/PH652/version/1304/export/codes/?format=xml
JSON	site_root/api/v1/public/phenotypes/PH652/version/1304/export/codes/?format=json
CSV	site_root/phenotypes/PH652/version/1304/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('PH652', '1304', api_client=client)`

Version History

Version ID	Name	Owner	Publish date
1304	Pancreas Cancer	ieuan.scanlon	2021-10-06	currently shown