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Research article:
Coding, Recording and Incidence of Different Forms of Coronary Heart Disease in Primary Care
Reference:
Nawaraj Bhattarai, Judith Charlton, Caroline Rudisill, Martin C. Gulliford(2012) Coding, Recording and Incidence of Different Forms of Coronary Heart Disease in Primary Care. PLoS ONE, doi: 10.1371/journal.pone.0029776
- Link to fulltext article
- Abstract
- Objectives To evaluate the coding, recording and incidence of coronary heart disease (CHD) in primary care electronic medical records. Methods Data were drawn from the UK General Practice Research Database. Analyses evaluated the occurrence of 271 READ medical diagnostic codes, including categories for ‘Angina’, ‘Myocardial Infarction’, ‘Coronary Artery Bypass Grafting’ (CABG), ‘percutaneous transluminal coronary angioplasty’ (PCTA) and ‘Other Coronary Heart Disease’. Time-to-event analyses were implemented to evaluate occurrences of different groups of codes after the index date. Results Among 300,020 participants aged greater than 30 years there were 75,197 unique occurrences of coronary heart disease codes in 24,244 participants, with 12,495 codes for incident events and 62,702 for prevalent events. Among incident event codes, 3,607 (28.87%) were for angina, 3,262 (26.11%) were for MI, 514 (4.11%) for PCTA, 161 (1.29%) for CABG and 4,951 (39.62%) were for ‘Other CHD’. Among prevalent codes, 20,254 (32.30%) were for angina, 3,644 (5.81%) for MI, 34,542 (55.09%) for ‘Other CHD’ and 4,262 (6.80%) for CABG or PCTA. Among 3,685 participants initially diagnosed exclusively with ‘Other CHD’ codes, 17.1% were recorded with angina within 5 years, 5.6% with myocardial infarction, 6.3% with CABG and 8.6% with PCTA. From 2000 to 2010, the overall incidence of CHD declined, as did the incidence of angina, but the incidence of MI did not change. The frequency of CABG declined, while PCTA increased. Conclusion In primary care electronic records, a substantial proportion of coronary heart disease events are recorded with codes that do not distinguish between different clinical presentations of CHD. The results draw attention to the need to improve coding practice in primary care. The results also draw attention to the importance of code selection in research studies and the need for sensitivity analyses using different sets of codes.
- Author for correspondence
- Nawaraj Bhattarai
- Email for correspondence
- nawaraj.bhattarai@kcl.ac.uk
Code list: res12: Other Coronary Heart Disease
59 codes in list
| Code | Coding system | Description | Entity type | List name | incidence percentage | prevalence percentage | |
|---|---|---|---|---|---|---|---|
| 14A..00 | Read | H/O: cardiovascular disease | diagnostic | res12: Other Coronary Heart Disease | 0.3 | 0.18 | |
| 14A3.00 | Read | H/O: myocardial infarct <60 | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0.13 | |
| 14A4.00 | Read | H/O: myocardial infarct >60 | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0.07 | |
| 14AH.00 | Read | H/O: Myocardial infarction in last year | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 322..00 | Read | ECG: myocardial ischaemia | diagnostic | res12: Other Coronary Heart Disease | 0.06 | 0.01 | |
| 5543 | Read | Coronary arteriograph.abnormal | diagnostic | res12: Other Coronary Heart Disease | 0.24 | 0.19 | |
| 6A2..00 | Read | Coronary heart disease annual review | diagnostic | res12: Other Coronary Heart Disease | 5.44 | 26.13 | |
| 6A4..00 | Read | Coronary heart disease review | diagnostic | res12: Other Coronary Heart Disease | 1.47 | 3.99 | |
| 792..00 | Read | Coronary artery operations | diagnostic | res12: Other Coronary Heart Disease | 0.36 | 0.54 | |
| 7927100 | Read | Repair of aneurysm of coronary artery | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0 | |
| 7927400 | Read | Exploration of coronary artery | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 7927500 | Read | Open angioplasty of coronary artery | diagnostic | res12: Other Coronary Heart Disease | 0.19 | 0.19 | |
| 7927z00 | Read | Other open operation on coronary artery NOS | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 792A.00 | Read | Diagnostic transluminal operations on coronary artery | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0.01 | |
| 792A100 | Read | Intravascular ultrasound of coronary artery | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 792Ay00 | Read | Diagnostic transluminal operation on coronary artery OS | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 792Az00 | Read | Diagnostic transluminal operation on coronary artery NOS | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| 792B.00 | Read | Repair of coronary artery NEC | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0 | |
