ClinicalCodes.org

An online clinical codes repository to improve validity and reproducibility of medical database research

Research article:

Can analyses of electronic patient records be independently and externally validated? Study 2: the Effect of Beta-Adrenoceptor Blocker Therapy on Cancer Survival; a Retrospective Cohort Study

Reference:

David a Springate, Darren M Ashcroft, Evangelos Kontopantelis, Tim Doran, Ronan Ryan, David Reeves(2015) Can analyses of electronic patient records be independently and externally validated? Study 2: the Effect of Beta-Adrenoceptor Blocker Therapy on Cancer Survival; a Retrospective Cohort Study. BMJ Open, doi: 10.1136/bmjopen-2014-007299

Link to fulltext article
Abstract
Objectives To conduct a fully independent and external validation of a research study based on one electronic health record database, using a different database sampling the same population. Design Retrospective cohort analysis of beta-blocker therapy and all-cause mortality in cancer patients. Setting Two UK national primary care databases (PCDs): the Clinical Practice Research Datalink (CPRD) and Doctors’ Independent Network (DIN). Participants CPRD data for 11302 cancer patients compared to 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 (betablockers only, beta-blockers plus other blood pressure lowering medicines (BPLM), other BPLMs only); and by cancer-site. Results Using CPRD, beta-blocker use was not associated with mortality (HR=1.03, 95%CI 0.93-1.14, vs patients prescribed other BPLMs only), but in DIN beta-blocker users had significantly higher mortality (HR=1.18, 95%CI 1.04 to 1.33). However, these hazard ratios were not statistically different (p=0.063), but did differ for patients on beta-blockers alone (CPRD=0.94, 95%CI 0.82-1.07; DIN=1.37, 95%CI 1.16-1.61; p<0.001). Results for nine 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. Our finding that overall treatment effect estimates were not statistically different, adds to a growing body of evidence that different UK PCDs produce effect estimates comparable within statistical tolerance. However, some subgroup effects differed significantly and individually the two studies lead to different conclusions regarding the safety of beta-blockers for cancer patients. Single studies based on internally well-validated databases therefore do not guarantee generalisable results, especially for subgroups. In all cases, confirmatory studies using at least one other independent data source are strongly recommended.
Author for correspondence
David Reeves
Email for correspondence
david.reeves@manchester.ac.uk

