| アブストラクト | OBJECTIVE: To assess the effect of coding quality on estimates of the incidence of diabetes in the UK between 1995 and 2014. DESIGN: A cross-sectional analysis examining diabetes coding from 1995 to 2014 and how the choice of codes (diagnosis codes vs codes which suggest diagnosis) and quality of coding affect estimated incidence. SETTING: Routine primary care data from 684 practices contributing to the UK Clinical Practice Research Datalink (data contributed from Vision (INPS) practices). MAIN OUTCOME MEASURE: Incidence rates of diabetes and how they are affected by (1) GP coding and (2) excluding 'poor' quality practices with at least 10% incident patients inaccurately coded between 2004 and 2014. RESULTS: Incidence rates and accuracy of coding varied widely between practices and the trends differed according to selected category of code. If diagnosis codes were used, the incidence of type 2 increased sharply until 2004 (when the UK Quality Outcomes Framework was introduced), and then flattened off, until 2009, after which they decreased. If non-diagnosis codes were included, the numbers continued to increase until 2012. Although coding quality improved over time, 15% of the 666 practices that contributed data between 2004 and 2014 were labelled 'poor' quality. When these practices were dropped from the analyses, the downward trend in the incidence of type 2 after 2009 became less marked and incidence rates were higher. CONCLUSIONS: In contrast to some previous reports, diabetes incidence (based on diagnostic codes) appears not to have increased since 2004 in the UK. Choice of codes can make a significant difference to incidence estimates, as can quality of recording. Codes and data quality should be checked when assessing incidence rates using GP data. |
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| ジャーナル名 | BMJ open |
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| 投稿日 | 2017/1/27 |
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| 投稿者 | Tate, A Rosemary; Dungey, Sheena; Glew, Simon; Beloff, Natalia; Williams, Rachael; Williams, Tim |
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| 組織名 | Department of Informatics, University of Sussex, Brighton, UK.;CPRD, MHRA, London, UK.;Division of Primary Care and Public Health, Brighton and Sussex Medical School,;Brighton, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28122831/ |
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