| 792B000 | Read | Endarterectomy of coronary artery NEC | diagnostic | res12: Other Coronary Heart Disease | 0.09 | 0.02 | |
| 792z.00 | Read | Coronary artery operations NOS | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0.04 | |
| 8B3k.00 | Read | Coronary heart disease medication review | diagnostic | res12: Other Coronary Heart Disease | 0.24 | 0.68 | |
| 8B63.11 | Read | Aspirin prophylaxis - IHD | diagnostic | res12: Other Coronary Heart Disease | 4.02 | 3.09 | |
| 9Ob0.00 | Read | Attends coronary heart disease monitoring | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0.29 | |
| G3...00 | Read | Ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 15.47 | 10.03 | |
| G31..00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G3...11 | Read | Arteriosclerotic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0.01 | |
| G311.00 | Read | Preinfarction syndrome | diagnostic | res12: Other Coronary Heart Disease | 0.04 | 0.04 | |
| G3...12 | Read | Atherosclerotic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0.05 | 0.16 | |
| G3...13 | Read | IHD - Ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 5.54 | 5.09 | |
| G31y.00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G31yz00 | Read | Other acute and subacute ischaemic heart disease NOS | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0 | |
| G332.00 | Read | Coronary artery spasm | diagnostic | res12: Other Coronary Heart Disease | 0.13 | 0.03 | |
| G34..00 | Read | Other chronic ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0.05 | 0.02 | |
| G340.00 | Read | Coronary atherosclerosis | diagnostic | res12: Other Coronary Heart Disease | 0.31 | 0.07 | |
| G340000 | Read | Single coronary vessel disease | diagnostic | res12: Other Coronary Heart Disease | 0.31 | 0.19 | |
| G340100 | Read | Double coronary vessel disease | diagnostic | res12: Other Coronary Heart Disease | 0.24 | 0.15 | |
| G340.11 | Read | Triple vessel disease of the heart | diagnostic | res12: Other Coronary Heart Disease | 0.27 | 0.36 | |
| G340.12 | Read | Coronary artery disease | diagnostic | res12: Other Coronary Heart Disease | 1.98 | 0.92 | |
| G341.00 | Read | Aneurysm of heart | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G341000 | Read | Ventricular cardiac aneurysm | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0.02 | |
| G341100 | Read | Other cardiac wall aneurysm | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0 | |
| G341.11 | Read | Cardiac aneurysm | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G341200 | Read | Aneurysm of coronary vessels | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G341z00 | Read | Aneurysm of heart NOS | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G342.00 | Read | Atherosclerotic cardiovascular disease | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0 | |
| G343.00 | Read | Ischaemic cardiomyopathy | diagnostic | res12: Other Coronary Heart Disease | 0.05 | 0.04 | |
| G34y000 | Read | Chronic coronary insufficiency | diagnostic | res12: Other Coronary Heart Disease | 0 | 0 | |
| G34y100 | Read | Chronic myocardial ischaemia | diagnostic | res12: Other Coronary Heart Disease | 0.02 | 0.01 | |
| G34z.00 | Read | Other chronic ischaemic heart disease NOS | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0 | |
| G34z000 | Read | Asymptomatic coronary heart disease | diagnostic | res12: Other Coronary Heart Disease | 0.05 | 0.09 | |
| G37..00 | Read | Cardiac syndrome X | diagnostic | res12: Other Coronary Heart Disease | 0.08 | 0.07 | |
| G3y..00 | Read | Other specified ischaemic heart disease | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0.01 | |
| G3z..00 | Read | Ischaemic heart disease NOS | diagnostic | res12: Other Coronary Heart Disease | 1.34 | 0.49 | |
| Gyu3.00 | Read | [X]Ischaemic heart diseases | diagnostic | res12: Other Coronary Heart Disease | 0.08 | 0.03 | |
| SP07600 | Read | Coronary artery bypass graft occlusion | diagnostic | res12: Other Coronary Heart Disease | 0.12 | 0.18 | |
| ZV45700 | Read | [V]Presence of aortocoronary bypass graft | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0 | |
| ZV45800 | Read | [V]Presence of coronary angioplasty implant and graft | diagnostic | res12: Other Coronary Heart Disease | 0.01 | 0.03 | |
| ZV45K00 | Read | [V]Presence of coronary artery bypass graft | diagnostic | res12: Other Coronary Heart Disease | 0.04 | 0.09 | |
| ZV45K11 | Read | [V]Presence of coronary artery bypass graft - CABG | diagnostic | res12: Other Coronary Heart Disease | 0.07 | 0.16 |
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