The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review
Purpose The purpose of the study is to assess the validity of codes or algorithms used to identify dementia in UK electronic health record (EHR) primary care and hospitalisation databases. Methods Relevant studies were identified by searching the MEDLINE/EMBASE databases from inception to June 2018,...
Saved in:
Published in | Pharmacoepidemiology and drug safety Vol. 28; no. 2; pp. 244 - 255 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
England
Wiley Subscription Services, Inc
01.02.2019
John Wiley and Sons Inc |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Purpose
The purpose of the study is to assess the validity of codes or algorithms used to identify dementia in UK electronic health record (EHR) primary care and hospitalisation databases.
Methods
Relevant studies were identified by searching the MEDLINE/EMBASE databases from inception to June 2018, hand‐searching reference lists, and consulting experts. The search strategy included synonyms for “Dementia”, “Europe”, and “EHR”. Studies were included if they validated dementia diagnoses in UK primary care or hospitalisation databases, irrespective of validation method used. The Quality Assessment for Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool was used to assess risk of bias.
Results
From 1469 unique records, 14 relevant studies were included. Thirteen validated individual diagnoses against a reference standard, reporting high estimates of validity. Most reported only the positive predictive value (PPV), with estimates ranging between 0.09 and 1.0 and 0.62 and 0.85 in primary care and hospitalisation databases, respectively. One study performed a rate comparison, indicating good generalisability of dementia diagnoses in The Health Improvement Network (THIN) database to the UK population. Studies were of low methodological quality. As studies were not comparable, no summary validity estimates were produced.
Conclusion
While heterogenous across studies, reported validity estimates were generally high. However, the credibility of these estimates is limited by the methodological quality of studies, primarily resulting from insufficient blinding of researchers interpreting the reference test. Inadequate reporting, particularly of the specific codes validated, hindered comparison of estimates across studies. Future validation studies should make use of more robust reference tests, follow established reporting guidelines, and calculate all measures of validity. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Louisa R. Moorhouse's present address is different from where the work was carried out. Louisa R. Moorhouse's current institutional affiliation is Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, Medical School Building, St. Mary's Campus, Norfolk Place, London W2 1PG. |
ISSN: | 1053-8569 1099-1557 1099-1557 |
DOI: | 10.1002/pds.4669 |