Code list: res24: comorbidities

234 codes in list

Code Coding system Description Entity type List name
14A3.00 Read H/O: myocardial infarct <60 diagnostic res24: comorbidities
14A4.00 Read H/O: myocardial infarct >60 diagnostic res24: comorbidities
14A5.00 Read H/O: angina pectoris diagnostic res24: comorbidities
14A6.00 Read H/O: heart failure diagnostic res24: comorbidities
14A7.00 Read H/O: CVA/stroke diagnostic res24: comorbidities
14AB.00 Read H/O: TIA diagnostic res24: comorbidities
14AH.00 Read H/O: Myocardial infarction in last year diagnostic res24: comorbidities
14AJ.00 Read H/O: Angina in last year diagnostic res24: comorbidities
14AK.00 Read H/O: Stroke in last year diagnostic res24: comorbidities
14AL.00 Read H/O: Treatment for ischaemic heart disease diagnostic res24: comorbidities
14AM.00 Read H/O: Heart failure in last year diagnostic res24: comorbidities
14AN.00 Read H/O: atrial fibrillation diagnostic res24: comorbidities
14B3.00 Read H/O: chr.obstr. airway disease diagnostic res24: comorbidities
14B4.00 Read H/O: asthma diagnostic res24: comorbidities
14V2.00 Read H/O: renal dialysis diagnostic res24: comorbidities
173A.00 Read Exercise induced asthma diagnostic res24: comorbidities
1O2..00 Read Asthma confirmed diagnostic res24: comorbidities
322..00 Read ECG: myocardial ischaemia diagnostic res24: comorbidities
3222 Read ECG:shows myocardial ischaemia diagnostic res24: comorbidities
322Z.00 Read ECG: myocardial ischaemia NOS diagnostic res24: comorbidities
323..00 Read ECG: myocardial infarction diagnostic res24: comorbidities
3232 Read ECG: old myocardial infarction diagnostic res24: comorbidities
3233 Read ECG: antero-septal infarct. diagnostic res24: comorbidities
3234 Read ECG:posterior/inferior infarct diagnostic res24: comorbidities
3235 Read ECG: subendocardial infarct diagnostic res24: comorbidities
3236 Read ECG: lateral infarction diagnostic res24: comorbidities
323Z.00 Read ECG: myocardial infarct NOS diagnostic res24: comorbidities
662K.00 Read Angina control diagnostic res24: comorbidities
7920 Read Saphenous vein graft replacement of coronary artery diagnostic res24: comorbidities
792..00 Read Coronary artery operations diagnostic res24: comorbidities
7920000 Read Saphenous vein graft replacement of one coronary artery diagnostic res24: comorbidities
7920100 Read Saphenous vein graft replacement of two coronary arteries diagnostic res24: comorbidities
7920200 Read Saphenous vein graft replacement of three coronary arteries diagnostic res24: comorbidities
7920300 Read Saphenous vein graft replacement of four+ coronary arteries diagnostic res24: comorbidities
7920y00 Read Saphenous vein graft replacement of coronary artery OS diagnostic res24: comorbidities
7920z00 Read Saphenous vein graft replacement coronary artery NOS diagnostic res24: comorbidities
7921 Read Other autograft replacement of coronary artery diagnostic res24: comorbidities
7921000 Read Autograft replacement of one coronary artery NEC diagnostic res24: comorbidities
7921100 Read Autograft replacement of two coronary arteries NEC diagnostic res24: comorbidities
7921200 Read Autograft replacement of three coronary arteries NEC diagnostic res24: comorbidities
7921300 Read Autograft replacement of four of more coronary arteries NEC diagnostic res24: comorbidities
7921y00 Read Other autograft replacement of coronary artery OS diagnostic res24: comorbidities
7921z00 Read Other autograft replacement of coronary artery NOS diagnostic res24: comorbidities
7922 Read Allograft replacement of coronary artery diagnostic res24: comorbidities
7922000 Read Allograft replacement of one coronary artery diagnostic res24: comorbidities
7922100 Read Allograft replacement of two coronary arteries diagnostic res24: comorbidities
7922200 Read Allograft replacement of three coronary arteries diagnostic res24: comorbidities
7922300 Read Allograft replacement of four or more coronary arteries diagnostic res24: comorbidities
