RT Journal Article
SR Electronic
T1 Concordance in the recording of stroke across UK primary and secondary care datasets: a population-based cohort study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2020.0117
DO 10.3399/BJGPO.2020.0117
VO 5
IS 2
A1 Ann Morgan
A1 Sarah-Jo Sinnott
A1 Liam Smeeth
A1 Caroline Minassian
A1 Jennifer Quint
YR 2021
UL http://bjgpopen.org/content/5/2/BJGPO.2020.0117.abstract
AB Background Previous work has demonstrated that the recording of acute health outcomes, such as myocardial infarction (MI), may be suboptimal in primary healthcare databases.Aim To assess the completeness and accuracy of the recording of stroke in UK primary care.Design & setting A population-based longitudinal cohort study.Method Cases of stroke were identified separately in Clinical Practice Research Datalink (CPRD) primary care records and linked Hospital Episode Statistics (HES). The recording of events in the same patient across the two datasets was compared. The reliability of strategies to identify fatal strokes in primary care and hospital records was also assessed.Results Of the 75 674 stroke events that were identified in either CPRD or HES data during the period of the study, 54 929 (72.6%) were recorded in CPRD and 51 013 (67.4%) were recorded in HES. Two-fifths (n = 30 268) of all recorded strokes were found in both datasets (allowing for a time window of 120 days). Among these 'matched' strokes the subtype was recorded accurately in approximately 75% of CPRD records (compared with coding in HES); however, 43.5% of ischaemic strokes in HES were coded as 'non-specific' strokes in CPRD data. Furthermore, 48.2% had same-day recordings, and 56.2% were date-matched within ±1 day.Conclusion The completeness and accuracy of stroke recording is improved by the use of linked hospital and primary care records. For studies that have a time-sensitive research question, the use of linked, as opposed to stand-alone, CPRD data is strongly recommended.