Approach to record linkage of primary care data from Clinical Practice Research Datalink to other health-related patient data: overview and implications

ObjectiveTo examine the concordance between dates of death recorded in UK primary care and national mortality records.MethodsUK primary care data from the Clinical Practice Research Datalink were linked to Office for National Statistics (ONS) data, for 118 571 patients who died between September 2010 and September 2015. Logistic regression was used to examine factors associated with discrepancy in death dates between data sets.ResultsDeath dates matched in 76.8% of cases with primary care dates preceding ONS date in 2.9%, and following in 20.3% of cases; 92.2% of cases differed by <2 weeks. Primary care date was >4 weeks later than ONS in 1.5% of cases and occurred more frequently with deaths categorised as ‘external’ (15.8% vs 0.8% for cancer), and in younger patients (15.9% vs 1% for 18–29 and 80–89 years, respectively). General practices with the greatest discrepancies (97.5th percentile) had around 200 times higher odds of recording substantially discordant dates than practices with the lowest discrepancies (2.5th percentile).ConclusionDates of death in primary care records often disagree with national records and should be treated with caution. There is marked variation between practices, and studies involving young patients, unexplained deaths and where precise date of death is important are particularly vulnerable to these issues.

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THU0414 The Incidence and Presentation of Systemic Lupus Erythematosus (SLE) in UK Primary Care Using the UK Clinical Practice Research Datalink (CPRD)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.3573 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 325.2-325

Author(s):

A.L. Nightingale ◽

J.E. Davidson ◽

C.T. Molta ◽

H.J. Kan ◽

N.J. McHugh

Keyword(s):

Systemic Lupus Erythematosus ◽

Primary Care ◽

Clinical Practice ◽

Lupus Erythematosus ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Systemic Lupus ◽

The Uk

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Evidence of disparities in the provision of the maternal postpartum 6-week check in primary care in England, 2015–2018: an observational study using the Clinical Practice Research Datalink (CPRD)

Journal of Epidemiology & Community Health ◽

10.1136/jech-2021-216640 ◽

2021 ◽

pp. jech-2021-216640

Author(s):

Yangmei Li ◽

Jennifer J Kurinczuk ◽

Christopher Gale ◽

Dimitrios Siassakos ◽

Claire Carson

Keyword(s):

Primary Care ◽

Clinical Practice ◽

Policy Change ◽

Post Partum ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Younger Women ◽

Preterm Babies ◽

Deprived Areas

BackgroundA maternal postpartum 6-week check (SWC) with a general practitioner (GP) is now considered an essential service in England, a recent policy change intended to improve women’s health. We aimed to provide an up-to-date snapshot of the prevalence of SWC prior to the policy change as a baseline, and to explore factors associated with having a late or no check.MethodsWe conducted a cohort study using primary care records in England (Clinical Practice Research Datalink (CPRD)). 34 337 women who gave birth between 1 July 2015 and 30 June 2018 and had ≥12 weeks of follow-up post partum were identified in the CPRD Pregnancy Register. The proportion who had evidence of an SWC with a GP was calculated, and regression analysis was used to assess the association between women’s characteristics and risks of a late or no check.ResultsSixty-two per cent (95% CI 58% to 67%) of women had an SWC recorded at their GP practice within 12 weeks post partum, another 27% had other consultations. Forty per cent had an SWC at the recommended 6–8 weeks, 2% earlier and 20% later. A late or no check was more common among younger women, mothers of preterm babies or those registered in more deprived areas.ConclusionsNearly 40% of women did not have a postpartum SWC recorded. Provision or uptake was not equitable; younger women and those in more deprived areas were less likely to have a record of such check, suggesting postpartum care in general practice may be missing some women who need it most.

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Use of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracy

British Journal of General Practice ◽

10.3399/bjgp19x704309 ◽

2019 ◽

Vol 69 (684) ◽

pp. e462-e469 ◽

Cited By ~ 10

Author(s):

Jessica Watson ◽

Hayley E Jones ◽

Jonathan Banks ◽

Penny Whiting ◽

Chris Salisbury ◽

...

Keyword(s):

Primary Care ◽

Clinical Practice ◽

Test Performance ◽

Predictive Value ◽

Inflammatory Markers ◽

Inflammatory Marker ◽

Superior Performance ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Autoimmune Conditions

BackgroundResearch comparing C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and plasma viscosity (PV) in primary care is lacking. Clinicians often test multiple inflammatory markers, leading to concerns about overuse.AimTo compare the diagnostic accuracies of CRP, ESR, and PV, and to evaluate whether measuring two inflammatory markers increases accuracy.Design and settingProspective cohort study in UK primary care using the Clinical Practice Research Datalink.MethodThe authors compared diagnostic test performance of inflammatory markers, singly and paired, for relevant disease, defined as any infections, autoimmune conditions, or cancers. For each of the three tests (CRP, ESR, and PV), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under receiver operator curve (AUC) were calculated.ResultsParticipants comprised 136 961 patients with inflammatory marker testing in 2014; 83 761 (61.2%) had a single inflammatory marker at the index date, and 53 200 (38.8%) had multiple inflammatory markers. For ‘any relevant disease’, small differences were seen between the three tests; AUC ranged from 0.659 to 0.682. CRP had the highest overall AUC, largely because of marginally superior performance in infection (AUC CRP 0.617, versus ESR 0.589, P<0.001). Adding a second test gave limited improvement in the AUC for relevant disease (CRP 0.682, versus CRP plus ESR 0.688, P<0.001); this is of debatable clinical significance. The NPV for any single inflammatory marker was 94% compared with 94.1% for multiple negative tests.ConclusionTesting multiple inflammatory markers simultaneously does not increase ability to rule out disease and should generally be avoided. CRP has marginally superior diagnostic accuracy for infections, and is equivalent for autoimmune conditions and cancers, so should generally be the first-line test.

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