7922y00 Read Other specified allograft replacement of coronary artery diagnostic res24: comorbidities
7922z00 Read Allograft replacement of coronary artery NOS diagnostic res24: comorbidities
7923 Read Prosthetic replacement of coronary artery diagnostic res24: comorbidities
7923000 Read Prosthetic replacement of one coronary artery diagnostic res24: comorbidities
7923100 Read Prosthetic replacement of two coronary arteries diagnostic res24: comorbidities
7923200 Read Prosthetic replacement of three coronary arteries diagnostic res24: comorbidities
7923300 Read Prosthetic replacement of four or more coronary arteries diagnostic res24: comorbidities
7923z00 Read Prosthetic replacement of coronary artery NOS diagnostic res24: comorbidities
7924 Read Revision of bypass for coronary artery diagnostic res24: comorbidities
7924000 Read Revision of bypass for one coronary artery diagnostic res24: comorbidities
7924100 Read Revision of bypass for two coronary arteries diagnostic res24: comorbidities
7924200 Read Revision of bypass for three coronary arteries diagnostic res24: comorbidities
7924300 Read Revision of bypass for four or more coronary arteries diagnostic res24: comorbidities
7924500 Read Revision of implantation of thoracic artery into heart diagnostic res24: comorbidities
7924y00 Read Other specified revision of bypass for coronary artery diagnostic res24: comorbidities
7924z00 Read Revision of bypass for coronary artery NOS diagnostic res24: comorbidities
7925 Read Connection of mammary artery to coronary artery diagnostic res24: comorbidities
7925000 Read Double anastomosis of mammary arteries to coronary arteries diagnostic res24: comorbidities
7925100 Read Double implant of mammary arteries into coronary arteries diagnostic res24: comorbidities
7925200 Read Single anast mammary art to left ant descend coronary art diagnostic res24: comorbidities
7925300 Read Single anastomosis of mammary artery to coronary artery NEC diagnostic res24: comorbidities
7925400 Read Single implantation of mammary artery into coronary artery diagnostic res24: comorbidities
7925y00 Read Connection of mammary artery to coronary artery OS diagnostic res24: comorbidities
7925z00 Read Connection of mammary artery to coronary artery NOS diagnostic res24: comorbidities
7926 Read Connection of other thoracic artery to coronary artery diagnostic res24: comorbidities
7926000 Read Double anastom thoracic arteries to coronary arteries NEC diagnostic res24: comorbidities
7926200 Read Single anastomosis of thoracic artery to coronary artery NEC diagnostic res24: comorbidities
7926300 Read Single implantation thoracic artery into coronary artery NEC diagnostic res24: comorbidities
7926z00 Read Connection of other thoracic artery to coronary artery NOS diagnostic res24: comorbidities
7927 Read Other open operations on coronary artery diagnostic res24: comorbidities
7927500 Read Open angioplasty of coronary artery diagnostic res24: comorbidities
7927y00 Read Other specified other open operation on coronary artery diagnostic res24: comorbidities
7927z00 Read Other open operation on coronary artery NOS diagnostic res24: comorbidities
7928 Read Transluminal balloon angioplasty of coronary artery diagnostic res24: comorbidities
7928000 Read Percut transluminal balloon angioplasty one coronary artery diagnostic res24: comorbidities
7928100 Read Percut translum balloon angioplasty mult coronary arteries diagnostic res24: comorbidities
7928200 Read Percut translum balloon angioplasty bypass graft coronary a diagnostic res24: comorbidities
7928y00 Read Transluminal balloon angioplasty of coronary artery OS diagnostic res24: comorbidities
7928z00 Read Transluminal balloon angioplasty of coronary artery NOS diagnostic res24: comorbidities
7929 Read Other therapeutic transluminal operations on coronary artery diagnostic res24: comorbidities
7929000 Read Percutaneous transluminal laser coronary angioplasty diagnostic res24: comorbidities
7929100 Read Percut transluminal coronary thrombolysis with streptokinase diagnostic res24: comorbidities
