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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? The effect of statins on the mortality of patients with Ischaemic heart disease: a cohort study with nested case-control analysis
Reference:
David Reeves, David Springate, Darren M Ashcroft, Ronan Ryan, Tim Doran, Richard Morris, Ivan Olier, Evangelos Kontopantelis(2014) Can analyses of electronic patient records be independently and externally validated? The effect of statins on the mortality of patients with Ischaemic heart disease: a cohort study with nested case-control analysis. BMJ Open, doi: doi:10.1136/bmjopen-2014-004952
- Link to fulltext article
- Abstract
- Objective To conduct a fully independent and external validation of a research study based on one electronic health records database, using a different electronic database sampling the same population. Design Using the Clinical Practice Research Datalink (CPRD), we replicated a published investigation into the effects of statins in patients with ischaemic heart disease (IHD) by a different research team using QResearch. We replicated the original methods and analysed all cause mortality using: (i) a cohort analysis and (ii) a case-control analysis nested within the full cohort. Setting Electronic health record databases containing longitudinal patient consultation data from large numbers of general practices distributed throughout the UK. Participants CPRD data for 34925 patients with IHD from 224 general practices, compared against previously published results from QResearch for 13,029 patients from 89 general practices. The study period was January 1996 to December 2003. Results We successfully replicated the methods of the original study very closely. In cohort analysis risk of death was lower by 55% for patients on statins, compared to 53% for QResearch (adjusted HR 0.45, 95% CI 0.40 to 0.50; versus 0.47, 95% CI 0.41 to 0.53). In case-control analyses patients on statins had a 31% lower odds of death, compared to 39% for QResearch (adjusted OR 0.69, 95% CI 0.63 to 0.75; versus OR 0.61, 95% CI 0.52 to 0.72). Results were also close for individual statins. Conclusion Database differences in population characteristics and in data definitions, recording, quality and completeness had minimal impact on key statistical outputs. The results uphold the validity of research using CPRD and QResearch, by providing independent evidence that both datasets produce very similar estimates of treatment effect, leading to the same clinical and policy decisions. Together with other, non-independent, replication studies there is a nascent body of evidence for wider validity.
- Author for correspondence
- David Reeves
- Email for correspondence
- david.reeves@manchester.ac.uk
Code list: Ischaemic Heart Disease
115 codes in list
| Code | Coding system | Description | Entity type | List name | group | ||
|---|---|---|---|---|---|---|---|
| G3...00 | Read | Ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G30..00 | Read | Acute myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G300.00 | Read | Acute anterolateral infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G301.00 | Read | Other specified anterior myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G301000 | Read | Acute anteroapical infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30..11 | Read | Attack - heart | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G301100 | Read | Acute anteroseptal infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30..12 | Read | Coronary thrombosis | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G30..13 | Read | Cardiac rupture following myocardial infarction (MI) | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30..14 | Read | Heart attack | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30..15 | Read | MI - acute myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30..16 | Read | Thrombosis - coronary | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G30..17 | Read | Silent myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G301z00 | Read | Anterior myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G302.00 | Read | Acute inferolateral infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G303.00 | Read | Acute inferoposterior infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G304.00 | Read | Posterior myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G305.00 | Read | Lateral myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G306.00 | Read | True posterior myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G307.00 | Read | Acute subendocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G307000 | Read | Acute non-Q wave infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G307100 | Read | Acute non-ST segment elevation myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G308.00 | Read | Inferior myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G309.00 | Read | Acute Q-wave infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30A.00 | Read | Mural thrombosis | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G30B.00 | Read | Acute posterolateral myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30X.00 | Read | Acute transmural myocardial infarction of unspecif site | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30X000 | Read | Acute ST segment elevation myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30y.00 | Read | Other acute myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30y000 | Read | Acute atrial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30y100 | Read | Acute papillary muscle infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30y200 | Read | Acute septal infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30yz00 | Read | Other acute myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G30z.00 | Read | Acute myocardial infarction NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G31..00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G310.00 | Read | Postmyocardial infarction syndrome | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G310.11 | Read | Dressler's syndrome | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G3...11 | Read | Arteriosclerotic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311.00 | Read | Preinfarction syndrome | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G311000 | Read | Myocardial infarction aborted | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G311011 | Read | MI - myocardial infarction aborted | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G311100 | Read | Unstable angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311.11 | Read | Crescendo angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311.12 | Read | Impending infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G311.13 | Read | Unstable angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311.14 | Read | Angina at rest | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311200 | Read | Angina at rest | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311300 | Read | Refractory angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311400 | Read | Worsening angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311500 | Read | Acute coronary syndrome | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G311z00 | Read | Preinfarction syndrome NOS | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G3...12 | Read | Atherosclerotic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G312.00 | Read | Coronary thrombosis not resulting in myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G3...13 | Read | IHD - Ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G31y.00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G31y000 | Read | Acute coronary insufficiency | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G31y100 | Read | Microinfarction of heart | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G31y200 | Read | Subendocardial ischaemia | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G31y300 | Read | Transient myocardial ischaemia | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G31yz00 | Read | Other acute and subacute ischaemic heart disease NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G32..00 | Read | Old myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G32..11 | Read | Healed myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G32..12 | Read | Personal history of myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G33..00 | Read | Angina pectoris | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G330.00 | Read | Angina decubitus | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G330000 | Read | Nocturnal angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G330z00 | Read | Angina decubitus NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G331.00 | Read | Prinzmetal's angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G331.11 | Read | Variant angina pectoris | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G332.00 | Read | Coronary artery spasm | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z.00 | Read | Angina pectoris NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z000 | Read | Status anginosus | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z100 | Read | Stenocardia | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z200 | Read | Syncope anginosa | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z300 | Read | Angina on effort | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z400 | Read | Ischaemic chest pain | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z500 | Read | Post infarct angina | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G33z600 | Read | New onset angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33z700 | Read | Stable angina | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G33zz00 | Read | Angina pectoris NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34..00 | Read | Other chronic ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G340.00 | Read | Coronary atherosclerosis | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G340000 | Read | Single coronary vessel disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G340100 | Read | Double coronary vessel disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G340.11 | Read | Triple vessel disease of the heart | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G340.12 | Read | Coronary artery disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G342.00 | Read | Atherosclerotic cardiovascular disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G343.00 | Read | Ischaemic cardiomyopathy | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G344.00 | Read | Silent myocardial ischaemia | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34y.00 | Read | Other specified chronic ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34y000 | Read | Chronic coronary insufficiency | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34y100 | Read | Chronic myocardial ischaemia | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34yz00 | Read | Other specified chronic ischaemic heart disease NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34z.00 | Read | Other chronic ischaemic heart disease NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G34z000 | Read | Asymptomatic coronary heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G35..00 | Read | Subsequent myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G350.00 | Read | Subsequent myocardial infarction of anterior wall | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G351.00 | Read | Subsequent myocardial infarction of inferior wall | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G353.00 | Read | Subsequent myocardial infarction of other sites | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G35X.00 | Read | Subsequent myocardial infarction of unspecified site | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G36..00 | Read | Certain current complication follow acute myocardial infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G360.00 | Read | Haemopericardium/current comp folow acut myocard infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G361.00 | Read | Atrial septal defect/curr comp folow acut myocardal infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G362.00 | Read | Ventric septal defect/curr comp fol acut myocardal infarctn | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G363.00 | Read | Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G364.00 | Read | Ruptur chordae tendinae/curr comp fol acute myocard infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G365.00 | Read | Rupture papillary muscle/curr comp fol acute myocard infarct | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G366.00 | Read | Thrombosis atrium;auric append&vent/curr comp foll acute MI | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G38..00 | Read | Postoperative myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G380.00 | Read | Postoperative transmural myocardial infarction anterior wall | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G381.00 | Read | Postoperative transmural myocardial infarction inferior wall | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G384.00 | Read | Postoperative subendocardial myocardial infarction | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G38z.00 | Read | Postoperative myocardial infarction; unspecified | diagnostic | Ischaemic Heart Disease | Myocardial infarction | ||
| G3y..00 | Read | Other specified ischaemic heart disease | diagnostic | Ischaemic Heart Disease | Not myocardial infarction | ||
| G3z..00 | Read | Ischaemic heart disease NOS | diagnostic | Ischaemic Heart Disease | Not myocardial infarction |
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