Coding, Recording and Incidence of Different Forms of Coronary Heart Disease in Primary Care
Coding, Recording and Incidence of Different Forms of Coronary Heart Disease in Primary Care
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DOI：
10.1371/journal.pone.0029776
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发表时间：
2012-01-19
期刊：
影响因子：
3.7
通讯作者：
Gulliford, Martin C.
中科院分区：
文献类型：
--
作者：
Bhattarai, Nawaraj;Charlton, Judith;Gulliford, Martin C.
目的：评价基层医疗电子病历中冠心病（CHD）的编码、记录和发病率。方法：数据来自英国全科医学研究数据库。分析评估了271个READ医疗诊断代码的发生率，包括“心绞痛"、”心肌梗死“、”冠状动脉旁路移植术“（CABG）、”经皮腔内冠状动脉成形术“（PCTA）和”其他冠心病“。时间到事件的分析，以评估发生后的索引data.Results：在300,020名年龄大于30岁的参与者中，有75,197个独特的冠心病代码发生在24,244名参与者中，有12,495个代码为事件事件和62,702为流行事件。在事件代码中，3，607例（28.87%）为心绞痛，3，262例（26.11%）为MI，514例（4.11%）为PCTA，161例（1.29%）为CABG，4，951例（39.62%）为“其他CHD”。在流行代码中，20，254例（32.30%）为心绞痛，3，644例（5.81%）为MI，34，542例（55.09%）为“其他CHD”，4，262例（6.80%）为CABG或PCTA。在3，685名最初被诊断为“其他CHD”代码的参与者中，17.1%在5年内记录了心绞痛，5.6%记录了心肌梗死，6.3%记录了CABG，8.6%记录了PCTA。从2000年到2010年，CHD的总体发病率下降，心绞痛的发病率也下降，但MI的发病率没有变化。CABG的频率下降，而PCTA increased.Conclusion：在初级保健电子记录，相当大比例的冠心病事件记录的代码，不区分不同的临床表现的冠心病。结果提请注意，需要改善编码的做法，在初级保健。结果还提请注意的重要性，在研究中的代码选择和敏感性分析，使用不同的代码集的必要性。
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.