7929200 Read Percut translum inject therap subst to coronary artery NEC diagnostic res24: comorbidities
7929300 Read Rotary blade coronary angioplasty diagnostic res24: comorbidities
7929400 Read Insertion of coronary artery stent diagnostic res24: comorbidities
7929500 Read Insertion of drug-eluting coronary artery stent diagnostic res24: comorbidities
7929600 Read Percutaneous transluminal atherectomy of coronary artery diagnostic res24: comorbidities
7929y00 Read Other therapeutic transluminal op on coronary artery OS diagnostic res24: comorbidities
7929z00 Read Other therapeutic transluminal op on coronary artery NOS diagnostic res24: comorbidities
792A.00 Read Diagnostic transluminal operations on coronary artery diagnostic res24: comorbidities
792A000 Read Percutaneous transluminal angioscopy diagnostic res24: comorbidities
792A100 Read Intravascular ultrasound of coronary artery diagnostic res24: comorbidities
792Ay00 Read Diagnostic transluminal operation on coronary artery OS diagnostic res24: comorbidities
792Az00 Read Diagnostic transluminal operation on coronary artery NOS diagnostic res24: comorbidities
792B.00 Read Repair of coronary artery NEC diagnostic res24: comorbidities
792B000 Read Endarterectomy of coronary artery NEC diagnostic res24: comorbidities
792By00 Read Other specified repair of coronary artery diagnostic res24: comorbidities
792Bz00 Read Repair of coronary artery NOS diagnostic res24: comorbidities
792C.00 Read Other replacement of coronary artery diagnostic res24: comorbidities
792C000 Read Replacement of coronary arteries using multiple methods diagnostic res24: comorbidities
792Cy00 Read Other specified replacement of coronary artery diagnostic res24: comorbidities
792Cz00 Read Replacement of coronary artery NOS diagnostic res24: comorbidities
792D.00 Read Other bypass of coronary artery diagnostic res24: comorbidities
792Dy00 Read Other specified other bypass of coronary artery diagnostic res24: comorbidities
792Dz00 Read Other bypass of coronary artery NOS diagnostic res24: comorbidities
792y.00 Read Other specified operations on coronary artery diagnostic res24: comorbidities
792z.00 Read Coronary artery operations NOS diagnostic res24: comorbidities
F423600 Read Amaurosis fugax diagnostic res24: comorbidities
G3...00 Read Ischaemic heart disease diagnostic res24: comorbidities
G30..00 Read Acute myocardial infarction diagnostic res24: comorbidities
G300.00 Read Acute anterolateral infarction diagnostic res24: comorbidities
G301.00 Read Other specified anterior myocardial infarction diagnostic res24: comorbidities
G301000 Read Acute anteroapical infarction diagnostic res24: comorbidities
G301100 Read Acute anteroseptal infarction diagnostic res24: comorbidities
G301z00 Read Anterior myocardial infarction NOS diagnostic res24: comorbidities
G302.00 Read Acute inferolateral infarction diagnostic res24: comorbidities
G303.00 Read Acute inferoposterior infarction diagnostic res24: comorbidities
G304.00 Read Posterior myocardial infarction NOS diagnostic res24: comorbidities
G305.00 Read Lateral myocardial infarction NOS diagnostic res24: comorbidities
G306.00 Read True posterior myocardial infarction diagnostic res24: comorbidities
G307.00 Read Acute subendocardial infarction diagnostic res24: comorbidities
G307000 Read Acute non-Q wave infarction diagnostic res24: comorbidities
G307100 Read Acute non-ST segment elevation myocardial infarction diagnostic res24: comorbidities
G308.00 Read Inferior myocardial infarction NOS diagnostic res24: comorbidities
G309.00 Read Acute Q-wave infarct diagnostic res24: comorbidities
G30A.00 Read Mural thrombosis diagnostic res24: comorbidities
G30B.00 Read Acute posterolateral myocardial infarction diagnostic res24: comorbidities
G30X.00 Read Acute transmural myocardial infarction of unspecif site diagnostic res24: comorbidities
G30X000 Read Acute ST segment elevation myocardial infarction diagnostic res24: comorbidities
G30y.00 Read Other acute myocardial infarction diagnostic res24: comorbidities
G30y000 Read Acute atrial infarction diagnostic res24: comorbidities
G30y100 Read Acute papillary muscle infarction diagnostic res24: comorbidities
G30y200 Read Acute septal infarction diagnostic res24: comorbidities
G30yz00 Read Other acute myocardial infarction NOS diagnostic res24: comorbidities
G30z.00 Read Acute myocardial infarction NOS diagnostic res24: comorbidities
G31..00 Read Other acute and subacute ischaemic heart disease diagnostic res24: comorbidities
G310.00 Read Postmyocardial infarction syndrome diagnostic res24: comorbidities
G311.00 Read Preinfarction syndrome diagnostic res24: comorbidities
G311000 Read Myocardial infarction aborted diagnostic res24: comorbidities
G311100 Read Unstable angina diagnostic res24: comorbidities
G311200 Read Angina at rest diagnostic res24: comorbidities
G311300 Read Refractory angina diagnostic res24: comorbidities
G311400 Read Worsening angina diagnostic res24: comorbidities
G311500 Read Acute coronary syndrome diagnostic res24: comorbidities
G311z00 Read Preinfarction syndrome NOS diagnostic res24: comorbidities
G312.00 Read Coronary thrombosis not resulting in myocardial infarction diagnostic res24: comorbidities
G31y.00 Read Other acute and subacute ischaemic heart disease diagnostic res24: comorbidities
G31y000 Read Acute coronary insufficiency diagnostic res24: comorbidities
G31y100 Read Microinfarction of heart diagnostic res24: comorbidities
G31y200 Read Subendocardial ischaemia diagnostic res24: comorbidities
G31y300 Read Transient myocardial ischaemia diagnostic res24: comorbidities
G31yz00 Read Other acute and subacute ischaemic heart disease NOS diagnostic res24: comorbidities
G32..00 Read Old myocardial infarction diagnostic res24: comorbidities
G33..00 Read Angina pectoris diagnostic res24: comorbidities
G330.00 Read Angina decubitus diagnostic res24: comorbidities
G330000 Read Nocturnal angina diagnostic res24: comorbidities
G330z00 Read Angina decubitus NOS diagnostic res24: comorbidities
G331.00 Read Prinzmetal's angina diagnostic res24: comorbidities
G332.00 Read Coronary artery spasm diagnostic res24: comorbidities
G33z.00 Read Angina pectoris NOS diagnostic res24: comorbidities
G33z000 Read Status anginosus diagnostic res24: comorbidities
G33z100 Read Stenocardia diagnostic res24: comorbidities
G33z200 Read Syncope anginosa diagnostic res24: comorbidities
G33z300 Read Angina on effort diagnostic res24: comorbidities
G33z400 Read Ischaemic chest pain diagnostic res24: comorbidities
G33z500 Read Post infarct angina diagnostic res24: comorbidities
G33z600 Read New onset angina diagnostic res24: comorbidities
G33z700 Read Stable angina diagnostic res24: comorbidities
G33zz00 Read Angina pectoris NOS diagnostic res24: comorbidities
G34..00 Read Other chronic ischaemic heart disease diagnostic res24: comorbidities
G340.00 Read Coronary atherosclerosis diagnostic res24: comorbidities
G340000 Read Single coronary vessel disease diagnostic res24: comorbidities
G340100 Read Double coronary vessel disease diagnostic res24: comorbidities
G342.00 Read Atherosclerotic cardiovascular disease diagnostic res24: comorbidities
G343.00 Read Ischaemic cardiomyopathy diagnostic res24: comorbidities
G344.00 Read Silent myocardial ischaemia diagnostic res24: comorbidities
G34y.00 Read Other specified chronic ischaemic heart disease diagnostic res24: comorbidities
G34y000 Read Chronic coronary insufficiency diagnostic res24: comorbidities
G34y100 Read Chronic myocardial ischaemia diagnostic res24: comorbidities
G34yz00 Read Other specified chronic ischaemic heart disease NOS diagnostic res24: comorbidities
G34z.00 Read Other chronic ischaemic heart disease NOS diagnostic res24: comorbidities
G34z000 Read Asymptomatic coronary heart disease diagnostic res24: comorbidities
G35..00 Read Subsequent myocardial infarction diagnostic res24: comorbidities
G350.00 Read Subsequent myocardial infarction of anterior wall diagnostic res24: comorbidities
G351.00 Read Subsequent myocardial infarction of inferior wall diagnostic res24: comorbidities
G353.00 Read Subsequent myocardial infarction of other sites diagnostic res24: comorbidities
G35X.00 Read Subsequent myocardial infarction of unspecified site diagnostic res24: comorbidities
G36..00 Read Certain current complication follow acute myocardial infarct diagnostic res24: comorbidities
G360.00 Read Haemopericardium/current comp folow acut myocard infarct diagnostic res24: comorbidities
G361.00 Read Atrial septal defect/curr comp folow acut myocardal infarct diagnostic res24: comorbidities
G362.00 Read Ventric septal defect/curr comp fol acut myocardal infarctn diagnostic res24: comorbidities
G363.00 Read Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI diagnostic res24: comorbidities
G364.00 Read Ruptur chordae tendinae/curr comp fol acute myocard infarct diagnostic res24: comorbidities
G365.00 Read Rupture papillary muscle/curr comp fol acute myocard infarct diagnostic res24: comorbidities
G366.00 Read Thrombosis atrium; auric append&vent/curr comp foll acute MI diagnostic res24: comorbidities
G38..00 Read Postoperative myocardial infarction diagnostic res24: comorbidities
G380.00 Read Postoperative transmural myocardial infarction anterior wall diagnostic res24: comorbidities
G381.00 Read Postoperative transmural myocardial infarction inferior wall diagnostic res24: comorbidities
G384.00 Read Postoperative subendocardial myocardial infarction diagnostic res24: comorbidities
G38z.00 Read Postoperative myocardial infarction; unspecified diagnostic res24: comorbidities
G3y..00 Read Other specified ischaemic heart disease diagnostic res24: comorbidities
G3z..00 Read Ischaemic heart disease NOS diagnostic res24: comorbidities
G63y000 Read Cerebral infarct due to thrombosis of precerebral arteries diagnostic res24: comorbidities
G63y100 Read Cerebral infarction due to embolism of precerebral arteries diagnostic res24: comorbidities
G676000 Read Cereb infarct due cerebral venous thrombosis; nonpyogenic diagnostic res24: comorbidities
G6W..00 Read Cereb infarct due unsp occlus/stenos precerebr arteries diagnostic res24: comorbidities
G6X..00 Read Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs diagnostic res24: comorbidities
Gyu3.00 Read [X]Ischaemic heart diseases diagnostic res24: comorbidities
Gyu3000 Read [X]Other forms of angina pectoris diagnostic res24: comorbidities
Gyu3200 Read [X]Other forms of acute ischaemic heart disease diagnostic res24: comorbidities
Gyu3300 Read [X]Other forms of chronic ischaemic heart disease diagnostic res24: comorbidities
Gyu3400 Read [X]Acute transmural myocardial infarction of unspecif site diagnostic res24: comorbidities
Gyu3600 Read [X]Subsequent myocardial infarction of unspecified site diagnostic res24: comorbidities
Gyu6200 Read [X]Other intracerebral haemorrhage diagnostic res24: comorbidities
Gyu6300 Read [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs diagnostic res24: comorbidities
Gyu6400 Read [X]Other cerebral infarction diagnostic res24: comorbidities
Gyu6500 Read [X]Occlusion and stenosis of other precerebral arteries diagnostic res24: comorbidities
Gyu6600 Read [X]Occlusion and stenosis of other cerebral arteries diagnostic res24: comorbidities
Gyu6F00 Read [X]Intracerebral haemorrhage in hemisphere; unspecified diagnostic res24: comorbidities
Gyu6G00 Read [X]Cereb infarct due unsp occlus/stenos precerebr arteries diagnostic res24: comorbidities
K0C0.00 Read Analgesic nephropathy diagnostic res24: comorbidities
K0z..00 Read Nephritis; nephrosis and nephrotic syndrome NOS diagnostic res24: comorbidities
ZV45700 Read [V]Presence of aortocoronary bypass graft diagnostic res24: comorbidities
ZV45800 Read [V]Presence of coronary angioplasty implant and graft diagnostic res24: comorbidities
ZV45K00 Read [V]Presence of coronary artery bypass graft diagnostic res24: comorbidities
ZV45L00 Read [V]Status following coronary angioplasty NOS diagnostic res24: comorbidities

0 comments have been posted.

Please log in to leave a comment.